Healthy Skepticism Library item: 1577

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: Journal Article

Behar D, Schaller JL.
Letter to the Editor: Drug rep visits actually improve care for patients
American Medical Association News 2005-2005 May-May 23-30;

Full text:

Regarding “Iowa practice draws notice for its ‘no-gift’ policy” (AMNews, Feb.
14): In AMNews articles, there is a need for the clinician “street” view of
drug company representative detailing.

Doctors’ are not controlled by pharmaceutical “bribes.” If patients do well in
brief and lucrative visits, the practitioner gains an enhanced reputation, more
referrals and the feeling of achievement. What ravioli dinner competes?
Physician feedback is taken seriously by drug companies, resulting in new
dosages, vehicles of administration and instructions. Many adverse effects
would go unreported to the Food and Drug Administration without manufacturer
persistence in chasing the clinician to complete onerous forms. One type of
feedback that is given to pharmaceutical company officials is the aggressive
demand for off-label research. They provide insufficient support of costly
research to substantiate the use of off-label prescriptions, causing doctors to
define the standard of care by clinical experience, rather than by rigorous
group data.
Pharmaceutical dinners result in physician exchanges of experiences. The paid
speaker will learn pearls of wisdom from the veteran audience, with a long-term
value exceeding any fee to speak. Including annoying travel time, even a modest-
income speaker is losing money, compared with providing local patient care. At
these dinners, bad-tempered physicians often publicly bash the product and
interrogate the speaker, asking about their toughest cases. From a
pharmaceutical company perspective, these dinners are a mixed experience. And
all dinners and sponsored meetings are counteracted by competitor events. True,
generics might be underrepresented, except that members of the audience
frequently promote them in comments.
For five minutes of time listening to a detail rep, a physician will receive
$200 to $400 worth of brand-name samples. It is often a choice of these samples
or no treatment for uninsured patients.
Finally, most “propaganda” materials are reprints from the leading journals in
medicine. After receiving 20 per month, one is only receiving a wide range of
articles that one should be aware of anyway.
Drop the false caricature of physicians as naïve lemmings who are on sale for
trinkets. We can eat and say what we think while accepting expensive life-
saving samples all at the same time