A Critical Evaluation of the Interplay between Relationship Quality and Pricing Mechanisms in Physicians' Prescription Decision Making

Khan, Sohail M. (2018) A Critical Evaluation of the Interplay between Relationship Quality and Pricing Mechanisms in Physicians' Prescription Decision Making. DBA thesis, University of Gloucestershire.

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Pharmaceutical managers and sales representatives (PSRs) rely greatly on relationship marketing activities in order to develop relationship quality (RQ) with physicians. The aim is to influence physicians' prescription behaviour to engender positive sales outcomes based on their RQ. There is little known about how PSR-physician RQ develops in the context of Pakistan, or how far RQ helps a PSR to achieve objective outcomes for a firm (i.e. positive sales), when it interacts or interplays with product price, particularly in specific economic conditions such as those of patients in Pakistan - who pay directly for their medicines. Drawing on available literature on RQ, this research firstly aims to discover what determinants are required and why they help to achieve RQ between a PSR and physician. Secondly, by integrating the literature on physician's prescription decision making, it seeks to identify how far product price affects RQ’s objective (or sales) outcomes under contingent patient economic conditions. Based on critical realism's guiding philosophical principles, this qualitative research adopted an embedded case study strategy; and using a semi-structured interview method 22 participants (i.e. pharmaceutical sales managers and physicians) from urban and rural sales areas of Multan in Pakistan were purposively interviewed in two sequential phases. Findings revealed that along with determinants identified through RQ literature, i.e. firm's image product quality, PSR's visit frequency, product knowledge, ethical selling behaviour and relationship investments, some additional determinants such as PSR's appearance, communication, and flexible responses to varied situations were also required by a PSR to achieve RQ with physicians in the context of Pakistan. These determinants were essential in order to fulfil physicians' technical, as well as social needs. When a PSR fulfils these physician needs, both physician's self-interest and emotional sentiments for a PSR are engendered, which serve as mechanisms that further foster the physician's reciprocity mechanism for a PSR. The presence of a reciprocity mechanism for a PSR thus influences the physician's prescription decision making in terms of a PSR's product. However, findings also indicated that higher product price serves as a barrier, which mitigates the effect of reciprocity mechanism because of the presence of more prevalent mechanisms, i.e. patient's non-affordability due to overall poor economic conditions. This engenders further mechanisms such as physician's emotional sentiments for patients, physician's self-interest in patient's wellbeing, their retention and physician's own practice viability. Therefore, the price of a product did not affect subjective or behavioural outcomes, such as physicians providing more time and priority to the PSR, when they had RQ. However, PSR-physician RQ worked more effectively for PSR in terms of achieving his objective (sales) outcomes, when product price and quality was competitive. Thus, the findings of this research suggest that RQ determinants are contingent to the research context and the context of the research should be taken into account. Furthermore, RQ's objective outcomes cannot be seen in isolation or by just predicting that RQ between the partners will ultimately lead to objective outcomes. For its comprehensive understanding and implementation, it is crucial to investigate other prevailing factors, such as: broader economic conditions and the presence of various relationships in the value chain that either support, or restrain, RQ between partners. Because, RQ works more effectively in terms of achieving its objective (or positive sales) outcomes in the context where overall economic conditions and product price related mechanisms support salespeople-customer's RQ related reciprocity mechanism.

Item Type: Thesis (DBA)
Uncontrolled Keywords: Prescribing decisions; Pharmaceutical pricing
Subjects: H Social Sciences > HF Commerce > HF5001 Business
R Medicine > RM Therapeutics. Pharmacology
Divisions: Schools and Research Institutes > School of Business, Computing and Social Sciences
Depositing User: Susan Turner
Date Deposited: 30 Aug 2018 08:54
Last Modified: 01 Aug 2023 14:52
URI: https://eprints.glos.ac.uk/id/eprint/5916

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