The social sciences explain why small gifts are a powerful marketing tool. They are effective because we are not wary of them and their influence is subconscious, which is why small gifts are so common in all areas of business.

Small gifts and dinner invitations from the pharmaceutical companies are “the price to be paid” for wooing healthcare professionals and building a pleasant even “friendly” relationship with them. Acceptance of a small gift or dinner invitation creates a bond between the giver and the recipient who feels gratitude and a sense of obligation.

Throughout the world, healthcare professionals swear in good faith that the pharmaceutical companies “cannot bribe them with a pen or a crust of bread”. However the compulsion to reciprocate is independent of the value of the gift. It can exist even when the giver is not particularly appreciated. Unsolicited gifts also create this compulsion. And the return gift is often of higher value than the one received. It has also been shown that after a person has accepted a gift once, it is difficult for them to change their stance.

Social scientists consider accepting food as anything but innocuous. Meals create a particularly strong liking of the giver. There is evidence that written and oral messages have more impact and seem more convincing to people who have been invited to a meal. Psychologists explain this saying that food is “the most commonly used technique to derail the judgment aspect of decision making”.

In the USA, teaching hospitals teach these concepts to medical students and ban meals hosted by pharmaceutical companies on their premises. When will other countries follow suit?

©Prescrire 1 July 2013

"Meals: a very effective gift" Prescrire Int 2013; 22 (140): 193. (Pdf, free).