Informational Shocks, Off-Label Prescribing, and the Effects of Physician Detailing

AbstractThe relationship between pharmaceutical detailing and prescriptions for non-FDA-approved off-label use has been the subject of regulatory scrutiny, with more than $12 billion in regulatory settlements for off-label promotion since 2004. Using the case of AstraZeneca's antipsychotic drug, Seroquel, I study the extent to which off-label prescriptions are caused by detailing. Using a physician panel that connects detailing exposure to medical charts, I exploit within-physician variation to identify detailing effects. I find the effect of detailing on off-label prescriptions is small in both absolute and relative terms. Detailing on net tilts the prescribing distribution toward on-label. This paper was accepted by Eric Anderson, marketing.