This article represents
the views of one person involved in the pharmaceutical industry. It
should not be assumed to represent any other opinions of others involved
in the industry.
After you take a look at the article, consider the following:
1.
Should there be tighter restrictions on the pharmaceutical industry?
Who should impose the restrictions? Should they be federal, state, or
self-imposed?
2. Direct to consumer
advertising is another topic well connected to this one. Do you agree
with DTC advertising being allowed at all? Do you feel that it creates a
more well informed patient, or one that will try to bully a prescriber
into giving them a medication that they don't necessarily need?
3. Are sample medications effective at reducing health care costs in the short term? In the long term?
47 comments:
In all honesty I don't think pharmaceutical companies should be able to monitor physicians scripts and what medications are actually being picked up by the patient. I also feel like it is wrong to be convincing a prescriber to buy a drug by taking them out to eat or sending them gifts. Meetings should be more formal. I believe that DTC will involve bullying a prescriber into giving them a medication they don't really need and more so just want. Ultimately the physicican can make the ultimate decision but I can see how issues can arise. I do think that sample medications can be effective at reducing health care costs. If patients can sample a medication before picking up a script for it they can discover allergies and other side effects which can avoid wasting an entire vial of pills. Although there may be drawbacks I think the benefits will outweigh them.
I'm going to play the devil's advocate here because there are some cases where drug sale representatives should reward people with gifts, lunches and other goodies. I'll give you a perfect example from our store.
There is a certain eye lotion drug which is very cost prohibitive for many patients, even the ones with insurances. For patients of ours who do have insurances and have prescriptions for this medication, their co-pays average around $50, and that's if they are lucky. Usually, the HMO/PPO will refuse to pay a single dime for it. This means my mom, the pharmacist, or our staff has to stop what we are doing and fill out a Prior Authorization form to send to the insurance company justifying why this patient has to be on the medication.
This takes lots of time and effort because we have lots of cases like this on a daily basis and no one pays us for going the extra mile. Unfortunately, none of the cheaper substitutes will work as good as this expensive drug does and to make matters worst, some eye specialist doctors absolutely want their patients to use this particular eye drug and would not settle for anything else.
So of course, drug sales reps from this company would be grateful to us because we are bringing them lots of revenues. So a few lunches here and there are not a bad thing.
I think there should be tighter monitoring on pharmaceutical companies when it comes to seeking out prescription information. I understand that to pharmaceutical companies, it's all just part of conducting business but by them edging certain medications in over others, they can have effects on the patient through what the physician actually chooses to prescribe. I also think that these restrictions should be enforced federally to protect all doctors (and potentially patients) within the US. Some physicians may choose to prescribe a drug because that drug has been made easily accessible or because prescribing that drug will get them more freebies from the company the drug comes from. The ease of access can be facilitated by the distribution of sample medications. The article referred to the idea that sample medications could cut medication costs, but I only see a cut in costs for the short run. Eventually the samples will run out and then the patient may be left with needing a medication that they can’t afford. This type of methodology of prescribing medications – centered on accessibility and medication promotion – shifts choosing a medication to potentially benefit the physician more than it benefits the patient. Isn't medical/health care supposed to be patient centered? As long as pharmaceutical reps push physicians to prescribe medications for the wrong reasons, health care will not be as patient centered as we'd like it to be. Could a physician's want for gifts and attention from pharmaceutical companies lead them to prescribe against their better judgment? There may be potential for that to occur, and that potential will only increase if tighter restrictions aren't placed on the amount of information pharmaceutical companies are allowed to have.
Maybe one way pharmaceutical companies try to make their approach more "patient centered" is to directly advertise to consumers or patients themselves. I think this could be even worse than pharmaceutical rep/ doctor interactions. The damage occurs when consumers think they know what type of medication they need solely based on those short spurts of drug information they see during sixty second commercials. Now the patient/consumer thinks he/she knows exactly what medication to "ask for" when they visit their physician. Physicians are the prescribers, right, so why should it matter that the patient asks for a certain medication? I've heard of a number of instances where a physician's prescription has been altered due to the request of the patient - even to the point where the patient is given an antibiotic when there are no signs of a bacterial infection. All in all, I think the facts should be given to doctors without gimmicks and without the business games so that the patient can be the foremost beneficiary again.
I don’t agree with the ability of pharmaceutical companies to track “high prescribers.” That is an instigating factor allowing pharmaceutical companies to take advantage of some physicians while ignoring others. I can see some benefit to pharmaceutical companies allowed the opportunity to educate physicians about the effectiveness of their medications and to provide samples for physicians to use with their patients. However, I would hope that physicians keep in mind that reps are providing a very biased set of information. It was not surprising to read in the article that physicians did not feel that the information received from the reps was necessarily accurate. It is good to know that physicians polled in this survey were remaining cautious about the information they were receiving.
I think this topic opens up a gap that could be filled by the pharmacy industry. Pharmacists who were reps of a pharmaceutical organization, for instance, instead of a pharmaceutical manufacturer, could provide pharmaceutical information to physicians and other healthcare staff without bias. The education received in this fashion could be taken more seriously and without suspicion that it was coming from someone with an ulterior motive.
I think there should be a federal restriction on the amount of prescription information pharmaceutical companies are allowed access to. It’s disturbing how pharmaceutical companies abuse this access. “… prescribing data, which are used both to identify “highprescribers” and to track the effects of promotion. Physicians are ranked on a scale from one to ten based on how many prescriptions they write. Reps lavish high-prescribers with attention, gifts, and unrestricted “educational” grants.”
It’s appalling that any money at all – let alone how much money – is spent on drug reps and their manipulative activities/gifts. I do not agree with direct-to-consumer (DTC) advertising because it would be too difficult to regulate how much of the advertising is false or neglectful information. I even question the reliability of the drug rep as a source of accurate information for their prescribing clients. What is the criterion for hiring these drug reps, exactly? I know somebody who recently began their career as a drug rep after working for a couple of years in a management position at Sherwin Williams. She has no scientific background whatsoever and says that her job really isn’t about that; it’s about the relationships you build with your clients. I find this system very corrupt. Though it is important to keep prescribers informed on new medications out there; this system seems to be entirely business oriented and takes advantage of that fact.
In an ideal world, pharmaceutical companies would not have access to sensitive information like prescriptions with which they could track, and use against physicians who did not meet quota. Since pharmaceutical companies make the pills being tracked however, any restrictions here would most likely increase the cost of healthcare more than they would benefit consumers. On the other end physicians should show a little more moral fortitude when it comes to drug reps. If a drug rep was trying to convince me to fill all brand prescriptions for his company, it would take more than a few free meals to put his interests above my patients wallets. Direct to consumer advertising is much harder for us as professionals to ignore. Having to convince uneducated patients that they do not need something that advertising companies just promised would make their life better can often lead to lost business if the physician stands their ground. For this reason DTC should be regulated straight into the ground.
Jabon Efird
First and foremost, I don't see anything wrong with "bribing" a doctor with gifts and favors. The pharmaceutical companies have a right to make a living, too, and their specialty is in conducting business. Unlike the sciences which are based on cold, hard facts, business requires a humanistic aspect that comes with making a friendly appearance. Therefore, it is quite understandable for drug reps to act more personable to their "clients," the physicians, to get them to use their company's products. The article make drug reps seem like deceptive, money-hungry corporate members out to get their clients. I admit, this may be true in some cases, BUT even if they were trying to push the drug samples to physicians, the decision to dispense those samples still lies within the physician's discretion. Physicians should be held accountable for the outcomes of these drugs on patients' health assuming that these drugs are FDA-approved and have passed all tests. They should be well-informed about the work that drug reps do and exercise extreme caution when approached by one trying to sell their products. A physician’s top priority should always be their patients’ well-being and if physicians are taking advantage of patients to get gifts from drug reps, then those physicians are not doing their job to treat patients effectively and should be condemned from practicing medicine.
Pharmaceutical company's, in my opinion should not be able to monitor what physicians are writing for. The hospital pharmacy where I worked would not allow pharmaceutical representatives into the pharmacy for lunches or presentations, unless it was pertinent to what we were doing. For example we changed TPN fluids, so we had a rep come in and hold a teaching lunch. I think that if reps are able to persuade using lunch, dinner, and "stuff", we are not making decisions solely on what is best for patients. I have never thought that it was a good idea to leave samples with physicians only because it sways what they are going to write for the patient. I think it is convenient and a cost savings for patients but there is the chance it isn't the right medication.
"In the interests of patients, physicians must reject the false friendship provided by reps. Physicians must
rely on information on drugs from unconflicted sources, and seek friends among those who are not paid to be
friends." I agree with this article and this statement pretty much summarizes how I feel. I do not think it is right for pharmaceutical companies to have access to the scripts that are being prescribed and I think it should be more tightly controlled. Also, I think sample medications could be cost effective in the short run. What happens for the patient when they run out and the medication is too expensive? I think that this leads to helping out the physician and forgetting about the main concern and goal as a healthcare professional. This profession, along with every other health related career's main focus is the patient. I think this takes away from that idea. If the patient can't afford the medication after they are out of samples is it really in the benefit of the patient? Or is it now a benefit to the physician? I do not think physicians should make these friendships with reps and consider the interest of the patient first and foremost.
I think medication samples are a great way for patients to gain access to new, effective medications at no cost. I also think medication coupons can be just as useful. I’m not sure how these samples and coupons affect the pharmaceutical industry providing them. I would assume that it benefits the company by allowing the patients to try the medication and hopefully continue to use them once the sample has run out. Obviously, when the drug representative drops off the free sample and provides a free lunch to the doctors, biases can start to form. However, I think it is the doctor’s and pharmacist’s responsibility to remain objective and to provide the patient with the best treatment. I also think it is important to listen to the patient’s comments after trying the medication. If all of the patients seem to think the drug works well, the doctor and pharmacist should consider that information when prescribing it to other patients. If most patients complain about it, the doctor shouldn’t continue prescribing it just because they have samples or a good relationship with the drug representative.
As James Reidy stated in the article, "An official job description for a pharmaceutical sales rep would read: Provide health-care professionals with product information, answer their questions on the use of products, and deliver product samples. An unofficial, and more accurate, description would have been: Change the prescribing habits of physicians." I do not think it is a pharmaceutical representative's job to be influencing the types and brands of medication in which a doctor prescribes. First of all, pharmacists are the most educated people regarding medication, pharmacotherapy, and pretty much anything specifically pertaining to drugs. Pharmaceutical representatives are essentially salesmen. They likely know very little about the drug they are selling, and they are conveniently marketing the most expensive drug, despite cheeper alternatives or generics that do exactly the same thing. It is a representatives job to sell the product, not do what is best for the patient. As I was looking through the various techniques representatives tend to uses the "no see/no time" technique particularly stood out. Sometimes when doctors refuse to see representatives for whatever reason, the representatives call and essentially bribe the nurses and receptionist. It is a money making industry, and in my opinion healthcare should primarily be concerned with patient benefit. In regards to whether or not samples save money in the short and long term: short term yes, samples save money as they are given to the patient absolutely free; however, in the long run they end up costing the patient more money because the representatives only give out the expensive name brands claiming they work so much better when the generic which costs a fraction of the price does the exact same thing. I agree with the conclusion which states, "the concept that reps provide necessary services to physicians and patients is fiction. Pharmaceutical companies spend billions of dollars annually to ensure that physicians most susceptible to marketing prescribe the most expensive, most promoted drugs to the most people possible."
This article may be an accurate representation of pharmaceutical salesmen nationwide, but I believe this industry has another story to tell. (No matter how flat a pancake is, it always has another side.) Since this article focused on one pharmaceutical sales representative, I think it’s unfair to base an opinion solely using this information. If this is an ongoing issue, I think that states should have the right to regulate and impose restrictions. Since states have their own boards of pharmacy, I believe it is best taken care of at the state level.
One of the contributing factors to the above-referenced issue is the pay structure at pharmaceutical companies. Since commission is included, it may lead to fostering relationships only to increase numbers. It benefits the pharmaceutical company’s bottom line; however, it does not create a nonbiased environment for physicians to choose the best therapy for their patients. In some situations, the sales representative may be the best book of knowledge concerning the new drug, and it benefits the patient, physician and sales representative.
I agree with the overall cynical tone of the article concerning the current state of pharma rep-prescriber interactions. The conclusion in particular is succinct in wording, reading “In the interests of patients, physicians must reject the false friendship provided by reps.” In an ideal world, only medications that have been proven to improve patient outcomes in significant ways would be marketed and promoted by drug reps. Also, it would be ideal if reps only promoted medications they earnestly believed in, and did so in unquestionably ethical ways. It is unfortunate that capitalist corporate strategy finds its way into patients’ homes in the forms of medications that have the potential to manage their diseases in incomplete or substandard ways. In light of the fact that we do not live in an ideal world, and that drug manufacturers will continue to lobby prescribers utilizing drug reps, I am in favor of nearly every form of regulation of representatives’ insight into prescribing data as it relates to specific prescribers. The only concession I can think of that should be made is that prescribers, and their patients, may benefit from the informative functions of drug reps if the medications they are “pushing” are promising in terms of improved patient outcomes. The problem here is one of distinguishing genuine informative functions and behaviors of drug reps from profit-seeking ones. I can’t envision an easy way of making these types of distinctions.
I think there should be tighter restrictions on the pharmaceutical industry because they are just bribing doctors to get their product out to the community. They don't care about the patients and since the physician is the one that is prescribing the medication then I don't think it is right for pharmaceutical companies to take advantage of the physician. I don't agree with DTC because I feel that the patient will feel like they are informed and doesn't need the doctor's opinion. The only reason they will go to see the physician is so they can try to pressure the doctor in to giving them the medication. I feel that it is important that doctors do not give in to the patient and should offer their recommendations and expertise because that's why they went to medical school. I think that sample medications are a good thing to have because you want to make sure the medication will work for the patient before they spend money on it. Sample meds are good for the short term but depending on the price of the medication I am not sure that it will be good for the long term. There may be a cheaper alternative that the patient doesn't know about because the prescriber just wants to put them on a medication that pharmaceutical reps have talked them into prescribing.
Sarah Martin
It is the responsibility of salesmen and saleswomen of every company to boost their numbers and make their products more appealing and available for the general public. If you are a car salesman for example, you will tell your customer everything about how great the car is, and how terrible the rival's car is in contrast. But that's mostly the extent of the similarities. Drug reps do not get to talk directly to the customers consuming their product. Since they go through a middleman, the physician, it makes sense their companies would provide them with every advantage to boost their sales. I don't see an issue with that because it still comes down to the doctor to make an informed decision on the best way to treat their patients. If they choose to disregard all their education and experience because of a free lunch, then they are not being a very good doctor.
However, drug reps also provide a service. In the office I worked at, when drug reps came in and gave us lunch and a seminar, it might be to introduce a new product that had just become available. They fielded the questions they could answer, and if they didn't know the answer, they provided a phone number where on staff doctors could answer their questions. Sometimes they would even bring a doctor in who could answer questions in person. Again, it was the reponsibility of the prescribing doctor to assess the information that was given to them and make an informed decision when prescribing products for their patients.
~Chris Pavero
Drug reps have a certain job to do, just like the rest of us. There job is to increase their sales. Since they do not talk directly to patients, they must persuade physicians to prescribe their drug. The drug rep might do this with a free lunch or gift, but there is no contract stating the physician must always prescribe their drug. Therefore, it is ultimately up to the physician to be a professional and prescribe the best drug for that patient, regardless of outside influences by drug reps.
On the subject of medication samples, I think samples are good for patients. They can see if the medication will be effective and have any adverse effects. This could ultimately save the patient money because the patient won't have to keep switching to more effective medications.
-Curtis Austin
I think that pharmaceutical representatives have a role in education practitioners about new medications. However, I don't agree with some of the tactics used by the sales reps. The idea of giving gifts to physicians to influence them is ethically wrong. Drugs should be sold based only on their properties and therapeutics effects. I think physicians need to be objective and select their drugs very carefully.
To be honest, I think this whole game is a little sick. The point of healthcare is to help patients, not to manipulate them. What is the point of creating new and improved drug therapies, if the doctors will just be bribed and manipulated into prescribing one brand of drug for a said illness? There should be medical justification for prescribing a certain medication. Patients trust that their doctors are recommending the best therapy for them and this articles proves that sometimes, this is not the case. Maybe doctors should have a continuing education requirement annually to learn about new drugs out on the market so the pharmaceutical sales industry can be outlawed.
Based off of my retail experience, I think that the pharmaceutical industry, especially drug representatives distributing sample medications and manufacturer coupons should be restricted. Sample medications cannot be monitored efficiently; ie. patients may take the drug incorrectly, recalls, or a patient may not inform the pharmacist that they are taking that medication, etc. Samples may save the patient money at first, but then reality sets in the first time the patient fills that script and they discover the copay is very high. I think that drug reps are bullies and push their expensive brand name drugs on physicians, pharmacies, and patients. It may provide physicians free meals or other perks and it is a huge profitable market, but is not cost effective for the patient. For example, a patient dropped off an Rx for Zutripro, a cough syrup, and presented a coupon that was given to them by their physician. The patient's copay was $75, because it was considered the highest tier drug on their insurance. The coupon only brought it down to $50, and the patient was shocked and requested that we contact her MD to get it changed to something cheaper (i.e. Hydromet). Zutripro was the expensive brand name drug of the week at that physician's office; you can always tell when a drup rep has been in the area. Overall, it wasted the time of the pharmacy, the patient, and the physician. In addition, the pharmacy lost money because they are stuck with an expensive, open bottle of a drug that will probably never be dispensed.
I agree with what Whitney said this whole process of doctors being bribed and manipulated is not what healthcare should be about. As professionals we are here to help patients. Pharmaceutical companies, while it is their job to sale their product, I think it should be done differently. In the article it shows how the drug reps have classified doctors based on their personalities and charted a way to manipulate them and sell their drug to that type of doctor. This is a good example to see how this process of pharmaceutical sales has gone too far. I think that companies should look to other advertising tactics, but with many of those different options they again, must be regulated. For instance commercials, they can be very helpful, but also persuasive. So really all forms of advertising whether it is directly to the doctor or broadcasted through commercials should be regulated heavily.
Tighter restrictions on the pharmaceutical industry are a must. It cannot be left up to pharmaceutical industries to sway the opinions of physicians on which drugs are to be prescribed. The health of patients lies in the hands of physicians, and a physician who has their own priorities in mind will only jeopardized those patients. Federal imposition of these restrictions would be of best benefit in order to create a level playing field throughout the nation.
DTC advertising should also be regulated. Of course pharmaceutical companies are going to present biased advertisements in order to sway patients into buying their products. They only care about business. At least doctors have a piece of mind on the issue. Patients are completely vulnerable to fancy advertisements and can be easily swayed without knowing what is best for them.
Speaking of doctors and the medications they prescribe, posted below is a TED talk I recently watched. Ben Goldacre talks about “negative or inconclusive” research results of medications going unpublished and the effects these results can have. His talk goes to show how “shady” the industry can be.
http://www.ted.com/talks/ben_goldacre_what_doctors_don_t_know_about_the_drugs_they_prescribe.html
I agreed with most of the posts above about applying tighter restrictions on the amount of prescription information pharmaceutical companies are allowed to have access to because these information are confidential and pharmaceutical companies may take advantage of these information to enhance their business profitability. However, I did not agreed on the idea that the article portrayed drug reps as a cold-hearted person who only do whatever it takes to sale drugs. These drug reps are in a business environment making something for a living. There should not be any hasty conclusion on how they should perform or do their work. Also, the last call to prescribe any medications always lie in the hand of the physician as the articled noted "..the physicians control access." The drug reps are there to provide information about new drugs that physicians may not know about yet. But, to prescribe it or not, is up to the physician. Also, if any physician that is easily manipulate or bride by these drug reps, then they should reevaluate their action.
I agreed with most of the posts above about applying tighter restrictions on the amount of prescription information pharmaceutical companies are allowed to have access to because these information are confidential and pharmaceutical companies may take advantage of these information to enhance their business profitability. However, I did not agreed on the idea that the article portrayed drug reps as a cold-hearted person who only do whatever it takes to sale drugs. These drug reps are in a business environment making something for a living. There should not be any hasty conclusion on how they should perform or do their work. Also, the last call to prescribe any medications always lie in the hand of the physician as the articled noted "..the physicians control access." The drug reps are there to provide information about new drugs that physicians may not know about yet. But, to prescribe it or not, is up to the physician. Also, if any physician that is easily manipulate or bride by these drug reps, then they should reevaluate their action.
- Tam Pham
I really don't feel strongly either way about the restrictions on the pharmaceutical industry, as far as the selling on prescribing information goes. I don't see a problem with allowing pharmaceutical companies access to that data, as long as it does not violate a patients privacy. If there is a problem with it from the doctor's side of things, then I would think that they should work to legislate the issue on their end. For pharmacies, it is probably advantageous to sell that information. As with much of this article, I felt like it applied to medical doctors rather than pharmacists; I don't believe that the issue of drug rep influence should have any bearing on a pharmacy practice.
With respect to the issue of direct to consumer advertising, I feel like much of this would just confuse patient's so it would seem like more of a hassle. Sure it would create some scenarios where a bothersome customer would feel like they can tell the pharmacist what they need, but this is already the case with commercials or other advertisements; for the most part, average patients have no idea what is going on with their medications or what new drug will mean for them. Anyway,the good customers would still be likely to trust the advice of their pharmacist even with the new information in-hand. And, once again, this issue would really affect prescribers rather than typical pharmacists, since we would not have too much of a say in the patient's therapy.
As for sample medications, they are effective in reducing costs for the patient for as long as they are given out and patients love them. Big picture, their has to be a reasonable cut-off point for samples or the drug manufacturers would not be able to make a profit. Thus, the short-term benefit of notoriety for the drug company must be balanced out by the long-term benefit of increased product sales. And I just really want my goodies and free lunches back.
- Jesse R Alvarado
In today’s society a Drug Representative will inform physicians of the various new drugs just released and often use various techniques to persuade the physician to prescribe this drug as often as possible. The benefit of a Drug Representative is the information he or she holds pertaining to the drug they are marketing, this information may be of great benefit to the doctor and many patients. However, often times the information the drug rep. has may not be complete or completely accurate ; therefore as a physician looking out for the best interest in a patient they should ask more questions to really test whether this product will be beneficial and if it will produce the results desired. Another issue with drug reps. include this bribery they have begun. I personally do not see how a drug representative who has never met any of a physician’s patients can assume they have a drug that will help so many of these individuals. If a physician feels the drug that was just marketed is in fact the best and most appropriate for their patient then by all means prescribe that patient that drug. However, when a physician is prescribing a drug because they just made friends with someone who asked them nicely to help them out by prescribing more of that medication, then there is a problem. I do understand Drug Representatives are in the business aspect of the world and they are trying to make a dollar. However, this is when physician’s needs to be held to higher accountability in making the choice to prescribe a medication that may be cheaper for someone and more beneficial versus a newly marketed drug that has high risks of side effects and ultimately is not the best choice for the patient. In the end, I am not sure we can argue is it right for drug representatives to bribe their physicians but how is it fair for the patient whose physician has a biased opinion. As a physician the interest should be in the patient, not in what gifts they may get from prescribing one drug over another.
--Jennifer Jones
I think that the pharmaceutical companies should be looked at more closely when it comes to their reactions with doctors. In theory, it would be great if there talks were more informative rather than persuasive. I also do not think they should have access to who writes what. If the doctors know they have access to this information it could put pressure on them. However, even with all of these tatics by pharmaceutical companies one would hope that doctors are choosing the best medicine for their patients no matter what.
Sample drugs are no doubt a positive for patients who are unable to afford their drugs. These samples allow them to have a few free months of dosing to ensure that the medication will work properly for its indication and save money off of the high Brand price. The same applies to discount cards for these prescriptions however these are continually getting more complicated to be activated, oftentimes needing internet access to fill out surveys about your usage of the drug. These hoops that are required to be jumped through in order to activate the card are oftentimes deterrents toward the elderly and cause much confusion, because the card says they "can get it for free, why do they need to call someone?" Pharmaceutical representatives are great to inform doctors on the release of new specialty drugs, however, there is very little need for continual visits after the initial knowledge has been presented. DTC advertising however, I cannot find any positives in, it oftentimes causes unneeded doctor visits and patients being convinced that they have diseases, through their own self-diagnoses from these television or magazine ads. The industry is on the way to being reigned in and regulated in positive ways by the government but as always there is room for improvement to better our healthcare system.
I don't really see pharmaceutical reps as doing anything wrong if they're trying to win over doctors with food, gifts, etc.. That is their job. They get paid to be good at their job and get medical professionals to prescribe for a particular medication. Reps are hired to get this job done whether it be with gifts or playing doctor's likes to the conversation. Samples really are good because there are some instances where doctors truly want to see if a medication works without prescribing a whole months worth of medication. There are also instances where my father has had to use samples because the doctor forgot to reorder his medication through mail order, so he wouldn't have it for a couple days and it was an important blood pressure medication. So those samples really did come in handy. There is one thing I despise about these medications though and that is the price associated with the actual prescription. If a sample medication was offered to a patient, it worked, and the doctor wanted to prescribe it then that patient would probably get a prescription. That prescription could be very expensive and the patient might not be able to afford it. There could be many different alternative choices of medications, but the doctor picked that particular one because of the drug rep. Now the patient can't afford their medication and has to wait for the doctor to change it. Samples and drug reps are still good though to an extent!
-Aaron Shaver
I think it is sketch that the pharmaceutical reps can check in on the prescribing habits of physicians. At first it sounded good in that they can find the drugs that doctors normally prescribe and provide details on why the reps drug is better. What i found almost immoral was the checking in on the doctors after visits. They gave certain gifts and then would go back and see if the doctor rewarded the reps in return for the gift. If the doctor was just trying to be a moocher and get free things the rep doesn't see them and other reps are warned. This to me seems wrong, as it basically was stating that hey I gave you a gift so prescribe my medication even if better or cheaper options are out there. To improve this maybe have the reps be able to see the general profile on drugs but not be able to see the exact drugs that he prescribes, especially the drug the rep is representing.
Evan Medford
I believe there should be tighter restrictions on the pharmaceutical industry. I feel that there is too much bias influencing doctors’ prescribing choices, which is not necessarily always the best reason for prescribing a course of treatment for a patient, such as how many steak dinners the doctor gets from one drug’s rep, vs. the alternative drug’s rep. I think the FDA should impose these restrictions, so that it is consistent across the nation. That is only fair. I don’t agree with direct to consumer advertising of prescription meds, either because I feel that most consumers, who are uninformed/uneducated in most areas of healthcare and drug therapy should not be choosing what they should or should not be taking as a course of treatment from their doctor, based on a tv commercial or magazine ad. It just seems so backward. I can see how it might inform patients more on different options available, which is a bit of a checks and balances method to deal with doctors who might only prescribe one medication on a bias they have formed from one company. I don’t think sample meds are effective overall in reducing healthcare costs, because in the long run, less people actually get the rx filled, when they get some of their meds for free and then become non-compliant, or just beg the dr. for more free samples and this drives up the cost of those meds in general.
Evan Palmieri
Personally I believe that pharmaceutical companies and their representatives should be able to give out sample meds and monitor prescriptions being used. It is fine for representatives to take people out to lunch and little gifts as long as it doesn't go too far. When physicians start writing prescriptions just to get gifts from reps that is just unethical. Some physicians might start writing prescriptions for a certain drug more just because it is on their mind.
-Jay Billingsley
I have not considered the reason that prescribers seem to favor certain medications so much. However, it makes perfect sense that the pharmaceutical sales reps might be a little "too convincing," when it comes to selling their drugs. Doctor's should not be able to accept such bribes. Most importantly because some patients may not gain benefit from the exact drug that the prescriber has committed to writing for. It could be another brand that works for them. Perhaps pharmaceutical industries could advertise to public crowds of patients AND health care providers. That way, the advertising can be more patient-centered. With a more patient-centered approach, I would say there wouldn't be a need for any restrictions on the drug companies and their sample medications.
I feel that the swaying of physicians to prescribe a particular medication by a drug rep is not in the best interest of the patient. Like the article states, drug companies want physicians to prescribe the most expensive drugs, which is not convenient for any patient, pharmacy, or insurance company. The only reason a drug should be prescribed is because it is in the best interest of the patient and the doctor genuinely thinks the drug will help the patient. Would it be acceptable for a stranger to walk in the pharmacy, become friends with the pharmacist and then ask the pharmacist to give them a bottle of a medication that they don't have a prescription for? No. So why should drug reps be allowed to sway physicians to only prescribe for a certain medication. I do believe sample medications are convenient when physicians aren't sure if a medication will work for a certain patient and those should not be inhibited.
I feel that pharmaceutical companies should be able to help promote drugs, but not necessarily monitor physicians scripts. They should be able to give samples for testing and shouldn't try to force their hand. I feel that when they promote drugs they can help educate patients about certain drugs including the side effects. For example the commercials you see on television seem to be very educational even though they are meant for advertising purposes. These commercials actually spark the patients' interest and allows the doctor or pharmacist to finish explaining the product to the patient, and let them know if it is right for them. I also feel that some extra perks here and there aren't too bad as long as they aren't too much, and as long as the doctor makes the right decisions for the patient in the end. - Nicholas Locklear
I believe that there should be tighter restrictions on these companies and their methods of tracking and appealing to the prescribers. I think that the focus on the wrong points of the physician's work would cause them to write more unnecessary prescription in order to get the gifts and the samples. This would cost the patients more in the long run. Also in costing the patients more, they will promote these expensive brand names that may not be covered by their insurance so they cannot afford it. This may cause them to not take their medication like they should which will hurt them down the road. The advertising simply exposes the patients to the medications and that is about it. I personally don't pay a lot of attention to commercials and pamphlets on medications and the doctors don't really explain too much about it either.
I agree with Irina, I believe that the reps of these pharmaceutical companies should try to educate their clients on important drug information. However, I feel that bribes and incentives to sell certain medications over another brand are unethical. When money is involved it is easy to get caught up in this but when the patients are the number one priority, these incentives and free samples should not persuade one to choose a product over another.
I believe although samples are a great marketing device, and give the patient free medication, which everyone would enjoy, however I don’t believe that the long term effects are going to be beneficial to either party. The drug may be great and the patient really likes the effect, however cost will probably detract the patient from purchasing and they will go to a cheaper alternative, which they may or may not be happy with. Also, because the patient isn’t purchasing the company did not receive money either. As far as pharmaceutical companies and drug reps, I agree with Sarah Leonall when she said “it would be great if their talks were more informative rather than persuasive.” This way, the doctor would be receiving the facts about the drugs, rather than how the doctor himself will benefit.
-Brittany Rector
Pharmaceutical companies should be allowed to give out gifts to doctors but they need to change their focus from selling drugs to educating clients on drug information; Doctors also play a role in this. Doctors need to stop thinking pharmaceutical representatives are just gift-givers and think of them as a way to gain more knowledge on drugs. When prescribing medications, doctors need to keep the patients health and well-being in mind instead of the gifts.
I believe that medication samples do improve costs for the patient in the short term but they also create a sense of false security for the patient. Once the samples of an expensive medication run out and a patient goes to get the rest of the prescription filled, the price may be well over $100. The patient may choose not to get the prescription filled and they will have then defeated the purpose of going to the doctor in the first place and being diagnosed with something. I feel that if physicians did not provide samples then patients would learn not to rely on them as much. Instead, it would be better for the physician to let the patient know upfront about the cost of a certain drug so the patient would not be shocked when they go to fill the prescription. If a drug that the physician wants to prescribe is too expensive for a patient, then an alternative should be found right then before the patient leaves the doctor's office.
As far as pharmaceutical companies go, I believe that they should not be able to bribe physicians with samples and gifts. Although healthcare is still a business, the ultimate goal of healthcare is to provide the best possible care to a patient. Whenever you have pharmaceutical companies bribing physicians to use certain drugs more often, they may prescribe a drug to a patient that is not neccessarily the best drug for that patient healthwise and costwise. When pharmaceutical companies interfere with the healthcare system by issuing bribes and free samples, it can compromise patient care.
Eric Kinzer
I don't really have a problem with sales tracking. That is very important information for drug reps to know so they can target sales for certain places. Gifts to "high prescribing" physicians are also not a bad thing because it encourages the physicians to prescribe even more. As long as the drug reps can prove that their drugs are better than the competitors and will work best for the patients, then why not encourage more prescribing? As long as the patient remains the central focus in all of this, then it is ok. The drug rep and the physician need to keep the patients treatment needs and therapy in mind in the midst of all this.
-Jessica Osteen
I believe that there should be more regulations to the influence of pharmaceutical representatives on physicians. The influence of pharmaceutical representatives can shift the focus on the patient to sales and thus take away from providing the best care for the patient. Medication samples may save the patient money in the short term, but because the samples are usually for medications that do not have generics, they do not save the patient money in the long term. There should be more federal regulations that prevent pharmaceutical representatives from providing physicians with incentives to prescribe their medication.
Pharmaceutical commercials are not very helpful because they put too much stress on Physicians to prescribe them to their patients. I think that the Doctors should have a system of keeping up with newly developed drugs and so they should prescribe them as needed and not just because their patients are asking for them.
..Vida Ohene Agyeman
By providing gifts and taking physicians and pharmacists out to dinner, it gives the impression that drug companies are only trying to win the trust of the these individuals all for the purpose of making connections with them. It seems like it's all about the money that they could potentially make, rather than the actual benefit of the future patients who will take the drug. I understand that they are producing drugs that could be beneficial, but I think that the method to do this shouldn't be so suspicious and staged.
I honestly don't have a strong opinion one way or the other regarding the distribution of samples by pharmaceutical companies to physicians. In terms of restrictions, however, I would plead with any regulatory organization that would possibly inhibit this process to please make any limits self-imposed. While all human beings are vulnerable to being influenced by their subconscious, practicing physicians operate from one of the highest places of honor in our society and I think it is well within their scope of decision making to ensure they aren't influenced by marketing ploys from sales reps and put their patient's interest first. Pharmaceutical companies aren't all bad, either, and I would in fact argue they are an integral facet of our healthcare system. Oversight might have some positive consequences, but it could also prove to be completely unnecessary.
i agree that physicians as leader of healthcare professions must put patient care into their priority. However, when it comes to pharmaceutical industry, it is business, and its goal is to make profit out of marketing drugs. Gifting and lunch from drug reps are not such bad behaviors. In order to have it as win-win game, physicians must try their best to prescribe patients with best cost effective medicines while drug reps are trying their best to market their new sample drugs to their physicians. Physicians must have enough research about the new drugs from pharmaceutical company so that they can make their own decision that leads to the best patient care.
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