The impact of pharmaceutical reps on physician prescribing
Thursday, June 29, 2017
The practice of "detailing" is designed to provide physicians with an incentive to prescribe certain drugs or at least give consideration of the latest drugs on the market. For many years, this has been an observed standard of practice across the U.S.
Detailing can involve pharmaceutical sales representatives providing physicians with drug samples or gifts as a means of getting through the door to promote their company's new drugs on the market.
A recent study conducted by a team of researchers at University of California and Carnegie Melon University and published in the Journal of the American Medical Association illustrates how detailing influences the prescribing behavior of physicians.
For years, members of the medical community have been concerned about how detailing can play a significant role in the prescribing patterns and behaviors of many physicians. At times, there may be the tendency to learn toward the selection of drugs that are more costly but do not demonstrate therapeutic superiority over less expensive agents.
Furthermore, detailing has become widely recognized as one of the most impactful forms of pharmaceutical company marketing. This is the primary reason why a substantial amount of money is spent on these visits of doctors' offices.
As a result, hospitals, healthcare institutions and a number of practices are starting to take steps to limit or even prevent sales representatives from discussing the latest drug products from their respective companies.
The study analyzed how placing restrictions on pharmaceutical representatives' visits at 19 academic medical centers in five U.S. states affected prescribing habits. Researchers compared the prescribing habits of the 2,126 physicians at those 19 medical centers to 24,593 matched control physicians during the same period for 262 drugs in eight drug classes.
With the restrictions in place, the physicians changed from prescribing more expensive drugs to cheaper, generic drugs. While a definitive connection cannot be made between the existence of policies in place that regulated detailing and prescribing practices of physicians, it was noted that the presence of the detailing policies did decrease the market share of the drugs during the time of the study.
The patient care aspect of the practice of detailing by pharmaceutical representatives is one that should be analyzed, because this brings to mind whether selections are being made based on therapeutic appropriateness or influence by an incentive being in place.
For any prescriber, the decision as to whether the initiation of a drug should be a benefit or a risk to a patient must always be evaluated regardless of the presence of an incentive. The influence and role of pharmaceutical sales representatives and detailing practices must be recognized by all prescribers and taken into consideration when making any patient care decisions related to the initiation of any drug.
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