• Susi Ari Kristina Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada
  • Sismindari Center of Bioethics and Humanities, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
  • Nur Aini Mardea Research Assistant, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia



Drug promotion; pharmacists; sales representatives


Interactions between pharmaceutical representatives and pharmacists are increasing. This study aimed to evaluate pharmacists’ views towards the drug promotion conducted by sales representatives in Indonesia. Adopting a cross-sectional survey study design, pharmacists completed questionnaires (n=120) to examine attitudes toward drug promotion by sales representatives, perception of the impact of drug promotion on attitudes and knowledge, and their experience in training in dealing with sales representatives and drug promotion. A total of 120 pharmacists participated in the study, of these; the majority of the respondents were females (80.83%) and aged 30-45 years (45.00%). Most respondents (55.83%) had experience in practice collaboration with doctors. However, only a small number of respondents (25.83%) were trained in drug promotion ethics. Approximately 71.67% of pharmacists do not agree with pharmaceutical company support of conferences and speakers, and the majority of respondents (73.33%) do not agree on the appropriateness of gifts provided by pharmaceutical companies. The majority of respondents believe that discussions with sales representatives impact prescribing (76.67%) and receiving gifts influences prescribing (72.50%). We found that majority of pharmacists accept promotion as a source of drug promotion and promotion as a source of information for the introduction of new medicines. Teaching the ethics or effects of drug company promotion has been never taught in pharmacy education. It is recommended that the structured curriculum of pharmacy education include courses/discussion groups on the ethical relationship between pharmacists and pharmaceutical companies.


American Pharmacists Association. The pharmaceutical industry, 1852-1902 [Available from:

Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47:533-43.

Francer J, Izquierdo JZ, Music T, et al. Ethical pharmaceutical promotion and communications worldwide: codes and regulations. Philos Ethics Humanit Med 2014; 9(1): 7.

World Health Organization. WHO ethical criteria for medicinal drug promotion. Geneva: World Health Organization; 1998.

Preechavuthinant S, Willis W and Coustasse A. Trends and effects of pharmaceutical DTCA. Int J Pharm Healthc Mark. 2018; 12(1): 61–70

Banks D. Pharmacists, pharmaceutical manufacturers, and conflicts of interest. Am J Health-Syst Pharm. 2005;62:1827-32.

Hall KB, Tett SE, Nissen LM. Perceptions of the influence of prescription medicine samples on prescribing by family physicians. Med Care. 2006;44:383-7.

Alves TL, Lexchin J and Mintzes B. Medicines information and the regulation of the promotion of pharmaceuticals. Sci Eng Ethics 2019; 25(4): 1167–1192

Ashker S, Burkiewicz JS. Pharmacy residents' attitudes toward pharmaceutical industry promotion. Am J Health-Syst Pharm. 2007;64.

Afi Kayi E, Atinga RA and Ansa GA. Informational sources on pharmaceutical medicines and factors affecting medication prescriptions: perspectives from Ghanaian physicians. J Med Mark 2014; 14(4): 176–181.

Brett AS, Burr W, Moloo J. Are gifts from pharmaceutical companies ethically problematic? A survey of physicians. Arch Intern Med. 2003;163:2213-8.

SPSS Statistics for Windows, version 21.0 (SPSS Inc., Chicago, Ill., USA

McFadden DW, Calvario E, Graves C. The devil is in the details: the pharmaceutical industry use gifts to physicians as marketing strategy. J Surg Res. 2007;140:1-5.

Alosaimi F, Alkaabba A, Qadi M, Albahlal A, Alabdulkarim Y, Alabduljabbar M, et al. Acceptance of pharmaceutical gifts. Variability by specialty and job rank in a Saudi healthcare setting. Saudi Med J. 2013;34:854-60.

York JM, Alexander JG, Barone JA. Clinical pharmacists: new partners for the industry? Pharm Exec. 1987;7(9):56-60.

American College of Clinical Pharmacy. Pharmacists and the pharmaceutical industry: guidelines for ethical interactions. Pharmacotherapy. 1993;13:531-3.

Pharmaceutical Research and Manufacturers of America. Principles on conduct of clinical trial results 2004 [Available from:

Zaki NM. Pharmacists’ and physicians’ perception and exposure to drug promotion: a Saudi study. Saudi Pharm J. 2014; 22(6): 528–536.

Farthing-Papineau EC, Peak AS. Pharmacists' perceptions of the pharmaceutical industry. Am J Health-Syst Pharm. 2005;62:2401-9.

World Health Organization. Drug Promotion - What We Know, What We Have Yet to Learn - Reviews of Materials in the WHO/HAI Database on Drug Promotion. 2017.

Spurling GK, Mansfield PR, Montgomery BD, Lexchin J, Doust J, Othman N. Information from pharmaceutical companies and the quality, quantity, and cost of physicians’ prescribing: a systematic review. PLoS Med. 2010.

Mackey TK, Cuomo RE and Liang BA. The rise of digital direct-to-consumer advertising? Comparison of direct-to-consumer advertising expenditure trends from publicly available data sources and global policy implications. BMC Health Serv Res 2015; 15(1): 236.




How to Cite

Kristina, S. A., Sismindari, & Mardea, N. A. (2022). PHARMACISTS’ VIEW OF DRUG PROMOTION BY SALES REPRESENTATIVES: A SURVEY FROM INDONESIA. Malaysian Journal of Public Health Medicine, 22(1), 236–241.