A sales representative is more likely to be successful if he offers a small gift - but only sometimes. In a controlled field experiment carried out in pharmacies and drugstores, researchers at the universities of Zurich and Lausanne came to the conclusion that small presents influence the purchase behavior positively. According to the experiment, six small tubes of toothpaste in the value of less than CHF 10 were enough to motivate customers to place an order twice more likely. However, this worked only if there was a preexisting business relationship and if the giver knew the receiver already. By contrast, if the incentive was offered at the first encounter, it was more likely to have the opposite effect. To start a business relationship with a gift is perceived as calculating and therefore, counterproductive. 

These empirical findings contrast with the intention of the Swiss lawmaker to limit the prohibition of undue benefits regarding prescription medicines. Incentives for nonprescription medicines (OTC) should no longer be prohibited, at least not under the Swiss Act on Therapeutic Products. However, the empirical evidence now suggests that drug stores and pharmacists are susceptible to incentives even if the gifts are of minor value and unrelated to prescription medicines. In addition, the empirical findings refute the law maker's assumption that important gifts potentially influence behavior and create conflicts of interest, but minor gifts do not. 

In addition, even with respect to prescription medicine, the prohibition of undue benefits is limited to benefits that exceed a value of CHF 300, provided that they are relevant for the pharmaceutical or medical practice. Were the signatories to the Pharmacodex right, requesting a more restrictive practice, independent of the incentive's value? Of course, one might object that the observed 200 transactions by 5 sales representatives are statistically irrelevant. 

The study results raise of course the question whether these findings apply to doctors as well. The situations in the medical practice might be different. For doctors, financial temptations lure just everywhere. They are unrelated to the prescription and/or dispense of drugs.  

A doctor just recently described the situation to me as follows:

If my incentive were monetary driven, there would always be one more consultation to make, another lab test or an additional x-ray to perform. But this is not the case. We doctors, more than any other professional group, are trained to resist financial temptations.  

Are doctors really different?  

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