Brody: Why Physicians Should Refuse to See Pharmaceutical Reps
It is all about the company we keep, writes Howard Brody in the current issue of Annals of Family Medicine, in what is easily the best and most straightforward, honest excoriation of the idea that physicians can see drug reps in their offices without compromising their integrity. Brody gives the question careful thought - and writes this piece directly to the docs who are doing the most interacting with drug reps: family clinicians. His conclusions are straight up.A majority of medical practitioners spend part of their time talking with and receiving gifts from pharmaceutical sales representatives (reps). Asked why they do so, most would initially be puzzled at the question. It is very likely that they have come to this place as a result of long-standing habit rather than conscious choice. Nonetheless, the decision to spend one’s time in this fashion has important ethical implications...The evidence available today ... seems conclusive on 2 points—first, that we are indeed heavily influenced by reps; and second, that we ourselves are very poor judges of the extent of that influence.10 To the extent that we claim to be scientific practitioners, we would seem obligated to take this evidence into account in deciding upon our proper professional behavior.
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Pharmaceutical reps provide doctors with hundreds of thousands of dollars worth of sample medications that are passed on to elderly and poor patients. The samples also give a patient time to have prescriptions filled. In other cases, the samples allow patients to try the first cycle before submitting the prescription, giving the patient an extra cycle of the drug at no cost. Doctors also receive updated information on drugs that many of them would not have time to learn in other ways.
- by J. Underwood on Feb 1, 2005 at 12:24 AM | link
All that for the low low price of bribery.
- by occasional tourist on Feb 1, 2005 at 1:01 AM | link
One wonders, really, do we even need the data on this one? If it doesn't work, why are they spending so much money on it?
- by anonymous on Feb 1, 2005 at 3:33 AM | link
No question it works. Underwood attempts the economic argument which Brody missed. But this is the main one my mentor in FP residency countered over 15 years ago. For the time spent with the rep, the Doc could earn more and provide the meds himself needy (if he uses economic sense choosing the best meds.)
- by Rob on Feb 1, 2005 at 8:51 PM | link
Drug pipeline is one of the most attractive titles in the industry. Everybody is looking for a complete and cheap source of data. The trick is you can get the whole pipeline for Glaxo or Pfizer but you cannot get the whole data for let's say diabetes. First you must search which companies do something in the area and then look for their drugs in development.
http://www.chartsbank.com/PipelineList.aspx
is a database with over 3 000 records of drugs in development of more than 600 companies. And guess what - you can have a subscription for half an hour that costs only 20 USD and 30 minutes is more than enough to find what you are looking for. So there is no necessity to pay lets say 500 USD for monthly subscription.
- by Kir Zila on May 5, 2006 at 12:22 PM | link
Samples are the currency that reps use for access (along with Bagels and Pizza). But reps are more than green college kids. Some are pharmacists or MD's and they do provide valuable data to physicians on new treatement options. Are there too many reps...absolutely...should doctors not leverage the knowledge of the pharmaceutical salesforce..that would be bad for consumers. There needs to be a better value exchange for the Physicians. The interactions must be more than just signing for samples or accepting bagels. Until then, doctors will be burdened with too many reps bringing too little value.
- by Greg on Jun 15, 2006 at 10:11 AM | link