Healthy Skepticism Library item: 13112

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Publication type: news

Kohl Requests Documents From Schering-Plough Regarding '49 Plan' Sales Push
Medical News Today 2008 Feb 14
http://www.medicalnewstoday.com/articles/100635.php

Full text:

U.S. Senate Special Committee on Aging Chairman Herb Kohl (D-WI) sent a letter to Schering-Plough Corporation, a pharmaceutical company, to request documentation on the company’s so-called “49 Plan,” an aggressive seven-week sales push to increase the amount of Zetia prescribed by doctors across the country. Published reports indicate that the “49 Plan” instructs Schering-Plough sales representatives to convince doctors to prescribe Zetia in the face of falling prescription rates by offering free meals or other entertainment. Zetia is a drug that, when used in combination with another medicine, is meant to lower cholesterol. Sales of the drug have dropped over the past year, possibly in reaction to a study that showed Zocor, a much cheaper alternative drug, to produce similar results.

“I am troubled by any attempts to persuade physicians to prescribe a drug for any reason other than the patient’s condition and the drug’s effectiveness in treating it,” Chairman Kohl said in the letter. “Unfortunately, it appears that your “49 Plan” may do exactly that.”

Chairman Kohl’s letter requests that Schering-Plough supply the Special Committee on Aging with details of the ’49 Plan,’ to include a written description, the number of sales representatives involved and their compensation, how the plan will comply with industry guidelines and ethics, and any information on internal oversight of the plan.

Background:

Yesterday Chairman Kohl held a hearing to consider an alternative to the current prevailing practice of doctors receiving the latest information on new drugs from the drug manufacturers themselves. Pharmaceutical sales representatives are currently one of the only ways doctors can learn about new drugs on the market. The industry’s educational outreach is essentially a marketing program, and evidence shows that doctors’ prescribing patterns can be impacted by pharmaceutical sales representatives. Wednesday’s hearing considered the implications of creating a federal “academic detailing” program, which would provide physicians and other prescribers with an objective source of unbiased information on all prescription drugs, based on scientific research.

“Pharmaceutical reps often confuse educating with selling, and evidence shows that doctors’ prescribing patterns can be heavily influenced by these sales representatives,” Chairman Kohl said at the hearing. “Without academic detailing, physicians may not have access to information about the full array of pharmaceutical options, including low-cost generic alternatives. However, research has shown that when they do, doctors prescribe the best drug-not just the newest one-and healthcare spending is lowered.”

Chairman Kohl plans to introduce a bill with Senator Dick Durbin (D-IL) this spring to create a federal academic detailing program. The proposed legislation would create a grant program to fund the production of educational materials for doctors on the safety and comparative effectiveness of prescription drugs, including generic and over-the-counter alternatives. The policy would also create a second grant program to dispatch trained medical professionals (such as pharmacists, nurses, and other health care professionals) into physicians’ offices to distribute the extensively researched and independent information. Because academic detailing lowers healthcare costs for the government, the bill is expected to pay for itself.

Last June, the Committee held a hearing examining the relationships between physicians and the pharmaceutical industry. Following the hearing, Chairman Kohl and Finance Committee Ranking Member Charles Grassley (R-IA) introduced the Physician Payment Sunshine Act (S.2029) to require manufacturers of pharmaceutical drugs, medical devices, and biologics to disclose the amount of money they give to doctors through payments, gifts, honoraria, travel and other means. The drug industry has challenged the Grassley-Kohl bill, claiming that the legislation will potentially restrict their ability to inform doctors about new drugs. The academic detailing legislation under consideration by Chairman Kohl and Senator Durbin addresses this charge.