blog.bioethics.net

So, just to push as devil's advocate, if the people doing the sales/marketing were trained MDs, would you feel differently?

- by Kelly on Feb 19, 2007 at 9:19 PM | link

I hope that doctors are smart enough to do their own research into drugs before using them. Sales reps do have a valid purpose: they give doctors the heads up they need to learn that there is a new drug out there. Many doctors don't spend their days reading medical journals for newer and better drugs; they spend their time treating patients. Sales reps are just the initial step in the complicated process that decides which drugs (if any) to prescribe when.
[Disclosure: I spent the past two summers working for a U.S. pharmaceutical company performing back end support for the sales force.]

- by Andrew on Feb 20, 2007 at 3:33 AM | link

To add to Kelly's question, the issue gets more difficult, for example, when dealing with the sales force for some kinds of medical devices, like pacemakers, where the sales team often as advanced engineering degrees and assists the physician with placement. Arguably, there isn't such a neat division between marketing and technical knowledge in that case.

- by Daniel on Feb 20, 2007 at 1:03 PM | link

And don't pharmaceutical and med equipment companies sponsor innumerable conferences that bring together many experts in the field? Much of that is self-serving but they can't control the interaction and synergy that may not lead to higher sales

- by robert b on Feb 20, 2007 at 4:26 PM | link

I don't think the argument is that there shouldn't be any contact between any representatives from pharmaceutical companies or device companies and physicians. Certainly some people in those companies could be quite valuable in disseminating information at times. But none of the interactions require free meals, free materials or other goods/services/items to change hands.

- by Chris on Feb 22, 2007 at 1:25 PM | link

Chris - when I take someone to lunch for a business meeting, 8 times out of 10, I buy. Most of the time, when I get asked out to business lunches or dinners, the person doing the asking/arranging buys. Likewise, people in all avenues of business and academia get paid/reimbursed for their time at conferences, lectures, and other events.
Is this then something that should stop in all avenues of academia and business? If the concern is really undue influence because of the nature of a human response to gifts, why aren't we focusing on freebies in general?
(And I really want to see how academia would function if it all went brown bag, no more free lunch...)

- by Kelly on Feb 22, 2007 at 11:11 PM | link

I would hope that any doctor talking with a sales rep for a drug company wouldn't buy and use the medication before researching it him/herself. I am sure a physician would not take that kind of a risk. Sales reps are a good information tool. They are able to get the information to where it needs to be.

- by Mary Beth Logan on Feb 23, 2007 at 4:37 PM | link

I don't think there is anything wrong with getting gifts from the sales reps- but wait does this mean we aren't going to get the pens anymore? The sales reps that are marketing their product to the doctors are usually assigned to only a few drugs. In this notion they are usually familiar with most of the formulary information. Does that mean they know what that means? No but the doctor should have a clue, that is why they are doctors. If the doctor is interested then that would be their responsibility to look further into the information. Futhermore if someone wanted to take me to lunch to try and sell me something more power to them, if I like the product I'll consider buying it. If I don't I still got a free lunch.

- by H Stetz on Feb 23, 2007 at 9:55 PM | link

Taking someone to lunch as a matter of collegial interaction is one thing. For instance, a visiting professor who comes to give a talk is an excellent example of a person who one probably ought to take to lunch or dinner.
But when you're talking about someone whose job it is to sell pharmaceuticals giving free things (lunch or anything else) to people whose job it is to care for patients, including potentially prescribing those same pharmaceuticals then it is no longer a collegial relationship but a sales pitch in which the seller is buying the sellee's time.
So, to the question in your second paragraph I think we should focus on all freebies; they have no proper place, at best they're neutral and more than likely they cause harm.
I wouldn't extend the "no free lunch" to all of academia because I don't see this as an "academic" problem (pun very much intended). A free lunch to get some grad students to turn up at a lecture is buying time, sure, but its not buying the influence to push medications in ways that might not be beneficial overall.

- by Chris on Feb 24, 2007 at 3:50 AM | link

I would think that these representitives would have some kind of knowledge base of the pharmaceuticals they are peddaling. I also would have to agree with Andrew, The doctor would surely do his/her own research into any medicine they prescribe. But as Andrew stated the docs are busy with the daily grind of seeing pt's and treating them. The drug reps could be giving these doctors a heads up as he says to what is new and improved on the market!!!

- by R. Phipps RN on Feb 24, 2007 at 6:32 AM | link

I forgot to post regarding the giving and recieving of "gifts" when the drug reps meet with the doctor. I dont' think it is called for, but if the drug rep wants to "treat" the office staff with lunch or breakfast goodies, that is fine. But as far as anything extensive and expensive, forget about it!!!!

- by R. Phipps RN on Feb 24, 2007 at 6:36 AM | link

The real question to be asked/answered if you want to say that "freebies" are ok or that a free lunch or free donuts are ok is: why? What does giving out free stuff of any kind do to enhance or improve the ability of doctors or a doctor's office staff to provide medical care to their patients?
Simply because it has been done doesn't mean its a good idea or a good system.

- by Chris on Feb 24, 2007 at 1:17 PM | link

My friend works for a group of oncologists, she's informing me of the great food that is bestowed upon the office for utilizing their pharmacological samples and promoting their product. I'm sure the drup rep is educated regarding their product. But, why all the bribing, talk to the physician, give your information and samples, then leave.

- by nancy on Feb 24, 2007 at 5:12 PM | link

I work for a large group of physicians and free lunches are common and I see nothing wrong with them, except that it adds to the cost of the medicine itself. The drug reps are out there to provide information on new and improved medications that could benefit patients if the doctor prescribes them. The freebies are a way for the drug reps to "remind" the doctor of their product when they are not standing in front of them telling them how successful drug trials have been. Overall, the majority of the drug reps that I have dealt with are respected by the physician as a source of information. They have the knowledge to explain to the physician the expected actions of the drug, side effects, etc and it is up to the physician to prescribe it to their patients. So even though the drug rep is peddaling their products through sale pitches, it may benefit some patient out there that is thankful that the drug was brought to the doctor's attention. On the flip side of that, I am not convinced that the drug reps are concerned with patient care and comfort but are forced to analyze sales and profits for the drug companies they work for. Afterall, healthcare today focuses on the mighty dollar over the patient in many aspects of care so are they really committing some atrocity or just blending in with the system?

- by Lisa (Gearhart) Campbell, RN on Feb 25, 2007 at 6:21 PM | link

Art, I totally disagree with you. The procedures we perform are complex and the advances in technology help make our job a little easier. I rely on the company rep. to inservice me on any new piece of equipment. Many of our company represenative have had extensive training for their product line and are fully qualified to educate physicians and nurses in its use. Sure some reps. are pushy but we have the ability to try out different technology and pick and choose what works best for us. Give the medical community some credit, Our decisions are not based on who brings better pen.

- by gigirl on Feb 25, 2007 at 9:52 PM | link

I can certainly understand the concerns of this treating docs and their staff to lunch/dinners. There certainly is the possibility of abuse here. In the one office I worked in, the reps had to buy lunch to have a chance to speak to the doctor/staff. They were not allowed to see the doctor in an appointment slot. (loss of money for the office) On the positive side, most reps come with data from recent studies not just "Pleeeeease order my drug so I can afford a bigger house". One very good thing from reps of newer drugs is the details on how to mix and administer the newer oncology drugs for the nurses.

- by Joyce on Feb 26, 2007 at 8:58 PM | link

How much does all of this marketing add to the cost of the drug? Advertising by pharmaceutical companies has exploded - are they rolling the cost of promoting their drugs to the masses into research and development costs? If that is the case, then the taxpayers are picking up the "free lunch" when drug costs are covered by a government subsidy.

- by rbilan on Feb 27, 2007 at 12:14 PM | link