ACCP Newsletter
Vol. 5, No. 151
Monday, Aug. 4, 2008
'Academic Detailing' Bill Would Circumvent Drugmakers' Salespeople
Lawmakers have introduced a bill that would fund nonprofit and government programs to develop educational materials about the safety, effectiveness and cost of prescription and nonprescription drugs and to train and deploy educators to provide the unbiased research to prescribers.
Sen. Herb Kohl (D-Wis.), chairman of the Special Committee on Aging, is sponsoring the bill, and Rep. Henry Waxman (D-Calif.), chairman of the House Committee on Oversight and Government Reform, is introducing it in the House of Representatives.
The proposed legislation would provide grants to produce educational materials for physicians on the safety, efficacy and cost of prescription drugs, including generic and OTC drugs. A second set of up to 10 grants would help send such healthcare professionals as pharmacists and nurses into physicians' offices to distribute and discuss the information. To ensure their neutrality, grant recipients would be barred from receiving financial support from drug manufacturers whose products they review.
In a written statement announcing his bill, Kohl cited an April editorial in the Journal of the American Medical Association that highlighted improper drugmaker influence on physicians. The April issue contained two articles that concluded Merck withheld mortality data on its painkiller Vioxx (rofecoxib) before its approval and that company employees guest-authored and ghostwrote medical literature for the drug.
"This bill will provide an important alternative to the way doctors currently get their information about drugs — from the drug companies themselves. This practice seems to be fraught with conflicts of interest," Kohl says in a statement.
"Many doctors learn about new drugs from drug company salespersons who may not be objective," Sen. Richard Durbin (D-Ill.), one of the bill's co-sponsors, says in the statement. "Studies confirm that when unbiased health professionals armed with educational materials provide guidance to doctors, they are more likely to purchase the best drug for the patient instead of the best deal for the pharmaceutical company."
11 comments:
I appreciate and value my association with many pharmaceutical representatives over the years. Most, as would describe a high percentage of healthcare professionals, are honest and care about their integrity. However, I feel that we must legislate guidelines and rules to protect the public from the few who overstep and misrepresent their products.
I would welcome more complete and unbiased information to be available to patients and the healthcare profession in general. My political agenda aside, I feel that the federal agencies should drive these mandates. I am also ever conscious about the costs involved in these type of programs, as well as the amendments and pork that make accompany them. I have seen too much overprescribing and drug misadventures from improper use of medications. It is time to step up and make a difference.
I think having such a program would certainly be beneficial to the patient. However, because drug companies are so influential will they actually let such guidelines to be put in place? Even if they will be, would the drug companies still have representatives go to the doctors' offices and offer information about the drug? I just wonder, how long would it take to implement such a program?
Do you feel that in order for this program to work the drug reps should be replaced by these educators? Do you think this program will be able to compete with drug reps for access to health care providers?
Do you think that Physicians would prefer to get information on drugs from the drug experts themselves; or from pharma drug reps who are more biased, but provide a free lunch?
I think that this a a great idea but do you think that it is possible to keep drug companies from influencing the new educators of these drug information sessions and swaying the way they teach?
Do you feel that drug representatives should be replaced by non-profit and government entities (teams of pharmacist's and nurse's)? How would this alter physician prescribing patterns and/or enhance pharmacist's autonomy?
Mike Parker's question draws an interesting point. I feel like physicians (and their staff) are not going to listen attentively to an "educated health professional" who has come into their office with nothing to offer versus a drug rep (who may/may not be biased) who has brought them a free lunch. In a perfect world, physicians should research newly marketed drugs on their own to provide the utmost care for their patients, but unfortunately more than often, this does not occur. So my question is how are we going to get physicians to listen to the information that these health professionals have to offer after numerous years of free gifts, meals, etc.?
I’m a Black Hat thinker. All I can see is how this program, although it is a step in the right direction, is going to ultimately fail. In my previous reflections and from our discussion in class, I have learned a lot of concerning the pharmaceutical industry and healthcare system in regard to pharmacy. We as a class, thanks for Dr. Nuzum, has much enlighten to us to a lot of the major issues with the healthcare industry. Hence, I believe with certainty – this Academic Detailing is as futile as roller-skating uphill.
Without serious reform regulating both the medical professionals need to stay updated, pharmaceutical companies practices in marketing their drugs, and health insurances companies and Medicaid restructuring their payment and approval policies – this Academic Detailing would amount to nearly nothing in the end. My biggest prime example is this: in the eighties and nineties, the Tobacco industry was found to be selling cancer and poison in with their cigarettes, despite their attempts to hid this fact. This fact was exposed. The Surgeon General put a nice big warning on the side of every pack of cigarettes stating in so many words – “this is will give you cancer and kill you.” Everyone, and I mean EVERYONE, knows (i.e. is educated) of the fact that cigarettes are bad for you.
Yet, this fact remains true – there are still millions of people smoking cigarettes everyday – and there are hundreds to thousands of people starting to smoke their first cigarette every day. With the rhetorical question being: Why? The answer is simple. The government did next to nothing in changing the advertising practices of the Tobacco industry. And despite the education we all received that cigarettes are bad, it can’t compete with a flawed system where the Tobacco industry gets to market to consumer, especially teenagers, that cigarettes are cool.
My point being, as long as the pharmaceutical industry has enough leeway to market to physicians – they will continue to market to physicians and they will be successful. Like we have read in the pharmaceutical sampling article, the pharmaceutical companies exploit the weakness of each of their target demographic, and they will be successful in their exploitations due to their near infinite marketing budget. We know advertising works. And education has lost a many battles to mindless advertising. While we all can the appreciate the fact that the Academic Detailing program is a step in the right direction, without the stage being proper leveled for its entrance – all we will have here is an uphill battle against Goliath with David on roller skates.
I would very much like hear someone else’s opinion on this or possibly an alternate perspective.
I really like this idea of having pharmacists distributing information about new drugs instead of sales representatives from the manufacturers. This will ensure that the information that physicians receive is non-biased, and it will also provide opportunities for pharmacists to stay up to date. Additionally, this opens up another avenue of career options for pharmacists.
I believe that having pharmacists educate doctors instead of pharmaceutical representatives is a good idea but I am worried about the economics of the situation. The question I ask is will the government be able to fun this program as well as the pharmaceutical companies. I just do not believe that the government will be willing or able to provide adequate funds for such a large project. Or am I wrong?
- Stephen B.
It is always interesting to see interactions between physician and drug rep in a real world setting. I agree that at the moment the system is set up with too many biased point of views giving direction to healthcare professionals. I think it is time that a program be put in place that gets to the real issues, so that physicians can make non-biased opinions. In our facility drug representatives are on very strict watch and our method of monitoring these representatives is strict. It is important for facilities to understand that these biased opinions do exist and to protect their healthcare professionals. With the PHARMA updates I believe that we will see changes in the ethical behavior of our reps, since they will have less wiggle room from there respective companies. Nathan
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