Factors that influence the prescribing habits of Doctors in Trinidad & Tobago.

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Factors that influence the prescribing habits of Doctors in Trinidad & Tobago.

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Physicians are perhaps the most important players in pharmaceutical sales. They write the prescriptions that determine which drugs will be used by the patient” (Pharmaceutical marketing.eu, 2008). Unfortunately is it is virtually impossible to obtain a precise figure for pharmaceutical marketing costs in Trinidad and Tobago, as these figures are considered confidential information by the local companies. A now semi-retired district manager Cyril MeeChong (2008) whose experience in the local industry has spanned over thirty years did indicate that the “amount invested for marketing is considerable and since sales budgets always increase on an annual basis, there is a tendency for the marketing budgets to spiral as well.” There are some that may argue that it is important to market pharmaceutical products aggressively to gain market share. Future Pharmaceuticals (2007) stated that “if physicians have not been adequately sold on the value of prescribing your product, as a brand manager, you would not only be wasting your budget dollars if you made a significant investment in targeting consumers, you would also be helping your competitors gain market share.” This factor amongst others therefore warrants closer examination in an attempt to identify which factors would most impact “clinical decisions” (Gøtzsche 2008:3), within the local context of Trinidad and Tobago. Most of the research into the factors that influence doctors’ prescribing habits has been conducted in the United States and United Kingdom, so it ought to be important to the pharmaceutical companies operating within this region to obtain the opinions of doctors in this setting with regards to the factors that influence their prescribing behavior. This information would also be invaluable in determining whether a “global branding approach” or a “regional or local marketing approach” (Business Wire 2004), would be more advantageous in this particular setting based on the factors perceived as being most important to these doctors.

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To bridge its substantial ‘infrastructure deficit’ India is attempting a very large program for the creation of physical infrastructure through public-private partnerships. PPP projects in India are of relatively recent origin, and the experience is not very established. Therefore there is an imperative need to clearly understand the risks associated with these projects, so that the managements of investors and the government can take an informed and apposite position.

This dissertation focuses on PPP projects in India, financed under project finance constructs. The research question relates to managements’ ability to realistically assess financing risks for such projects in terms of (a) The availability of appropriate appraisal methods and data; and (b) The managements’ outlook and approach to appraising such projects. The research question has been framed in the form of four hypotheses, which are tested for validity in this dissertation.

The research method is based on a method triangulation of analysing project cases, responses to questionnaires, and supplementary material from the regulatory and policy guidelines of nodal agencies of the government of India. Though academic literature on the subject in India is very sparse, the analysis is backed by an extensive survey of international academic literature dealing with PPP and project finance for infrastructure.

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