Disclaimer: the article only represents one side of the issue. While the author is speaking from their experience, the article should be viewed as the opinion of the author and thus does not necessarily represent the practice of all involved in the pharmaceutical industry.
We will discuss the larger concept of conflict of interest as healthcare providers in the weeks to come, but during this discussion I would like us to focus on sample medications and the pharmaceutical companies. After reading the article, please consider the following:
Should there be tighter restrictions on the pharmaceutical industry? If so, should they be federally, state or self-imposed?
Is direct-to-consumer advertising effective for educating the consumer or does it simply place prescribers in the position of feeling pressured to satisfy patient requests?
Are sample medications effective at reducing healthcare costs in the short-term? Long-term?
36 comments:
My opinion is that the federal government should step in and pass a law nationally that is similar to New Hampshire's legislation "...forbidding the sale of prescription data to commercial entities," as it states in the article "Following the Script: How Drug Reps Make Friends and Influence Doctors." The bottom line is, the field of social psychology has already shown strong evidence that a "schmoozing" relationship that includes flattery, attention and gifts CAN and DOES affect a person, and therefore doctors can never consider themselves immune from the influence of a drug rep. And then there's the worst scenario of all: the fact that there are doctors out there who can be bought with a price. Therefore,I would vote to start implementing some barriers that communicate to both doctors and pharmaceutical companies that we as a society will not accept this obviously immoral system of influencing what doctors prescribe.
Pharmaceutical industry should be tighter restricted by state because different states have different rules. Sample medication helps patients try the effect of new drug without any cost. It's good; however, there are some problems involved with it. Physicians will be affected when choosing the medications; so sometimes, patients don't receive the appropriate medication for their treatment.
Educating directly to consumer is a good idea. We want to improve patients' life so we have to make sure consumers know the administration of drugs and its indication.
Ngan Tran - P1
This article shows several problems with the pharmaceutical industry. Perhaps the worst one that I saw was how reps will try to manipulate a physician. They are focused solely on getting their drug prescribed more often than their competitor's. They appear to place little value in the true effects of the drug (how well does it help the patient, what problems does it cause, etc...)The reps are causing physicians to prescribe drugs that may be avoided (at least to a later date). Having some samples available in order to try drugs out (they have to learn about them some way) and implement therapy immediately is a very good thing; however, I feel that there should be some sort of restrictions on how the drug representatives manipulate the physicians and "guide" them into presribing the drug they are selling (we need to remove methods that are not solely based on information about the drug).
Greg Browning, P-1
I do not agree with the idea of drug reps being able to contact and influence physicians on which type of medication to prescribe. Once a physician becomes "comfortable" with a certain drug, they may continue to prescribe that drug even if another drug may be better suited for whatever symptoms a patient is trying to treat.
John Miller P1
As far as drug samples are concerned, I think it’s a fantastic idea. Not only does it give patients the time to try a drug before they purchase it, but it also decreases the health care costs for the patient as well. If a patient does not like the way a drug is working for them, the doctor won’t have to worry about writing a prescription for the patient. I know that I have personally received samples from doctors that ultimately helped me make a better decision regarding medications. I have also had situations happen to me where a medication did not work out for me. Ultimately I saved money and avoided having to purchase that medication in just to try it. For cases like these, it decreases hassles for pharmacists as well. If a pharmacist has a prescription in their computer, but has to remove it just a few days later, the time put in to getting that prescription ready is lost. In some cases the patient may even request their money back. This leads to some revenue lost for the pharmacy over a situation that could have been avoided.
-Sarah Helms (P1)
Should we shun the pharmaceutical rep for doing their jobs? Or should we agree with all that they say and agree to a contract to buy their medications? I am torn on this topic because yes we do need top of the line medications for the patients, and the manufactures need the money to conduct searches to find new leads and breakthroughs in medicine. But also, falling back on pharmaceutical care, should we agree to some medications that are not best for the patient just because a rep came and fed us lunch five days a week for a month? We as a healthcare profession whether it be a physician, pharmacist, or drug rep, should be there for the patient’s health not the dollar bill. So, my argument would be that if you feel as if the medication the drug rep is providing is the best for the patient; then yes you should get it. But, on the other hand, if they are providing false information please leave it alone and tell them you are not interested. Keep in mind the society determines our profession for the future.
Josh Waters P1
The discussion in class focused more on the drug representative aspect of sample medicines. I would like to talk more about the patient's view on samples. I know when I go in to my doctor, I am more than happy to get free medicines after my visit, especially when the samples will last a couple months. The sample is not exactly the same drug as what my doctor usually prescribes, but it saves me a lot of money, while achieving the same results. I guess my prescriber plays the system a little bit because she gives me the sample meds that are a brand version of my usual, but prescribes the generic. This way I get a couple months for free, but go back to my original low fee every other month. Some people may feel like this is corrupting the health care system, but as a patient, it is working out great.
I do feel that the current system in place is not ideal. I don't think that one group can be blamed for this problem, though. While drug reps are providing limited or incomplete information to the prescribers, it is sometimes because they are only taught certain things about the drug. I know some pharmaceutical companies have pharmacists that train drug reps or are even drug reps themselves. And prescribers keep allowing these drug companies to provide them with lunches, samples, etc. I think that the best way to improve the system is not to blame one group but to focus on everyone involved (drug reps, prescribers, and pharmacists).
Matthew Jones - P1
Restrictions should be set on the pharmaceutical industry and hopefully these restrictions need to be federally set, but that will not be an easy task. Federal law should be set due to the sales rep would just go to another state without these restrictions and push their drug which they are advertising and place a bias on the doctors which they advertise to. Also, more individuals within the healthcare field need to push these regulations to be set and show there is a higher need for a set of guideline because a large number of patients are not receiving the appropriate medication for their treatment when the doctor randomly chooses the drug that they have in a closet.
Direct to consumer advertising also I feel is about the same as advertising to the doctors with the medications advertised, because consumers can’t see every single drug advertisement out there just as the doctors can’t either. Which then the consumer would just use that certain medication which was advertised to them just because it is the one they saw and may not be the best medication for the consumer.
Shawn Jessup
WUSOP P1
There clearly needs to be some type of regulations/restrictions placed on the pharmaceutical industries for their actions taken to promote the sales of their drugs. I realize that art of marketing is the driving force for business and that money powers the world we live in, and that doing well in business is only as good as how profitable a company can be, etc. However the amount of drugs a pharmaceutical company is able to get into the hands of the consumer should not be “bought” by a trained professional salesman that pushes the products into the hands of the physicians. The ability of the drugs and their ability to perform definite outcomes for the patient should be the basis of sales and profit. If restrictions were to ever be a reality in today’s world, they would undoubtedly have to come from federally imposed regulations. A pharmaceutical company is not going to cease any actions that are generating dollars for them freely.
Direct to consumer advertising does not provide all of the information that a patient needs to decide if a drug is right for them. This is where the professional nature of the physician should come into play in my opinion. The physician may feel pressure from his/her patients to prescribe a medication but if there is no valid reason to support the request, then physician has the professional knowledge to deny the request and should. The physician has the ability to determine if the benefits outweigh the risks and if the disease state exists that call for the medication in demand. The physician should then apply their knowledge and license to make the ultimate call with no intimidation or pressure used to persuade their judgment.
In my opinion I think some sample medications can benefit a patient in the short term. If a patient only needs a onetime treatment of a basic medication then certainly this is going to short change the pharmaceutical manufacturer in the “cannibal” sense discussed in the article, but this will save the patient the cost and prove as an effective treatment for future patients seen by the providing physician. On the other hand if a physician has an antihypertensive medication like Benicar in his closet and no samples of any ace inhibitors, would he give the patient the sample to start on instead? I don’t personally know, but this is a good example that I can think of that may be an ineffective method to reduce healthcare costs in the long run should such an incident occur.
To the mentors: Have there ever been times that you were certain a physician had been “bought” by a drug rep due to the prescribing habits you have seen? Or perhaps felt that a patient is being treated inadequately because of this partiality towards a certain medication? If so did you take any action?
Tiffany Benfield P1
The rep is doing their job by getting to know the physicians that they communicate with. Reps are not lisenced pharmacists and their job is to "sell" their product. We cannot control how someone does their job. The more the rep is out giving out samples, the more money he or she is making the company, which in turn can devote more resources to research and development of new drugs. The profession may not like it, but reps are good at their jobs.
However, I believe that physicians should be better educated on how reps operate. They should be warned that a rep is paid to push prescribing of one drug, which may not be the best or most appropriate medication for every patient. I do think that more restrictions should be in placec on how much money a rep can spend to entice a physician, though.
Samples should continue to be used, but should not be relied on by the patient or the MD. They are useful for the patient ot get the medication quickly into their body without having to wait for a pharmacy. I like how the use of samples is monitored now.
As it stands now pharmaceutical companies are able to recoup the enormous cost of producing a drug through advertising. This can be directly to patients through commercials and other ads or drug reps who advertise to doctors. Both of these business tactics can be seen as wrong and not of long term benefit to the patient, but what is the alternative? Passing a law only limits our freedoms therefore I think the best course of action may be for pharmacists to give better feedback on drugs as opposed to a state mandate prohibiting drug representatives. I’m not sure how this would work, because doctors don’t have the time to research every new and old drug on the market, but we as the experts of drugs should have the knowledge to say “no this drug doesn’t work well for this” or “Drug x has some really nasty side effects that Drug y does not even though they can both be used for this situation.” Basically the system isn’t great right now, but mandating change infringes on our freedom. Taking steps as pharmacists to change the system and making sure drug reps aren’t a doctors primary source of information will limit their influence.
The article clearly shows that there is a problem with the current relationship between Drug Reps and Physicians. I think it is important that Physicians are up to date on current and new medications, but the method that drug reps are imposing should be revised. Perhaps a better way to handle this problem would be allowing physicians to pick 2-3 drug reps at a time instead of the drug reps selecting the physician. This would allow the physician to choose a drug that is ideal for them instead of them feeling the burden to pick a drug that a drug rep deems necessary. Although one can find some good out of drug reps and physician interacting, most people would argue that the current method of handling these transactions need to be revised or at least looked at a bit closer.
- Nick Conley (p1)
In my opinion, advertising directly to consumer is more efficiency in selling products. However, medication involves to our health quality so we need people who are knowledgable can help us determine which medication is suitable and helpful for us.
Pharmaceutical industry must be exist to improve our health system in manufacturing drugs. However, we have to have some rules or regulations that restrict the industry and avoid bad drugs produced in our market.
Ngan Tran - P1
I feel that this article clearly illustrates that there is a big problem between drug reps and healthcare providers. Drug companies want to make money and they use their reps to influence physicians and other healthcare providers. I feel that the federal government needs to step in and pass laws that restrict drug reps. Drug companies and their reps have no business knowing specifics about what drugs a specific doctor prescribes or knowing a prescriber’s tendency in order to target physicians. The federal government should ban drug companies and their reps from obtaining such data. With regards to physicians, I feel that large practices should probably have a pharmacist on staff to keep them educated about new drug therapies. Smaller practices could consult pharmacists in the community about new medications before they begin prescribing them.
-Kevin Morris
WUSOP P1
I think free samples are a good idea but only when their sole purpose is to help low income patients. Unfortunately we all know that's not the case. Drug reps are trained to make money for their companies and increase share holders divideds. I bet increased patient care and the best interest for the patient is the last thing on their list. On the other hand physicians are trained to keep patient needs first. Obviously this is a conflict of interest and their relationship should be regualted in some way weather at State or Fedaral level in order to protect the patient.
I agree that giving samples to patient's are a good thing for the patient side of this discussion. Saving any portion of money is always great, even if it's only for a couple of months.
However, there are plenty of problems that go along with this benefit. First off, I do not think that the way drug reps go about "educating" doctors is acceptable. Drug reps need to have more stipulations that make them more responsible for patient care as opposed to a sell. Drug reps should be concerned for patients well-being too.
Doctors should also be held accountable for this. Just because they have a closet full of samples from one rep does not mean that this drug should be used for all patients. Doctors should be very cautious of only giving away drug samples to patients who will actually benefit from the drug, not just so they can get rid of all the samples.
Katelyn Agee P1
Physicians are very well trained to critically analyze things before making any decisions. The article mentions that “physicians are susceptible to corporate influence because they are overworked, overwhelmed with information, and paper work, and feel underappreciated.” I disagree with this statement. Drug reps are doing their job to convince physicians to prescribe specific medications. I agree with the fact that there should be some sort of regulation on the amount of money these drug companies can spend per physician office or hospital. However, drug reps should not take the blame for physicians for prescribing similar medications over and over again. In my opinion drug reps are just doing their job by prompting their companies’ drugs but physicians do need to be cautious not to fall for that.
F Assefa
The pharmaceutical sales representatives certainly affect physicians in selecting which medications to treat their patients. The article is very informative. It helps to explain why many physicians prescribe expensive brand name drugs; why they just want the prescriptions to be filled exactly, and advise pharmacist not focus on replacing those drugs with generic ones. Patients like the drug samples, but they do not realize that the costly drugs will also be prescribed for them. Sincerely, I love these free samples as a patient. They are better than the saving coupons that some physicians are giving now. I have thrown many coupons into a trash can when I find that I can buy a similar drug at lower price.
Tai Tran - P1
On drug samples: A few weeks ago, a majority of the students posting to this blog stated that they disagreed with the use of the InstyMeds machines because they removed the pharmacist’s role of dispensing and educating; however, no one seems to have a problem with a doctor replacing the InstyMeds machine. Sure, we assume that the doctor (with their semester of pharmacology) has enough knowledge to be able to tell them patient how they want the medication taken, but I’d doubt that most could elaborate on the intricacies of the drug. Such is the problem that I have with sample medications… there’s no regulation, really. Pharmacists serve an important role within the healthcare world – the role of ensuring patient safety by screening for drug interactions and educating patients on the nuances of the drug. I don’t know what the best way to allow a patient to sample a medication is, but I do know that whatever is “best” involves the pharmacist ensuring patient safety and education.
On DTCA: The summer after my P2 year, I went to Australia for an internship. Australia practices socialized medicine, which means that the majority of healthcare is covered by the government. It also means that the majority of healthcare is REGULATED by the government – there, DTCA is illegal. Imagine the Americans’ surprise to sit down to watch Wheel of Fortune (the only American TV we could find) and not see ads for Detrol LA, Nasonex, and Abilify. Without this onslaught of DTCA, the Aussie patients seemed a bit more “accepting” of their medications… talking with patients about their meds was different because they literally knew NOTHING about them. Most barely knew their names, because they just weren’t part of their every day vernacular. On some level, I think DTCA prompts consumers to be aware that options exist for a given condition. As part of our society, we assume that patients just KNOW that they can be treated for a given condition… but what if they didn’t? I don’t necessarily think it’s so bad that a consumer gains a bit of insight from DTCA. It’s at the point that they turn from consumer to patient that we as healthcare providers take over, making determinations as to appropriateness, diagnostics, and education.
On drug reps: I actually enjoy seeing drug reps for three reasons: (1) they bring me current literature on their drug [so I can judge the evidence for myself], (2) they tell me who they’re detailing so I know if I’m going to see scripts for their product, and (3) they can attempt to answer my questions about their product. I haven’t found drug reps to be particularly aggressive or underhanded… I’m actually surprised that drug reps don’t spend more time with pharmacists, seeing as we’re the point at which the patient receives the medication (and hence, they make a sale). It’s a simple phone call for me to call and change a script – I’ve never called an office and have them deny a change, stating that they’re “using that drug because Drug Rep X said it was great.” They always change it, because in the end, positive patient outcomes are all about prescribing the right drug for the right patient at the right time.
_________________________________
Erica Harms, Pharm.D., R.Ph.
Executive Pharmacist
Target Pharmacy | Charlotte, NC
eharms@carolina.rr.com
I use to work in a doctor’s office a few years ago, and everyone loved it when a drug rep came and brought lunch. In fact, I also enjoyed getting the free lunch, because it meant I didn’t have to pack my lunch in the mornings or drive somewhere for lunch. I didn’t think twice about it until recently.
I think having a drug rep can be good or bad, depending on how you view the situation. Patients enjoy getting free samples when they leave the doctor’s office. But, patients do not realize that this will not decrease their healthcare costs for the long run. A lot of the times, the samples given to patients do not have generics available, and they end up paying for brand when their physician runs out of the samples. This is not the case every time, but I have seen this happen before.
I also believe it is important that doctors are more aware of these situations. This is where pharmacists can have a huge impact. I agree with David Baglio that, “Taking steps as pharmacists to change the system and making sure drug reps aren’t a doctors primary source of information will limit their influence.” As pharmacists we should be the ones that doctors refer to and rely on for new drugs and drug therapies for patients, and not drug reps.
Sendra Yang P1
Obviously, it costs a lot for drug sample, around several billion dollars to advertise new drugs. But it is one of sophisticated marketing methods; therefore, people tend to do that.
The controversy is that sample medicine can bring benefits also bring some harm to patients. The benefit is that patient can have trial experience before officially using that drug; hence, physicians can determine whether that drug is the most suitable for them. However, sample medicine can influence physicians' habits when prescribing drug. And moreover, the purpose of sample medicine is to encourage consumers try and buy it; yet, physicians can give sample medicine to patients who can't afford the drug cost. So people tend to take sample but not really buy drug.
Government laws are published in order to restrict the industry and protect patients.
After reading this article, I was amazed at the lengths that pharmaceutical sales reps would go to just to get more of their drug prescribed by doctors. As many of my fellow classmates have said, there is obviously a problem in the relationship between drug reps and physicians. What really caught me by surprise was the statistic about more than half of the "high-prescribing" doctors citing drug reps as their main source of information about new drugs. The most troubling thing about that statement is the drug reps are not pharmacists and they do not know how all drugs work. It seems to me they took some sort of "crash course" on the drug they would be trying to convince the doctor to prescribe without giving complete detailed and accurate information on how the drug actually works.
As future pharmacists, I feel this could come back to haunt us. If something is wrong with a prescription or how a drug is affecting the patient, pharmacists are almost always the first person contacted. I feel there needs to be some sort of legislation passed as it was in New Hampshire. I feel it would work better on a state level rather than a national level, even if it's as simple as forbidding the sale of prescription data to commercial entities.
Briana Rhyne-P1
I believe that the current system we have in place for Drug Reps isn't ideal. I believe that the Reps bias the doctors by coming in and playing friendly for a few minutes or over lunch. I personally view them as fancy car salesmen/women. They have a product that they are try to sell and they "brown-nose" and do whatever it takes to get the name of their drug out there. They are very good at their job or else hospitals and physician's offices would not get free lunch. The Reps sometimes skew the results of studies to make it seem like their drug is the new 'wonder drug' that can cure any type of disease... just like a car salesperson does with a car.
Of course there is a flip-side to this argument that the Drug Reps are helping educate the physicians on new drugs. Sometimes physicians can develop a bias towards a certain drug and the Drug Rep can educate the physician on breakthrough pharmaceuticals. When I got sick as a kid, it seemed like every prescription my physician wrote for me was Augmentin. It worked, but it conveys my point of the possibility of bias by physicians.
Jeremy Efird P1
I believe the system as it is, has its pros and cons. First, I believe it is a major pro for the less fortunate population who often do not take their medication because they cannot afford it. By giving them free samples, they are able to get the drug therapy they require. I also feel drug samples help when trying new medications. If you can try a drug before you purchase a full one-month (or even three-month) supply, you can determine its efficacy and whether or not the side effects are bearable.
On the con side however, I feel like drug samples, and Drug Representatives, can sway a physician to prescribe only that medication instead of one that may be more effective. Also, by giving the patient enough free samples to last a month or more would eliminate one of the fundamental tasks of a pharmacist, to catch drug interactions. If a patient is on a current prescription from one doctor, then receives free samples from another, the possibilty for drug-drug interactions increases. By forcing the patient to go to the pharmacist, these interactions could be prevented.
In comparing the pros and cons, I believe the risks that come with the cons outweigh the benefits of the pros. When it come to my health, I would prefer the most suitable medicine as opposed to the most prescribed medicine.
Christine Atkinson
P-1
Before reading this article, I really did not understand how much influence the drug reps have on prescribing physicians. I, like some of my classmates, am torn on this issue. It seems that the drug reps are simply doing their job. Unlike pharmacists and physicians, the primary focus for the drug reps is to increase sales. It is not their job to ensure that the patients are receiving adequate care. I believe that the physicians should accept more responsibility with this issue. As health care professionals, it is our job to ensure the welfare of the patient. Physicians should understand the objectives of the drug reps and make sure that they do not make themselves vulnerable to their gifts and persuasion. Physicians should understand that the main goal for the drug reps is to sell their product, and it is the physicians’ job to not fall into their traps and be so easily swayed.
Allison Hoyle
Student-P1
I feel that pharmaceutical representatives play a very important role in the evolving of medications. Pharmaceutical salesmen assist doctors in remaining current on new drugs and help the drug company they represent stay afloat. Their success allows for the research and development of new medications. Those involved in pharmaceutical sales are educated in marketing, not in health care and their commission is based on sales. For these reasons, it is acceptable that their goal is not always to provide a drug that is best for patients, but to maximize the sale of their drug. It is important for pharmaceutical representatives to have time to discuss their drug in detail with health care professionals in an autonomous environment such as lunch. However, I feel that there should be limits set forth to prevent bias towards specific drug companies based on gifts and incentives offered to prescribers.
Kirsten Wood
P1 Student
I personally feel as though there is nothing wrong with pharmaceutical companies providing physicians with sample medications/coupons to help patients pay for co-pays or free trials. There is a very fine line though--I was not aware that pharmaceutical companies were going to the extremes of "buying out" doctors in order for them to prescribe the latest drugs. I agree that advertising to physicians should be allowed, but only to a certain extent. I think what many people are failing to realize is that it is not the pharmaceutical company's fault if patients are not getting the best medication available, it is the physician's fault for only thinking of their own convenience. Physicians need to begin setting limits on the influence pharmaceutical companies make on them.
-Maryann Choy-Ames, P1
In my opinion, the problems we are seeing with sample medications are not due to the samples themselves, but instead how they are being used.
As I stated in class, I was taught in an undergraduate course that for every minute a drug rep spends with a physician, the physician's prescriptions for the marketed drug increase by 17%. When you increase the interaction time between the drug rep and the physician to 3 minutes, a 50% increase in prescriptions for that particular drug can be seen. When only a few minutes of marketing can dramatically change the prescribing patterns of a physician, the system is clearly not working to get each patient the best possible drug for the individual. A system needs to be put in place to ensure that patients are receiving the drugs which will work best for their condition, and not just the most recently “advertised” drug.
With such a system, drug samples would be advantageous for both the prescriber and the patient. By having samples to give, physicians could ensure that the medication they want to prescribe will work for the patient before writing a full prescription. Many quick onset adverse reactions could be discovered before the patient picks up a full month’s supply. A physician could also see how well the drug works for the patient, especially with drugs where effects can be seen within the first few doses. Patients benefit from samples mainly for the same reasons – drug efficacy and adverse effects can often be discovered before the patient pays for a full month’s supply. Samples also allow patients a grace period before needing to fill a new prescription while still allowing them to begin taking the drug immediately.
I’m also not sure how many of my classmates have had the opportunity to work in a “free clinic” setting, but my time spent at the Bradley Free Clinic in Roanoke gave me a new perspective on sample drugs. My opinion used to lean more towards the view that free samples should not be allowed, but without sample drugs, most free clinics would find it impossible to maintain a pharmacy. Most, if not all, of the medications that are dispensed from free clinics come from manufacturer samples, and if drug companies are restricted from marketing their products to physician’s offices in this way then free samples would to cease to exist. Until you have worked in a similar situation, however, I think it’s difficult to grasp the importance of the role of free clinics in health care as well as the role of the drug companies in clinic pharmacies.
There are so many reasons that free drug samples are a positive fixture in health care. However, in order to see the positive effects, regulations should be put in place to ensure that free samples are being given for the right reasons, and that patients are not taking a less effective drug simply because the doctor could give them a few tablets for free.
Carolyn Kilbane, P1
I don’t believe we should prohibit pharm. reps from doing their job and I don’t believe that this is the problem with our health care system today. I believe instead that educating the physician should be the priority. It is important to inform physicians of the unbiased facts at hand and let them make the logical decision. -Sam Weatherspoon
I think that pharmaceutical representatives being able to hand out pamphlets and vouchers is a great idea. I think that it is their job to advertise these products and I do not think we have a right to make them stop advertising simply because they are doing what their job requires them to do, advertising. I think that the responsibility falls on the physician at this point to correctly prescribe the needed drug. Handing out vouchers and samples is also a way to make physicians aware of new drugs on the market. Ultimately, i think drug samples and vouchers are a great idea, but I think that is is the professional responsibility of the physician to keep the patient's best interest and health in mind.
I have personally seen how beneficial sample meds can be. Many patients can't cover the costs of their monthly medications even with health insurance and some physicians ease these costs by providing sample meds periodically. I think this is wonderful, that is, if the medication being prescribed is really suited for the patient.
I too understand how physicians can be persuaded into prescribing the medications for which they have a great number of sample meds. Ultimately, the prescribing responsibility falls on the physician and not the drug rep who showers the physicians with samples. A physician who truly cares for his patients will not hesitate to prescribe the correct medication even when his/her closet is full of other sample meds.
Alisha Rivera-Menendez
WUSOP P1 student
In response to the article and to our class discussion, I do believe that vouchers and samples are a great way to try a new medication or reduce costs, if used appropriately. However, it seems that neither drug reps nor physicians are completely knowledgeable of the medications for which samples or vouchers are given out. It seems that it would be a good idea for physicians to be required to consult with a pharmacist before giving out samples or vouchers. This way, the physician could be properly educated on the medication by an unbiased third party who is skilled in the area of medicine. Hopefully, this would encourage physicians to give out samples and vouchers only if it is in the best interest of their patient and not just because they were "wined and dined."
P1 - Amanda Flores
I wish that I could say there was nothing wrong with the way things are between pharmaceutical companies, physicians, and patients. However, there seems to be a complicated web of problems mostly stemming from the marketing strategies of pharmaceutical companies such as “wining and dining” doctors offices.
I think that tighter state-sanctioned laws regarding the practices of the pharmaceutical industry is a great place to start. I have little faith in company CEOs as well as doctors and drug reps changing the ways on there own – after all, we are all human. I think once a few core states have tighter restrictions, a federal mandate could be put in place. Ultimately, I think that this would hold each party accountable and help remind us to think of what is best for the patient.
I recently did a presentation on direct-to-consumer advertising. From what I found in my research, it does add to the pressure that is put on the physician to prescribe a specific drug. In fact, one study showed that patients that asked for a specific drug from their doctor based on information from a DTC ad were sixteen times more likely to get a prescription for that drug. The same study showed that many doctors would go along with the patient’s request despite any reservations they may have.
In addition to this, I’d like to point out that the U.S. and New Zealand are the only developed countries in the world that permit direct-to-consumer advertising.
As far as samples are concerned, I believe they are cost effective in the short term. Samples are never given for the cheap “go-to” medications. They are typically fairly new brand-name medications. What happens when the patient runs out of the samples? What if their co-pay is not affordable? What if the patient was given the sample and the prescription simply because that’s what the doctor had available? Are the patient’s health outcomes as well as long term cost effectiveness really being considered in this situation?
Amanda Hill, P1 Student
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