Healthy Skepticism Library item: 13113

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Hoffer A.
An offset to drug industry's sales pitch
Milwaukee Journal Sentinel 2008 Mar 13
http://www.individual.com/story.php?story=79288465

Full text:

While pharmaceutical sales representatives inform doctors about drugs, physicians and patients would benefit from an objective source of drug information from outside the industry, says U.S. Sen. Herb Kohl.

“Sales reps are currently one of the only ways doctors can learn about the latest drugs on the market,” the Wisconsin Democrat said Wednesday at a hearing of the Senate Special Committee on Aging, which he chairs. “However, these sales reps often confuse educating with selling,” he said, and doctors’ prescribing patterns can be influenced by biased sales pitches.

Kohl called the hearing to explore whether to provide federal funding for a program called academic detailing, developed about 30 years ago by Jerry Avorn, a professor of medicine at Harvard Medical School.

The program entails training pharmacists, nurses and others with a health care background to visit physicians in their offices with evidence-based, non-commercial and unbiased scientific data about the drugs they prescribe.

A cost-benefit analysis found that such a program could save $2 for every $1 it cost to run, Avorn said.

Kohl said an academic detailing program is important now because the federal government is the largest purchaser of drugs. “A lot of money is being wasted because doctors don’t have enough information to make the best prescription decision,” he said.

The experts appearing before Kohl’s committee testified that doctors do not always prescribe the drugs that are the safest, best or cheapest.

Academic detailing is done by hospitals, managed-care plans and insurance companies. In the U.S., the program is seldom government funded.

Kohl wants to create a two-pronged federal academic detailing program that will distribute printed information about drugs to health care providers and dispatch specially trained people to talk to them. In the spring, he plans to introduce legislation with Sen. Richard Durbin (D-Ill.).

Wisconsin does not have a formal academic detailing program. However, the Drug Utilization Review Board, which is operated by the state Department of Health and Family Services, makes educational interventions with doctors, said Lee Vermeulen, a board member and director of the Center for Drug Policy at the University of Wisconsin-Madison.

“We make a recommendation that a particular drug could be safer or more cost-effective based on published scientific evidence,” he said. “We study the doctors’ patterns of drug prescription and show it to them.”

A former drug sales representative for Eli Lilly and Co., Shahram Ahari, told committee members, “The idea that the drug rep is an effective vehicle for disseminating objective science is pure fiction.”

Drug sales reps are trained to use persuasion and come armed with “a vast arsenal of gifts, including pens, pads, clipboards, food and drug samples,” Ahari said.

A national, voluntary program that will provide doctors with an alternative source of information will yield dividends for public health and a higher quality of care, Kohl said.

John Kamp, executive director of the Coalition for Healthcare Communication, a group representing the drug industry, said Wednesday the coalition doesn’t oppose the measure but “I question whether the federal government needs to be in the business of countering pharmaceutical sales.”

Kamp did not testify at Wednesday’s hearing.

The Associated Press contributed to this report.