‫‪Kingdom of Saudi Arabia‬‬ ‫ﺍاﻟﻤﻤﻠﻜـــــﺔ‪  ‬ﺍاﻟﻌﺮﺑﻴﯿـــــﺔ‪  ‬ﺍاﻟﺴـــــﻌﻮﺩدﻳﯾﺔ‬

‫‪Ministry of Higher Education‬‬ ‫ﻭوﺯزﺍاﺭرﺓة‪  ‬ﺍاﻟﺘﻌﻠﻴﯿـــﻢ‪  ‬ﺍاﻟﻌـــﺎﻟﻲ‬

‫‪King Saud University‬‬ ‫ﺟﺎﻣﻌــﺔ‪  ‬ﺍاﻟﻤــﻠﻚ‪  ‬ﺳﻌــﻮﺩد‬
‫‪College of Medicine‬‬ ‫ﻛﻠــــــﻴﯿﺔ‪  ‬ﺍاﻟﻄــــــﺐ‬

‫ﺩدﺭرﺍاﺳﺔ‪  ‬ﻭوﻁطﻨﻴﯿﺔ‪  ‬ﻟﻌﻼﻗﺔ‪  ‬ﺍاﻷﻁطﺒﺎء‪  ‬ﻣﻊ‪  ‬ﺍاﻟﺼﻨﺎﻋﺔ‪  ‬ﺍاﻟﻄﺒﻴﯿﺔ‪  ‬ﻓﻲ‪  ‬ﺍاﻟﻤﻤﻠﻜﺔ‪  ‬ﺍاﻟﻌﺮﺑﻴﯿﺔ‪  ‬ﺍاﻟﺴﻌﻮﺩدﻳﯾﺔ‬
‫‪A Survey of Physician-Industry Relationship in Saudi Arabia‬‬

‫‪  ‬‬
‫ﺃأﺧﻲ‪  ‬ﺍاﻟﻜﺮﻳﯾﻢ‪  /  ‬ﺃأﺧﺘﻲ‪  ‬ﺍاﻟﻜﺮﻳﯾﻤﺔ‪                      ....‬ﺳﻠﻤﻚ‪  ‬ﷲ‪  ‬‬
‫‪  ‬‬

‫ﺍاﻟﺴﻼﻡم‪  ‬ﻋﻠﻴﯿﻜﻢ‪  ‬ﻭوﺭرﺣﻤﺔ‪  ‬ﷲ‪  ‬ﻭوﺑﺮﻛﺎﺗﻪﮫ‪  ...............................  ‬ﻭوﺑﻌﺪ‪  ‬‬

‫‪  ‬‬
‫‪  ‬ﺃأ ُﻓﻴﯿﺪ ‪  ‬ﺳﻌﺎﺩدﺗﻜﻢ‪  ‬ﺃأﻧﻨﻲ‪  ‬ﻭوﻣﺠﻤﻮﻋﺔ‪  ‬ﻣﻦ‪  ‬ﺍاﻟﺒﺎﺣﺜﻴﯿﻦ‪  ‬ﻣﻌﻈﻤﻬﮭﻢ‪  ‬ﻁطﻼﺏب‪  ‬ﺳﻨﺔ‪  ‬ﺛﺎﻟﺜﺔ‪  ‬ﻁطﺐ‪  ‬ﺑﺼﺪﺩد‪  ‬ﺇإﺟﺮﺍاء ‪  ‬ﺩدﺭرﺍاﺳﺔ‪  ‬‬
‫ﻋﻦ‪  ‬ﻋﻼﻗﺔ‪  ‬ﺍاﻷﻁطﺒﺎء‪  ‬ﻣﻊ‪  ‬ﻣﻨﺪﻭوﺑﻲ‪  ‬ﺷﺮﻛﺎﺕت‪  ‬ﺍاﻷﺩدﻭوﻳﯾﺔ‪  ‬ﻓﻲ‪  ‬ﺍاﻟﻤﻤﻠﻜﺔ‪  ‬ﺍاﻟﻌﺮﺑﻴﯿﺔ‪  ‬ﺍاﻟﺴﻌﻮﺩدﻳﯾﺔ‪  .‬ﻧﻬﮭﺪﻑف‪  ‬ﻣﻦ‪  ‬ﺧﻼﻝل‪  ‬‬
‫ﻫﮬﮪھﺬﻩه‪  ‬ﺍاﻟﺪﺭرﺍاﺳﺔ‪  ،٬  ‬ﻭوﺍاﻟﻠﺘﻲ‪  ‬ﺗﻌﺪ‪  ‬ﺍاﻷﻭوﻝل‪  ‬ﻣﻦ‪  ‬ﻧﻮﻋﻬﮭﺎ‪  ‬ﻓﻲ‪  ‬ﺍاﻟﻤﻤﻠﻜﺔ‪  ،٬  ‬ﺇإﻟﻰ‪  ‬ﺇإﺩدﺭرﺍاﻙك‪  ‬ﺃأﺑﻌﺎﺩد‪  ‬ﻫﮬﮪھﺬﻩه‪  ‬ﺍاﻟﻌﻼﻗﺔ‪  ‬ﻭوﻣﺪﻯى‪  ‬‬
‫ﺗﻌﺎﺭرﺿﻬﮭﺎ ‪  ‬ﻣﻊ ‪  ‬ﺍاﻟﻤﻌﺎﻳﯾﻴﯿﺮ ‪  ‬ﺍاﻷﺧﻼﻗﻴﯿﺔ ‪  ‬ﺍاﻟﻤﺘﻌﺎﺭرﻑف ‪  ‬ﻋﻠﻴﯿﻬﮭﺎ ‪  ‬ﻓﻲ ‪  ‬ﺃأﺧﻼﻗﻴﯿﺎﺕت ‪  ‬ﻣﻬﮭﻨﺔ ‪  ‬ﺍاﻟﻄﺐ‪   .‬ﺍاﻟﺪﺭرﺍاﺳﺔ ‪  ‬ﺳﻮﻑف‪  ‬‬
‫ﺗﺸﻤﻞ‪  ‬ﻛﺎﻓﺔ‪  ‬ﺍاﻷﻁطﺒﺎء‪  ‬ﻣﻤﻦ‪  ‬ﻳﯾﻘﻮﻣﻮﻥن‪  ‬ﺑﻮﺍاﺟﺒﺎﺕت‪  ‬ﺇإﻛﻠﻴﯿﻨﻴﯿﻜﻴﯿﺔ‪  ‬ﺃأﻭو‪  ‬ﺗﺪﺧﻼﺕت‪  ‬ﺟﺮﺍاﺣﻴﯿﺔ‪  ،٬‬ﺑﺎﻹﺿﺎﻓﺔ‪  ‬ﺇإﻟﻰ‪  ‬ﺃأﻁطﺒﺎء‪  ‬‬
‫ﺍاﻹﻣﺘﻴﯿﺎﺯز‪   .‬ﻧﻮﺩد‪  ‬ﺃأﻥن‪  ‬ﻧﻠﻔﺖ‪  ‬ﻋﻨﺎﻳﯾﺘﻜﻢ‪  ‬ﺑﺄﻥن‪  ‬ﺍاﻟﻤﻌﻠﻮﻣﺎﺕت‪  ‬ﺍاﻟ ُﻤﺪﺧﻠﺔ‪  ‬ﻓﻲ‪  ‬ﺍاﻹﺳﺘﺒﻴﯿﺎﻥن‪  ‬ﺳﺘﻜﻮﻥن‪  ‬ﻓﻲ‪  ‬ﻏﺎﻳﯾﺔ‪  ‬ﺍاﻟﺴﺮﻳﯾﺔ‪  ‬‬
‫ﺑﺎﻹﺿﺎﻓﺔ‪  ‬ﺇإﻟﻰ‪  ‬ﺃأﻧﻪﮫ‪  ‬ﻟﻦ‪  ‬ﻳﯾﺘﻢ‪  ‬ﺍاﻟﺘﻌﺮﻑف‪  ‬ﻋﻠﻰ‪  ‬ﻫﮬﮪھﻮﻳﯾﺔ‪  ‬ﺍاﻟﻤﺸﺎﺭرﻛﻴﯿﻦ‪  ‬ﻓﻲ‪  ‬ﺗﻌﺒﺌﺔ‪  ‬ﺍاﻹﺳﺘﺒﻴﯿﺎﻥن‪  ‬ﻋﻠﻰ‪  ‬ﺍاﻹﻁطﻼﻕق‪  .‬‬
‫‪  ‬‬
‫ﺳﺄﻛﻮﻥن ‪  ‬ﺷﺎﻛﺮ ‪  ‬ﻭوﻣﻤﺘﻦ ‪  ‬ﻟﺴﻌﺎﺩدﻛﺘﻢ ‪  ‬ﺃأﻧﺎ ‪  ‬ﻭوﺃأﻋﻀﺎء ‪  ‬ﺍاﻟﺒﺤﺚ ‪  ‬ﻟﻮ ‪  ‬ﻣﻨﺤﺘﻮﻧﺎ ‪  ‬ﺃأﻗﻞ ‪  ‬ﻣﻦ ‪   ٥  ‬ﺩدﻗﺎﺋﻖ ‪  ‬ﻣﻦ ‪  ‬ﻭوﻗﺘﻜﻢ‪  ‬‬
‫ﺍاﻟﺜﻤﻴﯿﻦ‪  ‬ﻟﻤﻞء‪  ‬ﺇإﺳﺘﺒﻴﯿﺎﻥن‪  ‬ﺍاﻟﺒﺤﺚ‪  .‬‬

‫ﻭوﻟﻜﻢ‪  ‬ﺧﺎﻟﺺ‪  ‬ﺍاﻟﺸﻜﺮ‪  ‬ﻭو‪  ‬ﺍاﻟﺘﻘﺪﻳﯾﺮ‬

‫ﺃأﺧﻮﻛﻢ‪  ‬ﺩد‪  .‬ﻓﻬﮭﺪ‪  ‬ﺑﻦ‪  ‬ﺩدﺧﻴﯿﻞ‪  ‬ﺍاﻟﻌﺼﻴﯿﻤﻲ‬

‫ﺃأﺳﺘﺸﺎﺭرﻱي‪  ‬ﺍاﻟﻄﺐ‪  ‬ﺍاﻟﻨﻔﺴﻲ‪  ‬ﻭوﺍاﺳﺘﺎﺫذ‪  ‬ﻣﺴﺎﻋﺪ‬

‫ﻓﻲ‪  ‬ﺣﺎﻝل‪  ‬ﻭوﺟﻮﺩد‪  ‬ﻣﻼﺣﻈﺔ‪  ‬ﺃأﻭو‪  ‬ﺍاﺳﺘﻔﺴﺎﺭر‪  ‬ﺍاﻟﺮﺟﺎء‪  ‬ﺍاﻹﺗﺼﺎﻝل‪  ‬ﻋﻠﻰ‪  ‬ﺩد‪  .‬ﻓﻬﮭﺪ‪  ‬ﺍاﻟﻌﺼﻴﯿﻤﻲ‪  ‬‬
‫ﻋﻠﻰ‪  ‬ﺍاﻟﺮﻗﻢ‪+٩۹٦٦١۱٤٦٧۷١۱٢۲٢۲٦  :  ‬‬

‫‪31‬‬
 A Survey Of Physician-Industry Relationship in Saudi Arabia

Kingdom of Saudi Arabia ‫ ﺍاﻟﺴـــــﻌﻮﺩدﻳﯾﺔ‬ ‫ ﺍاﻟﻌﺮﺑﻴﯿـــــﺔ‬ ‫ﺍاﻟﻤﻤﻠﻜـــــﺔ‬

Ministry of Higher Education ‫ ﺍاﻟﻌـــﺎﻟﻲ‬ ‫ ﺍاﻟﺘﻌﻠﻴﯿـــﻢ‬ ‫ﻭوﺯزﺍاﺭرﺓة‬
King Saud University
‫ ﺳﻌــﻮﺩد‬ ‫ ﺍاﻟﻤــﻠﻚ‬ ‫ﺟﺎﻣﻌــﺔ‬
College of Medicine
‫ ﺍاﻟﻄــــــﺐ‬ ‫ﻛﻠــــــﻴﯿﺔ‬

A Survey of Physician-Industry Relationship in Saudi Arabia

Dear participating physician / colleague,

This study is intended to find out the nature of the relationship between physicians and health industry companies
in Saudi Arabia. At the end of this study, we hope that we would be able to understand the behaviors, knowledge
and attitudes of physicians in SA toward this relationship. Also, we will determine whether such a relationship
conforms to the ethical guidelines and policies worldwide.
“  Please note that you are not obliged to fill in this questionnaire. However, if you do so, we will be pleased and
grateful since this is probably the first study ever to be conducted in Saudi Arabia regarding this topic. You will
also help us to add new information  to  the  literature  regarding  this  issue.  ”
 For your inquiries, please contact Dr. Fahad Alosaimi-psychiatry on: +9661 467 1226
A) Demographic data:

(1) Sex: 1.( ) Male 2.( ) Female

(2) Age: …………………… years.

(3) Nationality: 1.( ) Saudi. 2. ( ) Non-Saudi. 3. Specify your nationality: ……………………………

(4) Study abroad: 1.( ) Yes. 2. ( ) No. 3. Specify the country: …………………………………...

(5) Work abroad: 1.( ) Yes. 2. ( ) No. 3. Specify the country: ……………………………..……...

(6) Job titles: : (You can chose more than one)

1. ( ) Consultant. 2. ( ) Specialist. 3. ( ) Resident. 4. ( ) Intern.
5. ( ) Professor. 6. ( ) Associate-professor. 7. ( ) Registrar. 8. ( ) Other, [specify]:  …….…..………….

(7) Main specialty:

1. ( ) Emergency medicine. 7. ( ) Oncology. 13. ( ) Orthopedic.
2. ( ) Family medicine. 8. ( ) Pediatrics. 14. ( ) Radiology.
3. ( ) Internal medicine. 9. ( ) Psychiatry. 15. ( ) Anesthesiology.
4. ( ) Obstetrics-gynecology. 10. ( ) Surgery. 16. ( ) Not specialized yet. (e.g. GP & Intern)
5. ( ) Dermatology. 11. ( ) ENT. 17. ( ) Other,  [specify]:……………………….....…….
6. ( ) Ophthalmology. 12. ( ) Neurology.

(8) Number of years in clinical practice: …………………… years.

(9) Monthly income: (In Saudi Riyals)

1. ( ) Less than 10,000. 2. ( ) 10,000 – less than 20,000. 3. ( ) 20,000 – less than 30,000.
4. ( ) 30,000 – less than 40,000. 5. ( ) 40,000 – less than 50,000. 6. ( ) 50,000 or more.

(10) Do you have other financial resources in addition to your main salary as a physician:
1. ( ) Yes. 2. ( ) No. If you chose No, please move to question 12.

(11) The financial resource / s I have in addition to my salary is / are: (You can chose more than one)
1. ( ) Private clinic. 2. ( ) Academic duties. 3. ( ) Military duties.
4. ( ) Property trading. 5. ( ) Share / Stock trading 6. ( ) Other non-medical sources.

(12) Are you satisfied with your current income:

5.( ) Strongly satisfied. 4.( ) Satisfied. 3.( ) Not sure. 2.( ) Dissatisfied. 1.( ) Strongly dissatisfied.

(13) Most of your patients belong to which of the following socioeconomic status:
3.( ) Upper class. 2.( ) Middle class. 1.( ) Lower class. 0.( ) Not sure.
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 A Survey Of Physician-Industry Relationship in Saudi Arabia

B) Physician-Industry Relationship:
(14) Have you ever encountered a pharmaceutical company representative (PRs)?
( If you chose No, please move to question 28 )
1.( ) Yes. 2.( ) No.

(15) How often do you encounter PRs (i.e. meet them by chance or unexpectedly)?
1.( ) Once or less a month. 2.( ) 2-3 times a month. 3.( ) Once a week.
4.( ) 2-5 times a week. 5.( ) Nearly every day.

(16) Most of pharmaceutical representatives (PRs) you have encountered are:

1.( ) Male. 2.( ) Female.

(17) Where do PRs usually come to you? (You can chose more than one answer)
1.( ) In my clinic during 2.( ) In my clinic after finishing 3.( ) In my office. 4.( ) At home.
the clinical hours. my clinical hours.
5.( ) In a restaurant / cafeteria 6. ( ) In the car parking 7.( ) In a coffee shop, restaurant or a mall
during my lunch break. next to my car. outside the work place

8.( ) In a conference / symposium 9.( ) Other place, [specify]: ………………………………………………

I am attending.

(18) Do you accept to meet them?

1.( ) Yes. 2.( ) No.

(19) On the average, how long does a single meeting with a PR last for?
1.( ) Less than 5 minutes. 2.( ) From 5 – 9 minutes. 3.( ) From 10 – 14 minutes.
4.( ) From 15 – 30 minutes. 5.( ) More than 30 minutes.
(20) Do you usually keep in touch with PRs after the meeting? ( If you chose No, move to question 22 )
1.( ) Yes. 2.( ) No.

(21) If you do so, then how do they usually communicate with you?
1.( ) Face-to-face 2.( ) Over the phone. 3.( ) By e-mails. 4.( ) Other,[specify]:  ………………..…

(22) Do they usually offer you a gift or promotion during or even after the meeting?
5.( ) Almost always 4.( ) Often. 3.( ) Sometimes. 2.( ) Rarely. 0.( ) Never.

(23) What kinds of gifts or promotions have been presented to you? (You can chose more than one answer)
1.( ) Free drug samples. 2.( ) Free meals. 3.( ) Stationary, such as pens or notepads.
4.( ) Funded research. 5.( ) Prepaid promotion cards / codes.
6.( ) Financial support to attend non-industry-sponsored CME events.
7.( ) Financial support to attend industry-sponsored CME events.
8.(      )  Other,  [specify]:  ……..………………………………...…..

(24) Do you accept their gifts and promotions? (If you chose Never, move to question 26)
5.( ) Almost always 4.( ) Often. 3.( ) Sometimes. 2.( ) Rarely. 0.( ) Never.

(25) What are your reasons for accepting their offers? (You can chose more than one answer)
1.( ) Human nature to accept free gifts. 2.( ) Do not want to say no.
3.( ) Helps me to remember their products. 4.( ) Salaries of doctors are inadequate.
5.( ) Minor gifts are always welcomed. 6.( ) Gifts are present in every profession not only in medicine.
7.( ) Other reason,  [specify]:  ……………………………………………………………..

(26) Do  gifts,  usually,  have  the  company’s  name  or  logo?

1.( ) Yes. 2.( ) No. 3.( ) I  don’t  know.

(27) If you got a free drug sample, why would you prescribe it over the medication that you normally
prescribe: (You can chose more than one answer)
1.( ) To benefit patients with economic incapability. 2.( ) Due to the availability of these samples.
3.( ) According to the patient’s  convenience. 4.( ) The drug sample is more effective.
5.( ) Giving free medications helps me to build a good 6.(      )  Other,  [specify]:  ………………………………
relationship with my patients.

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 A Survey Of Physician-Industry Relationship in Saudi Arabia

(28) Have you ever been educated or oriented about the ethics in physician-industry relationships?
1.( ) Yes. 2.( ) No. ( If you chose No, move to question 30 )

(29) What type of educational activity have you undergone?

1.( ) Lectures. 2.( ) Workshops. 3.( ) Courses.
4.( ) Other, [specify]:  ………………………………………………………………………

(30) Do you think that there are rules & polices in Saudi Arabia regulating the physician-
pharmaceutical industry relationships?
1.( ) Yes. 2.( ) No.

Please fill in the following table:

5 4 3 2 1
Strongly Strongly
Do you agree or disagree with the following statements: Agree Neutral Disagree
agree disagree
5 4 3 2 1
(31) Accepting gifts from PRs will affect my decision
regarding the use of certain medications or surgical
instruments.
5 4 3 2 1
(32) Doctors in my institution accept gifts from PRs.
(33) In general, decision of other physicians, regarding 5 4 3 2 1
use of certain medication or surgical instrument, is
influenced after receiving gifts from PRs.
5 4 3 2 1
(34) It is ethical to accept gifts from PRs.
5 4 3 2 1
(35) Pharmaceutical companies should be banned from
giving gifts to physicians.
5 4 3 2 1
(36) Patients should be informed about the gifts given
to their doctors by drug companies.
5 4 3 2 1
(37) PRs always provide accurate information about
their new medications.
(38) Detailing by PRs increases my preference for 5 4 3 2 1
prescribing the promoted drug.
(39) Drug information from PRs influences my 5 4 3 2 1
informed decision to prescribe.
(40) Drug information from other sources are more 5 4 3 2 1
important and reliable than from PRs.

If you have met a PR, please fill in the following table:

5 4 3 2 1
Discussion with PRs: Always Usually Sometimes Rarely Never
5 4 3 2 1
(41) PRs  use  the  word  “safe”  when  they  describe  their
products.
5 4 3 2 1
(42) Spontaneously, PRs mention the drug interactions.
5 4 3 2 1
(43) Spontaneously, PRs mention the adverse effects.
5 4 3 2 1
(44) Spontaneously, PRs mention the price.
5 4 3 2 1
(45) PRs are ready to answer my questions.
5 4 3 2 1
(46) PRs are convincing.
5 4 3 2 1
(47) I receive encouragement from PRs to try new
medicine on my patients.

3
Thank You…... 34