# Pharmaceutical marketing and patient trust: How do doctor-targeted campaigns affect patients?

**Authors:** Marta Makowska, Akihiko Ozaki, Piotr Ozieranski, John Rovers, John Rovers, John Rovers

PMC · DOI: 10.1371/journal.pone.0344509 · PLOS One · 2026-03-27

## TL;DR

This study explores how pharmaceutical marketing aimed at doctors affects patient trust, finding that visible marketing practices can lower trust in both doctors and drug companies.

## Contribution

The study empirically demonstrates how specific pharmaceutical marketing practices influence patient trust in physicians and pharmaceutical companies.

## Key findings

- Most patients noticed pharmaceutical marketing directed at doctors, which was linked to decreased trust in physicians and drug companies.
- Encountering pharmaceutical sales representatives and seeing company logos in doctors' offices reduced patient trust.
- Free drug samples slightly increased trust in physicians but had no effect on trust in pharmaceutical companies.

## Abstract

In the context of pervasive pharmaceutical marketing directed at doctors, it is crucial to understand whether patients notice these activities and, if so, what impact this may have on trust in doctor-patient relationships.

The study was conducted through an online survey with 1,057 Polish participants. A quota sample, reflecting the Polish population in terms of specific socio-demographic characteristics, was chosen from an internet panel.

The average trust in physicians among Poles, on a 10-point scale, was 6.3 (SD = 2.1), while the average trust in pharmaceutical companies was lower, at 5.0 (SD = 2.3). The results indicate that 83.4% of respondents noticed signs of pharmaceutical marketing directed at doctors, with 5.5% experiencing all six types of marketing practices addressed in the study. Seeing a company logo in the doctor’s office, encountering a pharmaceutical sales representative (PSR), and experiencing PSR-related longer waits were each associated with lower trust in physicians (t = −2.2, −2.3, −2.9; p = .028,.019,.004; d = −.136, − .148, − .188, respectively) and in pharmaceutical companies (t = −2.7, −3.1, −2.3; p = .008,.002,.021; d = −.166, − .202, − .151, respectively). Receiving a free drug sample was linked to slightly higher trust in physicians (t = 2.2, p = .028, d = .16) and showed no effect on trust in companies (p = .558). Most pairwise correlations among patient-encounter pharmaceutical marketing situations were weak, even when they reached statistical significance; the only strong association was between encountering a PSR in a medical facility and reporting PSR-related longer wait times (r = .69, p < .001).

Physicians and pharmaceutical companies must acknowledge that their marketing relationships can influence patient trust and should carefully assess the consequences of their collaboration on the public’s perception of medicine and public health.

## Full-text entities

- **Diseases:** fatigue (MESH:D005221), anxiety (MESH:D001007)
- **Chemicals:** PONE-D-25-23673R1 (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

93 references — full list in the complete paper: https://tomesphere.com/paper/PMC13028511/full.md

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Source: https://tomesphere.com/paper/PMC13028511