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?
53 comments:
I do think there should be tighter regulations on the pharmaceutical industry. The goal should be improving the overall health of people instead of promoting drugs simply to draw in revenue. I think what bothered me most was the act of bribing prescribers. Prescribers have degrees; they usually know what it is best for the patient. Having a drug rep take them out to dinner and give them free samples will only create chaos in the pharmaceutical industry. Patients will receive unnecessary drugs just because they were free samples or because the drug rep was a friend. Another drug on the market could be more beneficial, yet the patient is unknowingly taking a less effective medication. To me, that violates trust between prescriber and patient. I do believe that samples can reduce health care costs in the short run, but not the long run. Samples provide immediate treatment to the diagnosis. However, that sample medication might not necessarily be the best medication for that particular patient if taken chronically.
I personally believe that our job as pharmacists is to look after the well being of the patient, and it is the job of the physician to prescribe the medicine that will be of the most benefit to the patient. I think that it is extremely sad that prescriptions get written just to receive lavish gifts from drug companies. I do believe that laws should be established that are more strict and monitor what doctors are prescribing. They should monitor whether or not a physician is writing for a certain prescription based on incentive or whether or not it is indeed the best possible medication for the patient. It saddens me a great deal to think about the amount of doctors that prescribe medications in order to receive more and more gifts. I also think that it is sad that the drug representatives pretend to befriend the doctors in order to get them to give out their product. As medical professionals, it is our job to look after the well-being of the patient, not just prescribe them a medication that comes with a gift. The amount of money spent by pharmaceutical companies each year to try and get their product sold is sad. There is a great number of people that cannot even afford their medication. Instead of spending billions of dollars on figuring out how to market a product, they should instead offer programs to help patients be able to afford their medications. As professionals, it is our job to look after our patient, and above all else that should be put first.
Amanda Bradsher
After reading this article, it left a bad taste in my mouth. I worked in a doctor’s office for over five years and to have Drug Rep. Shahram Ahari so foolishly outline the comments categorized in the table, it makes me feel as though I was merely a pawn in a mind game. However, I do understand this is how the pharmaceutical companies get physicians to prescribe their products. The way author Fugh-Berman presented this information clearly shows the disgust she feels towards the motives and tactics used by drug representatives.
Despite being offended by the position this article was written, I do not feel that there should be tighter restrictions on the pharmaceutical industry. They are not doing anything wrong. They are businesses using their resources to target their “gatekeepers” and tracking their monies that are being poured into the “advertising” aspect of their marketing. Direct to consumer advertising does create a more well informed patient and as long as the line is not crossed from persuasive education to high-pressure sales. We as professional medical providers must assume the responsibility of guiding the patient to take the best path to achieve optimal outcomes. This responsibility cannot be expected to fall on the shoulders of the drug representative since there are so many external factors that enter the equation for them. Ultimately, it is the prescriber that is writing the prescription so they must be held accountable for their motivations for writing it.
In the short term, sample medications do save the patient money and the insurance company money by saving them the expense of not having to eat the cost of a medication that quite possibly might not work for that particular patient. Sample drugs should be just that, a tester, not a definitive long term fix.
Ginger Pedersen
I agree that there should be some regulations established as to how extensively a drug could be pushed. However, I'm not sure how regulation would be established except for regulating the amount of money put into advertising of the drug. I don't feel like physicians should be bribed to use certain prescription drugs, but I do think educating prescribers about new drugs on the market and giving them samples is perfectly feasible. Physicians that prescribe medications solely for promotional reasons when another drug may be more beneficial is not an ethical practice. Providing samples to patients can reduce some healthcare costs as long as the use of samples aren't abused. If patients are constantly asking doctors for samples instead of getting their prescriptions filled I think could potentially drive costs of healthcare.
Katie Brooks
I believe that there should be a tighter restriction on the pharmaceutical industry. All sales reps care about is how much they sell and the amount of money they are going to make. They bribe the physician to but from them. They will go to any measure. For example the article said they will buy a golf bag for a higher end physician who could bring them lots of money. It should not be about trying to sell the medication to make money. It should be about the patients overall health. Samples can reduce healthcare costs but you have some people who abuse them because they cannot afford medication so they keep wanting more and more samples. That is going to hurt the healthcare.
Becca Giannetti
I don't believe that there should be tighter restrictions on the pharmaceutical industry. I know where I work at, Walmart, there is already a ton of restrictions. Many of them don't make sense and only make the pharmacists-patient experience worse and slow down the process. Patients today want their prescriptions then and now, not later and eventually. But if there were to be any restrictions I think they should be federal, so that every state would be similar. I think that DTC advertising is unnecessary. Patients should have to go to the Dr or their PharmD and ask questions. Many patients take what they see on Dr.Oz and then walk over to the pharmacy asking for it, and wanting Pharmacists to order them. Sample medications effect health care costs long term. If a patient goes ahead and tries a drug and it doesn't work then they are less likely to take it in the future.
Matthew Ryan Quick
WUSOP
DOPC2017
I think there should be a tighter restriction on the pharmaceutical industry. The sales reps are manipulative when it comes to selling the drugs and their primary goal is to make profit not necessarily about patient care. In the article it says “Physicians invited and paid by a rep to speak to their peers may express their gratitude in increased prescriptions” so in other words physicians get bribed to promote the drug within their circle of peers regardless of the effects to the patients’ health or wellbeing. I think it’s pointless to have self-imposed restrictions it would work better for there to be state or federal imposed restrictions on the pharmaceutical industry. Direct to consumer advertising may push the prescriber into giving them a medication but I think this would educate patients and in the end the physician has the right to choose whether they want to try out the drug or not. Sample medications will reduce health care cost over the long run but will increase health care costs in short term because patients and healthcare providers would be monitoring how well the drug works and if it works then in the long run its used more frequently.
Pooja Duggaraju
WUSOP
Candidate of Pharmacy 2017
I think pharmaceutical sales representatives need to respect the health of the patients. They need to simply inform the prescriber of the facts and allow the prescriber to then make the decision on whether that medication will be beneficial for their patients or not. I think free samples are necessary for some patients who need maybe a 3 or 4 day supply of a medication. Overall I do not think there need to be stricter regulations because prescribers should be able to make their own decisions on whether a medication would be helpful and a sales rep should have the freedom to employ their sales techniques. It's up to the prescriber to turn down bribers.
Jacob Gibson
PharmD candidate 2017
WUSOP
Improving laws will benefit the pharmaceutical industry. There should be certain laws which are federally based and then states and certain companies can impose their own laws as long as federal laws are upheld. When it comes to sample medications they should be monitored. I know on several occasions if it were not for sample medications I would have had to pay hundreds of dollars out of my pocket to treat my problems. Therefore I do not think they are all that bad. As long as the medication is being used for its appropriate indications and the safety of the patient is considered samples are beneficial. Overall FDA regulations help to ensure the safety of medications. As long as therapy plans have the primary objective to have the patient in mind and pushing a particular drug as a low priority, sample medications should be allowed and utilized.
Monica White
WUSOP 2017
I don't agree with how drug reps present themselves, nor do I agree with how heavily they influence doctors for sales; however, I don't think restrictions would effectively solve the problem. They will always find a way to push the sales of new, expensive drugs. Because doctor don't seem to be fully aware of how they are being influenced, I think that the first step to addressing the issue is spreading awareness. If doctors are at least aware that they are being bribed or persuaded, they can use their own judgment to put a damper on the success rate of drug reps. I don't think direct to consumer advertising really has big negative effects, so I don't think there is a problem with allowing them. Sample medications can be useful in the short and long term. Short term often helps the patient get treatment for little to no cost, and samples for long term disease treatment can be helpful in costs by letting a patient try an expensive medication before wasting a bunch of money on a large supply.
Taylor Peterman
There should definitely be tighter restrictions on the pharmaceutical industry. Restrictions should be imposed on pharmaceutical companies by the federal government. The pharmaceutical reps have a large influence on the prescribing of doctors. I do not believe that DTC advertising should be allowed. This allows patients lacking the medical knowledge that health care professionals have to self prescribe medications that they believe they need. 9 times out of 10 if you say that you want to try a medication in replace of what you are already taking the doctor will say okay. Doctors, just as pharmacist have to respect the patient’s autonomy. Sample medication can reduce health care costs, and I believe they can reduce health care cost in the long term. As long as the sample medications are given out frequently and not just at the start of a medication usage. If they are continually given out it could ultimately reduce the cost of the medication for the patient and the insurance company. There is a downside, being that most samples are higher priced medications, but if that is the only option for that medication at least the patient gets a few free doses out of it.
Robert Byrd
I think that the pharmaceutical industry is the business aspect behind the healthcare field. It would be impossible to counter the numerous drug companies and their need to try and “sell” their product to physicians, so the physicians can prescribe their products. Restrictions should be placed to make sure that the drugs and statistics they are trying to convince the physician to use are accurate and correct. Restrictions on the way the sales rep. persuade the physician can’t really be controlled, because they are just recommendations that physician will hopefully make. The physician does not have to use these drugs the drug rep. is trying to persuade them to use. Even after all the friendship and gifts, it is still the physician’s choice. The federal government should impose the restrictions so the physician can determine that the facts and statement given by the drug rep are accurate about the drug. This would prevent the drug reps. from twisting the data to help convey his point. I believe DTC advertising should be allowed, this gives the patient a choice and options on the different treatments they can receive. This might give the patient the option to research and try different treatments or medications. It can create a better-informed patient, because the patient can then research or be inquisitive about these new medication options. I don’t believe sample medications are effective in either case. Sample medications are just for a few days/doses and won’t treat the problem that drastically. The medication might need to be taken for a prolonger/longer time to have an effect, and to have sample medications, which will only be taken for a trial wont effective treat the medication. Sample medications can give the patient different options for treatment, but it can’t effectively treat the problem in the long term.
Chris Chu
Pharmacy is a medical profession. This means that we are here to benefit people to get better. Of course we are not here doing all this for free, but the pharmaceutical field should not be focused upon making huge amounts of money and that is it. Whenever drug reps get into the picture, they are there to sell an item, not for the better of the patient. The also are usually there to promote a brand new medication that is brand name. Brand name medications are always very expensive and don't have the option of a generic. If a patient gets a new medication prescribed, I do not see it right to automatically prescribe a Brand Name only medication when others that have generics are available in the same class that treat the same thing. A patient should always be able to try the cheaper alternative and see if it works before moving to the more expensive option. Ultimately the doctor is in control of this but I believe that the patient should have a say in this especially because some patients actually want the brand name right away. All in all, drug reps should not be playing a role in what doctors prescribe to patients.
Edward Plugovoy
WUSOP 2017
After reading this article and seeing input already given about the restrictions already being imposed I don’t think there should be tighter restrictions on the pharmaceutical industry. I feel they will always find some loophole to get on with things they way they used too. On the topic of DTC advertising I feel that there are some beneficial areas to it but I feel they need to include that a primary physician knows medicine and their patients in a way that they are giving patients the best care possible. It’s good to have an informed patient on medications but they should know that the physician is there to look after their patient’s well being and there judgment should be considered more valuable than a advertisement made to the general public. Now for the area of sample medications being effective at reducing the health care costs, I’m not sure I agree with that at all. Sample medications aren’t enough to do any good except see the effects they have on a few patients. I think they should use sample medications in widespread clinical trials and have enough of the drug per patient to see if it has a beneficial outcome for the specific condition. I don’t think sample medications are used effectively to reduce health care costs.
Matthew Thompson
I think there should be tighter restrictions for pharmaceutical industries, which should be enforced federally. I also think there should be a general taboo associated with marketing pharmaceuticals directly to doctors with the intention of “gifting” to encourage prescribing.
Patients who want to learn about different medications have the option of going to the pharmaceutical websites or to scientific publishing. They do not need to have biased commercials convincing them of the necessity of a medication that they have not fully explored nor understand from the medical perspective. I think this gives patients a bias toward medications that may not be relevant to their specific situation. Pressuring their doctor to put them on said medication just continues the cycle. Medication prescribing should be made based on individual patient assessment, not clouded by gifts or pressure from outside forces.
I do think samples should be given to doctors to help those customers who need to reduce some of their costs. For example, if a patient wants to try a medication over the counter that is very expensive, but is not sure it will work for them yet, then they can get samples to find out if the cost is worth the benefit of the medication. However, I don’t think doctors should receive gifts for handing out more prescriptions of the medication. If a pharmaceutical company wants to push its product, it should give all doctors samples, and if the drug is worth it, then it will speak for itself. There is no need to push doctors to write for certain drugs, unless you have no faith in your product to begin with.
I think there should be more restrictions on the pharmaceutical industry. I think the notion of bribery between drugs reps and doctors should be decreased. Although this allows the medical provider to become aware of the different drugs that become available, awareness should not be promoted by who can hand out the best pens or best golf bag to win over the medical professional. Patient care is more serious than materialistic bribery. Restrictions should be imposed. I think this should be done federally. That way, there will be no controversy from state to state. I do not agree with DTC advertising. I think patients are easily convinced or swayed especially by drug reps who have experience with selling their product. The common consumer may not have experience in the healthcare field and would have a hard time deciphering the information drug reps give them. Lastly, sample medications are helpful in reducing healthcare costs short term. But, if patients only use samples and never buy the non-sample, costs would increase long term.
Pharmaceutical industry should be tighter because it has a major input on the profession of medicine. The information that is given for the community should be monitored so that it wouldn’t cause any misunderstanding between the patient and their doctors. I believe the restrictions should be from the federal so that it can be the same through out the country. I don’t believe advertising will create a well-informed patients instead it might put patients on unnecessary drugs. Because when ever patients see these commercials they believe that they should get all the positive outcomes that do not usually happen in all case. This might cause a problem in the patient/ physician relationship. I think sample medications are helpful in reducing the health care cost in the short term.
Helen Nure
Doctor of pharmacy candidate, 2017
WUSOP
I feel that there should be tighter regulations on the pharmaceutical industry; however, I am not certain who should be responsible for implementing such restrictions. The article presented eye-opening information regarding the drug industry, as well as the influence of drug reps. I do not believe it is correct for doctors to prescribe certain drugs for alternate reasons other than the purpose of improving a patient’s quality of life. From the view that the article displayed, it sounds as if the free samples of a drug cause physicians to be more likely to prescribe that particular medication. Therefore, this could be a disadvantage for patients since doctors may become more biased towards certain medications or feel pressured to prescribe a brand of drug because drug reps persuade them to do so. Furthermore, the article brought to my attention how surprisingly cunning drug reps appear to be. Prior to reading the article, I thought that a drug rep would interact on more of a business level rather than creating a “friendship” with physicians. It seems that the false friendship that drug reps establish with doctors serves only as a means of increasing production, or in other words, it goes to show that money is a major incentive for the pharmaceutical industry. As for direct to consumer advertising, I feel that there are two sides to the idea. First, such advertising would undoubtedly make patients more aware of the medications available to them. This is a positive outcome since it is beneficial for patients to take part in and know of healthcare options. On the negative side however, advertisements may cause patients to become convinced that the presented medication is appropriate for them when it really is not. As suggested, this could lead to doctors becoming prone to give in to the medication desires of the patient.
Kimberly Pullium
Doctor of Pharmacy Candidate 2017
WUSOP
I think that there should be tighter restrictions on drug reps and/or physicians. I don’t necessarily think that there needs to be laws because I think that this is something that should be self-imposed by physicians themselves. Physicians should be able to see what the intentions of these drug reps are and avoid being influenced by them. I do not feel that there is anything wrong with drug reps meeting with physicians to discuss new drugs that have been approved to tell the physician how they work and show them the evidence to back up their claims. Providing free samples is something else that I am ok with. Any behaviors beyond that are controversial to me because it is essentially bribery to give physicians special treatment in hopes to get that physician to feel indebted to that particular drug company so that they will write more prescriptions for their drugs. I do not really think that there always has to be a law for people to do the right thing. As far as direct to consumer advertising goes, I do think that it should be banned. The power of suggestion is powerful and these advertisements do kind of get in the way of physicians doing their jobs. If we are going to let people self-diagnose themselves, then we might as well just get rid of doctors and let people go buy whatever medications that they think they need. This type of advertising makes it look like the healthcare profession is easy and straight forward. For example, most of these commercials are along the lines of “if you have this and that and sometimes this, then you might have this.” People are going to start going to the doctor and instead of telling them their symptoms, they are going to start saying “I have this disease and this other disease and I need you to prescribe this medication and that medication.” As far as sample medications go, I think that they do reduce health care costs in the short term because they are free. The patient doesn’t have to pay for them and insurance companies do not have to pay for them. However, in the long run, they could increase health care costs in a couple different ways. First, if the free samples are for an expensive brand name drug and they work for the patient, then the patient may insist on the more expensive brand name drug as opposed to a cheaper generic if one is available. Also, if the medication works well, the physician might just keep patients on the more expensive medication because they know that it works instead of switching to the cheaper generic.
After reading some responses I will have to agree that there shouldn’t be tighter restrictions on pharmaceutical industry. I think even if the government became more involved people would always find the gray areas to make deals with other companies and or doctors.
As mention I think we should band DTC advertising. I feel it causes more issues in doctor offices by giving individuals ideas of diseases or other issue they “think” they have. I work in a pharmacy and every day I see individuals who are on medications that they really don’t need to be taking. However, after watching certain commercials some individuals have convinced themselves that they need to be on a certain type of medication and bombard the doctor for that particular drug. If the patient at first does not receive the medication they will go to other offices claiming they have the symptoms. To some extent it may help the general public have an idea of certain medications they can take but I feel if you have a serious issue you should be speaking to your doctor about options and possible treatments. If you have a serious issue then you would take the time and research possible drugs that may help and then you can discuss with your doctor. I don’t think drug companies should be allowed to air commercials for medications.
As far as sample medications I think it cuts cost in the short run for the individual who would need to purchase the medication. If the doctor isn’t a hundred percent sure a particular drug will help the patient he can give the patient samples to save the individual money for the month. If the drug works then they know they can continue writing a prescription for that drug and the patient is on their own. Some individual may be tight on money and the doctor might give them samples to help with cost for that month. I do not believe samples will have a long term cost saving for the individual other than saving the individual from purchasing other drugs that might not have been as effective as the sample drug.
Anna Smaragdis
Doctor of Pharmacy candidate 2017
Wingate school of Pharmacy
This article is very eye opening, and I am appalled that physicians are influenced so easily, when they should have the care of the patient as their number one concern. Being bribed to prescribe certain medications that cost more will lead to patients not receiving the quality care they deserve, because there could be another medication that is actually more beneficial for them. I feel like making tighter restrictions will be beneficial and somewhat help control the problem, but I have to agree with Taylor that spreading awareness of this issue will be most beneficial as a first step. Direct to consumer advertising can be both positive and negative. It can allow the patient to become more informed about medications available to them, but it can also convince them that they need a certain medication when it is actually not appropriate for them. This will cause the patient to become persistent until their doctor will give in to prescribing the medication.
Summer Powell
Doctor of Pharmacy Candidate
WUSOP Class of 2017
After reading through the article, I believe that there should be limits to pharmaceutical companies as well as to what drug representative can do in order to instigate a sale. Let’s face it, a salesman will do just about anything in order to earn their commission, and in this case the representatives bribed doctors for their business. This act is simply crazy, and I believe that the cause of the entire problem would be the number of pharmaceutical companies that are out there. I think that if the FDA could eliminate a few, then the bribing would go down. The sample drugs that the representatives are bribing doctors with can possibly hurt the patient in the long run. I also feel that the patients are just tossed around like their worth is nothing when this act is going on between physicians and drug companies.
Dustin Webster
WUSOP Class of 2017
I personally believe there should be tighter restrictions on the pharmaceutical industry. These restrictions should be enforced federally as well. I think physicians and drug representatives both should be more closely monitored. It is the job of these drug companies to inform physicians about new drugs, not to provide incentives on their use. I also disagree with DTC advertising. This allows patients to self-diagnose and therefore places pressures on the healthcare field to prescribe such medications. I think sample medications could be helpful short term in reducing healthcare costs. This only applies however, if the patient continues on the medication longterm.
Jordan Grubb
Doctor of Pharmacy Candidate 2017
WUSOP
I do think that there should be tighter restrictions imposed upon on the industry. I don’t think that the reps are doing anything wrong. Reps and the training programs are just being smart. A doctor is an intelligent person that should be able to realize what is going on and not let that influence the way they prescribe drugs. However I do think that the companies should not be allowed to advertise to the general population. The general population lacks the knowledge to correctly judge if a medication will truly be beneficial or not. They see commercials with beautiful people, colors, and music and think that that medication must be the miracle they’ve been waiting for. I think that this should be made illegal on the federal level. I do think that this direct to patient advertising can have a positive side of educating the patient further. Ultimately this should be done by the doctor and pharmacist, and makes this advertising unnecessary. I think that sample medications can be useful in the short term. It could be something that is fixed with 1-2 doses, and if you could solve that for free. This could also be useful in drug classes that contain a large number of variations. The doctor could use samples to pinpoint the correct therapy before having the patient pay for all the different medications.
Mitch Speer
I forgot to post my name on my above post so here is my post again:
I think that there should be tighter restrictions on drug reps and/or physicians. I don’t necessarily think that there needs to be laws because I think that this is something that should be self-imposed by physicians themselves. Physicians should be able to see what the intentions of these drug reps are and avoid being influenced by them. I do not feel that there is anything wrong with drug reps meeting with physicians to discuss new drugs that have been approved to tell the physician how they work and show them the evidence to back up their claims. Providing free samples is something else that I am ok with. Any behaviors beyond that are controversial to me because it is essentially bribery to give physicians special treatment in hopes to get that physician to feel indebted to that particular drug company so that they will write more prescriptions for their drugs. I do not really think that there always has to be a law for people to do the right thing. As far as direct to consumer advertising goes, I do think that it should be banned. The power of suggestion is powerful and these advertisements do kind of get in the way of physicians doing their jobs. If we are going to let people self-diagnose themselves, then we might as well just get rid of doctors and let people go buy whatever medications that they think they need. This type of advertising makes it look like the healthcare profession is easy and straight forward. For example, most of these commercials are along the lines of “if you have this and that and sometimes this, then you might have this.” People are going to start going to the doctor and instead of telling them their symptoms, they are going to start saying “I have this disease and this other disease and I need you to prescribe this medication and that medication.” As far as sample medications go, I think that they do reduce health care costs in the short term because they are free. The patient doesn’t have to pay for them and insurance companies do not have to pay for them. However, in the long run, they could increase health care costs in a couple different ways. First, if the free samples are for an expensive brand name drug and they work for the patient, then the patient may insist on the more expensive brand name drug as opposed to a cheaper generic if one is available. Also, if the medication works well, the physician might just keep patients on the more expensive medication because they know that it works instead of switching to the cheaper generic.
Ed Svendsen
PharmD Candidate
Class of 2017
After reading the article, I think there needs to be tighter restrictions on the pharmaceutical industry but I don’t think that it should be government regulated. I think physicians themselves should be responsible enough to not put themselves in a situation where they “owe” a rep. There is nothing wrong with accepting a pen or something in that nature, but to accept personal gifts and to be in debt to a rep is nonsense. Physicians should be looking out for the patient when it comes to practice, not themselves and there so called friends. Direct to consumer advertising is wrong in my opinion. Every time my Mom sees one of those commercials, she thinks that is the medicine that will make her better, as if she knows better than the professional who has, not only a larger knowledge base, but a better understanding of the drug and how it works. Physicians need to be able to make an educated decision about which drug to prescribe based only on the facts and maybe a sample of the medication. When it comes to sample medications, I am all for them. They allow the physician to get an idea on how the drug is going to react in their patients. I think they are effective at reducing the costs in health care but only for a short amount of time. I have personal experience with saving money on sample medications when I had to take Flomax in order to help a kidney stone pass.
Steven Walls
Doctor of Pharmacy Candidate 2017
WUSOP
I am in favor of tighter restrictions on the pharmaceutical industry. The persuasion of physicians to prescribe certain medications could lead to decisions that are not in favor of the patient’s health. The goal of pharmacists and physicians should be to promote choices that benefit the patient. This goal is at risk when we allow incentives to have an impact on our decisions. I do think that DTC advertising should be allowed. I think it makes the patient more informed and leads to discussion between the patient and their physician. It might result in unnecessary medication use but my hope is that the physician will make a thorough, well-informed, and patient-centered decision. I think sample medications may be effective at reducing health care costs in the short term but not in the long term. I think they may increase costs by leading to the use of name brand prescriptions that are higher cost and may not be of best interest for the patient. Additionally, costs could be raised by implementing inventory control and utilizing appropriate disposal procedures for unused/expired samples.
Laura Bowers
Doctor of Pharmacy Candidate 2017
WUSOP
Michael Crawford
Doctor of Pharmacy Candidate 2017
I agree with what many of my classmates have said on this issue. I feel that trying to coerce prescribers into choosing a drug based on anything (relationship with drug rep, free trips, etc.) other than the patient’s overall well-being is immoral and should possibly even be illegal. The counterpoint to this may be “they are a necessary evil to help spread the word about new products to doctors who may not otherwise learn about them.” My rebuttal to this would simply be, “these doctors should stop taking the path of least resistance and learn about the new drugs coming on their own.” This would lead to overall better patient care because they would no longer be getting their information from a highly biased (and financially motivated) source and learn simple objective facts about the drug.
Going through the article, it just occurred to me that, I may have been written a prescription by my physician, not because it was a best prescription for me, but because he had been greased to do so. Having said that, I must say that I was amazed at the level of detailing employed by these sales reps, to make sure that their own drugs were prescribed by these doctors. The article implies that the advertises have a well-oiled machinery that stems from the system that has the consumer pay for the prescription while the physician controls access to it.
Surely, I do not believe that there is anything that can be done about the marketing and intense advertising employed by these pharmaceutical industries. It is the nature of the system. America is a free enterprise, where demand and supply define the market. In the end it is the survival of the fittest and pharmaceutical companies will go to any length to stay ahead of their competition, even if it means influencing physicians with “finely titrated doses of friendships.”
Adaobi Obika
WUSOP
Doctor of Pharmacy Candidate
Class of 2017
I do not believe that there should be tighter restrictions on Pharmaceutical industries, when it comes to marketing drug products to Physicians. Physicians should not let themselves be so easily coerced by representatives. They should have the presence of mind to look more into drug trails instead of taking the representative's word on the efficacy and safeness of their product. Additionally, a Physician must be sure that there are vouchers available for patients, and that a surrounding community pharmacy(s) have a fairly adequate supply of the drug before making deals with a representative.
My views on DTC regulations on the other hand, are different since you are marketing the product to the general public. My bias stems from encounters I have had with patients who are so convinced that a drug or product they have seen on T.V. and have no clue about, is the best thing for them.
Greg Hanseler
WUSOP
Pharmacy Candidate 2017
I do not believe that there should be tighter restrictions on Pharmaceutical industries, when it comes to marketing drug products to Physicians. Physicians should not let themselves be so easily coerced by representatives. They should have the presence of mind to look more into drug trails instead of taking the representative's word on the efficacy and safeness of their product. Additionally, a Physician must be sure that there are vouchers available for patients, and that a surrounding community pharmacy(s) have a fairly adequate supply of the drug before making deals with a representative.
My views on DTC regulations on the other hand, are different since you are marketing the product to the general public. My bias stems from encounters I have had with patients who are so convinced that a drug or product they have seen on T.V. and have no clue about, is the best thing for them.
Greg Hanseler
WUSOP
Pharmacy Candidate 2017
I believe that there should be tighter restrictions in the pharmaceutical industry, specifically in the area of drug reps and advertising. The main goal of a drug rep is to make money, and they will use several tactics and strategies to manipulate their targets into selling their product; they usually have no concern for the patient. Currently, drug reps are trying to influence prescribers to write prescriptions for the drug they are promoting through becoming "friends" with them and giving them free samples of the drug. Both of these things can bias a prescriber toward one drug over another, and the overall health and safety of the patient can be compromised.
I also believe that direct to consumer advertising should be banned. Consumers can often be tricked into believing they have problems or medical conditions that they really do not have, and they may try to bully prescribers into giving them a certain medication. This pressures the prescriber into giving the patient a medication they do not need.
As far as sample medications, they could save money when used short-term, but should only be used in this way. Sample medications are meant to be a good way to test how well a drug works in a patient,and they are not intended for long-term use.
-Trent Tysinger
There have been tighter restrictions placed on the pharma industry in the past decade than ever before. I think those restrictions are warranted and beneficial to patients. That being said, we as a nation need to let the dust settle around these recent changes in law before regulating the advertising of pharma. Long-term trends will begin to emerge within the next 5 years. The data from the upcoming trends as well as consumer preferences and safety should then dictate what steps are necessary to restrict the data even more. Also, with the upcoming changes in healthcare law due to ObamaCare, trends may shift. The states should be in charge of making their own laws about pharma. Also, pharma companies as whole should agree on ethics to abide by.
That being said, the statistic from the article, 1 drug rep. for every 2.5 practicing physicians, is alarming. Patients bullying physicians as well as pharmacists in to prescribing and filling medications is alarming. The healthcare industry needs to be respectful of patients' autonomy; however, doctor and pharmacy "hopping" to get certain meds is not in the patient's best interest. A better database for tracking patient's and their prescriptions as well as training for prescribers and pharmacists on how to handle a "strong willed" patient is necessary for society as a whole as well as for individual patients.
I think DTC advertising should be allowed but healthcare providers need to do a better job of educating their patients. I am for an informed consumer as well as an informed patient. It is difficult for healthcare providers to navigate through the large amount of information and data available about prescription products let alone for a consumer. Therefore, HCP need to be better informed and they in turn need to relay the necessary information to their patients. MOST patients will respect their physician's opinion with regards to their health. A strong willed patient's bullying should not be enabled.
I would be interested to see data on the cost to pharmaceutical companies for providing samples to physicians because ultimately the costs of the medications production, advertising etc. is covered by consumers/patients. I know the money spent on advertising is HUGE and as this article mentioned points out, pharma drug reps are everywhere as well. It would seem to me that to most patients, who probably are unaware of how much money goes in to the development and marketing of a drug, it would seem cheaper to them to receive samples of medication at least when initially starting a drug therapy. However, I think looking at the big picture it seems that the costs associated with pharma companies paying for advertising and drug reps to get those samples in to physicians hands is costing the patients/consumers more than what they are willing to pay in the long term.
Kristin Payne
WUSOP Class of 2017
When it comes to the realm of advertising I think that there will always be a slippery slope of what is allowed and what is not allowed. I do however believe that DTC advertising is manipulative in many ways. I think that the consumers will have a harder time understanding the drug adverse effects and the pathophysiology compared to trained medical professionals. SO when it comes to DTC advertising I think that their should be some federal regulation. Giving out samples should be minimized to some drugs that have a short term effect and are not meant to have a lasting effect on the body. When it comes to reality I believe that it will be hard to pass a law on marketing of drugs but it may be possible in the future.
Charles Whisnant
WUSOP class of 2017
After reading the article, I believe there should be tighter restrictions on drug companies interactions with various health care professionals. It seems pharmaceutical companies are not based around patient-centered practice to ensure patients receive the most appropriate medication. It is about promoting the most expensive, most popular drug at that time to earn their commission. They will go beyond limits to sell as many drugs as possible. I am shocked that physicians are letting pharmaceutical companies influence which medications they prescribe their patients. It should be about the patients receiving the highest quality of care and which medication is most beneficial. Physicians should make their own decisions based on the patients’ diagnosis at hand. However, I do believe DTC advertising should be allowed. It allows the patient to be informed of the medications they are taking and educate them as well.
Paige Childers
WUSOP
Doctor of Pharmacy Candidate 2017
Restrictions should be placed on pharmaceutical industry but I believe it should be self-imposed unless this presents an issue. Then it would be ideal for the state to provide those restrictions and provide an organization that enforces those restrictions. Additionally I believe that direct consumer advertising is a complete waste of money. This sort of advertising should not be allowed simply for the fact that it does not completely educate the public on the said medication being advertised. It simply points out the main indications that it is used for without describing any contraindications. This gives the public a false sense of knowledge when it comes to medication that must be corrected by their physician or pharmacist. Furthermore I believe providing the public with this incomplete knowledge cheapens any profession involving medication. As for sample medications they are simply a marketing ploy. I believe they serve no benefit to anyone because sooner or later people will be responsible for paying for those medications and they won’t look as enticing.
Kim Coe
WUSOP Class of 2017
After reading this article, I think that maybe there could be a few restrictions placed within the pharmaceutical industry. The whole bribery and “gifting” between drug representatives and physicians should probably decrease. Also, there needs to be some way to make sure that the drug reps are telling the complete truth and not exaggerating or lying about anything. The physician gets to make the call on whether or not to use these drugs so I don’t believe that there should be too many restrictions. I can see where the bribery may make the care of the patient not be the physician’s number one concern. With the sample drugs, I do not think that they are very beneficial. Many drugs take time to work so just samples will not do anything.
Courtney Harrell
WUSOP 2017
I do not think there should be tighter regulations on the pharmaceutical industry. This article makes reference to bribery of the doctors by pharmaceutical reps. I feel that as a professional, whether it be a physician or pharmacist, it is our professional responsibility to do what is best for the patient. No matter how many more laws are added to try to regulate bribery and corruption, a corrupt person will always find ways to bend the rules and get over on the patients. As far as samples, I do think that samples are helpful in determining if a certain drug is effective for a patient. Sometimes patients are prescribed medications that are too expensive for them only to find out that they do not work. Finding out that they are not working for the patient saves cost.
Roslen Bell
I think that there should be some tighter restrictions because the drug reps seem like they are going way out of there way just to sell off a prescription to a physician. This doesn’t necessarily help physicians be on the same page of what the best drug is to use for a patient. I don’t necessarily feel like this is always patient centered when drug reps are sometimes trying to buy the physicians, although not all physicians are like this. I think that there needs to be some uniformity within the industries. I think that the physicians are being bought in a sense for what the physicians are going to say yes or no too.
I think that DTC advertising could lead to people thinking that they have something when they really don’t have it. I think the way the DTC advertising is directed towards patients can be misleading as how certain advertising is perceived to someone. I feel that advertising maybe beneficial in some cases when the physician has run out of a few options of what works for a patient and the patient sees an advertisement. Other than that scenario, I think that some patients think they know what to prescribe themselves better then the physician.
I think they are effective in the short term because the patient can use a sample of the medication to see if the drug works but as it stats in the article that most samples being given are the more expensive drugs and patients usually end up getting that prescription because the physician went with that drug representatives drug. I think in the long run the costs can become more then if the physician prescribed and went with a less costly drug.
Kelly Fuhrmann
WUSOP
Doctor of Pharmacy Candidate 2017
I do believe that there should be more restrictions placed within the pharmaceutical industry. The main goal of any health provider should be to make sure the patient is being diagnosed and treated properly to improve their overall health. It is sad that there is bribery between drug reps and physicians. It just shows that their main goal is to make more money, not improve the quality of health of the patient. This bribery should be monitored by the physician himself, and then doubled checked by collogues. A physician should have the responsibility to do the right thing and not accept bribery. However, if they are, the problem should be brought to up higher authority. DTC advertising can be manipulative to the patient and does not always inform them as well as it should about the drugs. It sets up a pretty picture of how taking the medication will make your life better; however, the diagnosing doctor is the one who should be able to determine that. The consumer may hear about a new medication, but I do not think they will be better informed about the drug. The physician or even pharmacist can better understand the way that the drug works and what sort of patient it will be most beneficial for. However, I do feel that is good in a sense of getting the word out about new medications and rising questions from the patients. As for the sample medications, I think they can be effective to help with cost efficiency. The patient can make sure that they like the mediation before paying for a prescription for it. I do think that they need to make sure that the drug would be covered on insurance when they do eventually need the prescription for it. The type of sample drugs should also be monitored.
After looking at the article posted, I do not think that there should be tighter restrictions on the pharmaceutical industry. Although the drug reps are trying to sway the doctor to use their product, they are not solely to blame if the doctor isn't open-minded about other drugs after you have talked to them. The drug rep is simply doing what he/she was hired and trained to do. The prescribing is ultimately the doctor's responsibility and if they are willing to always prescribe one drug just because they've been told by a drug rep that it's the best, that is on them. If there are restrictions in place, they should be self-imposed by the doctor because they are selling themselves short of everything they went to school for if they do not always look into what is best for each patient. When it comes to DTC, I feel that it is acceptable. Personally, I see that a DTC is just another advertisement and it does not mean that the drug is always effective for everyone. I feel that it broadens a patient's idea of what medications are out there for a certain condition. This also, could lead to some patients persisting on the doctor writing a prescription for the medicine they saw on television but once again, it is the doctor's integrity that is on the line when it comes to prescribing the medication that a patient sees on television. In the short term, drug samples may help some patients health care costs because they get medicine for free for a little while. In the long run, though, it could increase a patient's health care cost because in some cases, the brand that they were getting samples of are very expensive and not covered by insurance.
Andrea Huneycutt
Doctor of Pharmacy Candidate 2017
Wingate University School of Pharmacy
I think that drug samples can be beneficial for patients. It allows them to try out a medication before having to pay out a lot of money. If the drug doesn’t work for them they’re not in the negative. I had to buy a prescription for my son for his allergies that turned out not to work at all for him. It would have been better to try the drug out to see if it worked before having to pay for something that potentially doesn’t work. I do think the direct to public advertisement may be a bad thing to the public. I always see the commercials for Abilify. They tell the public they work along with your antidepressant. They practically convince the patients that if they’re on an antidepressant they should be on Abilify too. But that’s not true, so it misleads patients to thinking that they need something they don’t. The physician should know what’s best for the patient and I think those commercials are unnecessary.
Wendy Sanchezruiz
PharmD Candidate 2017
WUSOP
I think there a lot of problems that are associated with representatives targeting doctors to prescribe different medication. Doctors may be tempted to prescribe medication that is less effective simply because they are associated with a particular representative that pushes a certain brand.Direct to consumer branding by reprentatives I think is directly taking advantage of individuals. The average person is not going to understand all they need to know before taking a drug. There may be drug-drug, food, existing conditions that may cause adverse reactions that may be harmful to the patient. A pharmacist would not have a chance to counsel a patient and this is especially dangerous. Individuals may be able to introduce medication that is better for them to their doctor through direct to consumer advertising however, I think that the risks associated with that are just too high.
Brenda Simiyu
Wingate School of Pharmacy 2017
Sample medications can be very helpful in many cases, such as determining if an expensive drug will work for a patient before prescribing. There is a large population who cannot afford to pay for their medications, let alone pay for many medications while the physician is determining the best drug for therapy. Sample medications provide a free and cheap way for patients and physicians to find the prescription that works the best without having to pay a lot of money. It can also be extremely helpful for patients that need samples in between the filings of their prescriptions. When it comes to the pharmaceutical industry, I believe that tighter restrictions could help ensure better quality of care for the patient. With tighter restrictions, physicians might be more inclined to prescribe the medications that will better serve the patient instead of remaining loyal to a specific drug company. This can also mean that the physician can find a cheaper alternative for the patient instead of suggesting a brand name that is more expensive. A physician should not be swayed in their decision on a medication by the representative they support, but by the efficacy and fit for the patient.
Maegan Wells
Doctor of Pharmacy Candidate 2017
Wingate University School of Pharmacy
I think there is too much nonchalance towards medication in this country. A large majority of patients (or non patients) are non-compliant medicine takers or 'pill poppers'. Every pharmacy offers counseling on drugs and most people decline the help. We know that most physicians are incredibly busy and don't have much time to counsel patients on how to use the medication they prescribe. A lot of people don't bother to rectify this lack of knowledge and instead take their medicine however they want. I believe we are over medicated from young ages. Have a headache? Pop a pill! Have a stomach ache? Pop a pill! Have a cold? Pop a pill! Or drink some liquid. There is no concern for indications or even diagnosis. Have a cold? Are you sure it's a cold? Are you aware that the cold is a virus and antibiotics don't work? Have a stomach ache? Do you know what is causing it? So why are you taking anti-acids? Have a headache? Do you know what kind of headache it is? Is there a underlying cause for it like a tumor? Are you aware of the precautions of NSAIDs versus Aspirin or Tylenol? Personally I have been taking aspirin since I was six years old. That's ridiculous! Children shouldn't take aspirin right? Well no one told my parents that. So what's the point of my rant? I believe that sample medications add onto that nonchalance of medicinal use. I think that samples should be used in emergency cases only. Drugs are not candy, food, or something to be taken lightly, so why on Earth would we promote the sampling of drugs like we would frozen pizza at Costco or Sam's Club?
Crissy Negron
Doctor of Pharmacy Candidate 2017
Wingate University School of Pharmacy
Sample medicines have both their pros and their cons. It is good because when a new medicine comes out, it gives the doctors a chance to try it out on patients to see its effectiveness. This allows a way for the patients to freely figure out whether or not a new medicine works on them without having to pay a large cost for a medicine they are not even sure will work. Alongside this, many medications (such as commonly prescribed eye drops like Vigamox) have no available generic, so they would be forced to pay a large cost for their prescription since insurance does not cover much on brand names. I have personally seen patients pay nearly $200 dollars for a single 5mL box of eye drops. If they were available as samples, this allows the patient to get better therapy management.
On the other hand, there is the fact that this can cause bias in the healthcare field. Doctors may push a certain drug regardless of the patient’s needs, and this ultimately hurts the patient’s quality of life. It is hard to give an unbiased opinion when you are being given gifts, food, and basically being bribed. Drug representatives have personally given my pharmacy Dunkin Donuts, pizza, and Starbucks on multiple occasions. This is bribery and is ultimately just a money fiend drill, rather than worrying about a patient’s quality of life. The pharmaceutical business should be about bettering quality of life- not the weight of your pocket.
If more restrictions were put upon what a drug representative can and cannot do, I think this would higher the quality of care. If representatives could no longer give free dinners, food, and gifts then doctors would be able to give a more unbiased opinion. However, the free samples should still be available since this directly helps the patient and allows the doctor to see themselves the effectiveness of the drugs. While all of the free things are nice, that is not what the job is about. A patient’s health is far more important than the taste of a donut.
Karen Ross
Doctor of Pharmacy Candidate
Wingate University School of Pharmacy 2017
I think free samples is a great way for patients because it provides an opportunity for patients to try drugs to see if it will work for them as well as to make sure they do not have any bad reaction from the drug; this will save them money especially if the drug was expensive, but did not work or had a negative effect. Free samples are useful when patients have acute medical conditions that wouldn't be persistent; however, if patients have long-term medical condition, then free samples are not as beneficial. While free samples would save money that first time, in the long run it will cost them more money because free samples are usually brand name drugs, which are more costly than generic drugs. And if patients develop a preference for a brand name drug, then they will be less likely to switch over to a generic brand.
Sheng Vue
WUSOP
DOPC 2017
After reading this article, I don’t think there should have be tighter restrictions on the pharmaceutical industry. These samples are turned over to healthcare professionals and should be utilized by the physician only to benefit the patient’s current health condition. Therefore, it is ultimately up to the physician to determine under which circumstances it would be appropriate to give free samples to a patient. I have personally witnessed how free samples can benefit patients as they allow them to sample brand name products and to see if the effects are positive or negative. This allows the patient to determine if the product works before they pay out a large amount of money for a prescription that could potentially not work. Another benefit of samples is that it helps the physician to determine which medication is more appropriate as some disease states can be confusing when it comes to appropriate prescription dosing. Overall, I think that sample medications can be very beneficial as long as they are used appropriately.
Meagan Scott
WUSOP
Doctor Of Pharmacy Class of 2017
I think there should be tighter restrictions on the pharmaceutical industry. The laws should govern the restrictions of the industry. The laws would probably be better served as federal laws, rather than state laws. If the laws were self-imposed, they would not be enforced, and the problem would still exist. I do not think direct to consumer advertising is appropriate. The general public does not know enough about medications to “choose” their own. DTC advertising should not be allowed. Physicians should be able to suggest the best medications to their patients without any outside influences. Patients are not well-informed from a thirty-second commercial that they see on TV every so often. They may not realize that other medications could work better for them, and usually will be at a cheaper price. Patients may also see a commercial for a medication and decide they need it, when they truly don’t. Overall, DTC advertising should not be allowed. Sample medications can reduce health care costs in the short term, but probably not the long term. Most sample medications are of the more expensive drugs, instead of the cheap or generic drugs. These sample medications are given to patients, and if they like the drug, they will want to continue it. This creates a problem if the medication is expensive, and a generic could have been prescribed instead. In the long term, it may increase health care costs.
Jordan Richmond
Doctor of Pharmacy Candidate 2017
Wingate University School of Pharmacy
Medication commercial is becoming pretty popular at the moment, and sample medicine is something that physicians or pharmacists have to deal with everyday. When I volunteered at retail hospital and retail pharmacy, I have had a chance to see how pharmacists or physician get these sample medicines, counsel patients on using and provide information about adverse effect. Personally, I do not see there are any wrong to adverstise new drugs that just come out the market, because it does take up time for pharmacist or phycisian to come out and listen to them to advertise a new medication. I consider there are both cons and pros when using sample medicines. It is good because pharmacists have chances to find the best new medicines and see their effectiveness that could improve patient’s health and also help patients pay less. Then, they can advertise these new drugs for other patients, counsel them on using or adverse effects. However, the only thing annoying about this situation is a patient could go in and ask either why they did not get that medication or just simply want to try out the medication without consulting with the pharmacist or physician. I also see there are many side effects when people try to use the sample medicine.
Thuy Nguyen
WUSOP
Candidate of Pharmacy 2017
Honestly, I don’t see how regulations could be made against a large company; therefore I don’t see tight regulations being necessary. They are a business offering products that need to make money just like anyone else. It is up to the physicians and other health care providers to be able to recognize when they are being manipulated. In the short term, sample meds at a doctor’s office can help patients save hundreds of dollars on a small eye drop or help dramatically in emergency situations. However, if the medication is for long term use, then the sample medication would be detrimental because the patient only has a sample and they don’t know if their insurance can cover the actual medication. Then, they would have to change prescriptions, which they haven’t been on, and it might not work. Doctors need to be informed about the medication effects and typical duration of therapy. No matter what, the drug rep is always going to woe the physician. Some physicians will only push a certain drug because they are so enamored with the drug reps; it almost seems like the regulation needs to be on the physicians! If there are any regulations, I think it should be federal so that we have an even playing field. The states need to be more in tune with the same laws and regulations.
There should not be more regulations placed on pharmaceutical industry. Physicians should have the sense not to give away boatloads of free medications. This is not just a safety issue, although that is definitely part of it, but it is also an issue of professionalism. Physicians should not be attempting to fill prescriptions. Especially not without knowing what other medications that patient may actually be taking from other physicians. Nevertheless, safety is the biggest issue I see with this. Patients should not have tons of sample bottles of free medications to be taken without needing refills. If they were to add another medication, and a pharmacist did not know about those samples, the patient could suffer a life-threatening drug interaction.
Michael Russell
WUSOP Doctor of Pharmacy Candidate 2017
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