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DRUG company sales reps have only a small impact on what doctors prescribe, according to a large study of doctors’ drug choices. The claim is fuelling the debate over whether marketing tactics benefit or harm patients.

Drug marketing is a booming industry. Between 1995 and 2000 the number of people employed in marketing pharmaceuticals soared from 55,000 to 88,000 in the US, while the numbers researching new drugs has stayed constant (see Graph). By 2001, the industry in the US was spending $16 billion a year on direct marketing visits to doctors, dubbed “detailing”.

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