Physicians

PHARMA/PHYSICIANS: Attacking the Rx data stream

So perhaps this is getting serious. Doctors Object to Gathering of Drug Data

If the A.M.A effort succeeds, "legislators will turn their attention elsewhere, and the industry can hang on to one of its most valuable data sources," according to an article this week in the industry trade magazine Pharmaceutical Executive, which was co-written by an A.M.A. official and an executive with the leading vendor of prescription data. Even many critics concede that patients’ privacy is apparently not an issue, because the tracking systems identify only the prescribing doctors, not patients. But many doctors find the use of the data by sales representatives an intrusion into the way they practice medicine."These doctors were outraged that people came into their office and talked to them about how many times they prescribed a particular drug," said Dr. John C. Lewin, the chief executive of the state medical association in California, one of the states where complaints about the current system arose.  The California group is beginning its own program under which doctors who do not opt out under the A.M.A. system will get comparisons of their prescribing patterns in 17 classes of drugs from the data companies, said Dr. Lewin, who added that the program was being started as a pilot effort that he hoped would be extended statewide.

This latest dose of outrage is almost hysterical. In both senses of the word.

There are some doctors who are vehement in their opposition to drug companies. They won’t take the free lunch. There are some who take advantage. For most, they have a fairly neutral opinion of drug reps. But the concept of not allowing anyone to know their prescribing patterns doesn’t exactly smack of the transparency that we’ve heard so much about. And frankly if the drug companies don’t know how to detail docs as efficiently as possible (and for that they do need the data) it’s likely that their marketing efforts will get more unfocused and more onerous on the system as a whole. And in general I’m of the belief that useful targeted marketing & sales is better than blanket non-targeted efforts. So unless we are going to ban ALL pharma marketing (which will mean tossing a great deal of useful babies out with the bath-water) and fundamentally change how information about drugs is communicated to physicians, then getting rid of the IMS type data is not helpful.

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{ {I have|I’ve} been {surfing|browsing} online more than {three|3|2|4} hours today, yet I never found any interesting article like yours. {It’s|It is} pretty worth enough for me. {In my opinion|Personally|In my view}, if all {webmasters|site owners|website owners|web owners} and bloggers made good content as you did, the {internet|net|web} will be {much more|a lot more} useful than ever before.| I {couldn’t|could not} {resist|refrain from} commenting. {Very well|Perfectly|Well|Exceptionally well} written!| {I will|I’ll} {right away|immediately} {take hold of|grab|clutch|grasp|seize|snatch} your {rss|rss feed} as I {can not|can’t} {in finding|find|to find} your {email|e-mail} subscription {link|hyperlink} or {newsletter|e-newsletter} service. Do {you have|you’ve} any? {Please|Kindly} {allow|permit|let} me {realize|recognize|understand|recognise|know}… Read more »

Dan
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Dan

Are Drug Reps Really Necessary? One of the main functions of pharmaceutical representatives is to provide free samples to doctor’s offices presently instead of authentic persuasion, and these samples in themselves cost billions to the pharmaceutical industry. Yet arguably, samples are the most influential tool in influencing the prescribing habit of a health care provider. Let me be clear on that point: Its samples, not a representative, who may be the top influencer of prescribing habits. Yet considering that drug promotion cost overall is approaching 20 billion a year, combined with about 5 billion spent on drug reps themselves, what… Read more »

Terry Nugent
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Terry Nugent

I agree. R&D has become more of a challenge, but the industry is focusing to a greater extent on categories such as oncology, to a great extent based on profit motive. But that profit incentive is based on the fact that payers won’t pay for me too drugs. The market wants real cures for serious diseases and thus goes the industry’s focus. I think you will see cuts in marketing budgets over the next few years, particularly in the bloated sales forces. It’s tough, along the lines of nuclear disarmament. Everybody knows it needs to be done but every company… Read more »

Billy Jones
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Thanks, Terry! Well said.

george
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george

Well, Terry, you are disliked by honest physicians because of what drug marketers do. There are some decent drug reps who provide information and drug samples, as requested by physicians. However, the fact is that the drug industry spends more money on marketing than research. The U.S. health care system is the most expensive in the world, but it is falling apart at the seams because of all the non-productive costs. We all pay for drug marketing costs. The collection of physician prescribing information is an invitation to corruption. Physicians who prescribe expensive drugs have, in the past, been rewarded… Read more »

CarolynS
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CarolynS

Is there anyone out there who would be interested in starting a march on our state capitals to protest our enslavery by health insurance companies. I think the 4th of July would be a great time to do this so that we could ask for our freedom from health insurance companies running our lives. All we do is pay rising rates every year for very little if nothing. Then when we get a preexisting condition we can’t even change to another insurance company. We small business owners cannot afford health insurance anymore. Surely there are a lot of other people… Read more »

Matt
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Matt

Thanks, Terry! Well said.

Terry Nugent
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Terry Nugent

Matt, I scrolled through this whole debate just to tell you that I think you’re spot on regarding prescribing data availability. While it can be misused, it certainly helps marketers operate more efficiently when used properly. I was, as always, dismayed by the vitriol directed toward pharmaceutical marketing. I am in the business myself, as a supplier of data to the industry. I can assure the correspondents that pharmaceutical marketers do not knowingly market drugs that kill people. For the more charitably minded, the rationale that they are human beings may suffice. For the prejudiced, the cold hard fact that… Read more »

Tom Leith
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Tom Leith

Matthew writes in response to my question about the manner of prescribing: > Therapeutic substitution is not allowed yet I can see that what I have in mind will probably fall under this ruberic, but as “therapeutic substitution” is apparently defined right now, it isn’t quite that. The doc would not prescribe “Nexium” and leave the patient/pharmacist free to substitute Prilosec. No: the doc prescribes “proton pump inhibitor” or “statin” or whatever, and there is complete freedom to pick one from among the FDA approved drugs in that class. This is not “substitution” — it is “choice”, or “empowerment” or… Read more »

Matt
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Matt

Arguments are what I’m interested in. There is data every which way you look pointing in any direction you want. Even so, I’m going to cite more in a second. Healthcare should be run by the federal government? At all levels? Congratulations, you’ve hit my hottest button. You cannot be serious. Medicare is failing. Medicaid is failing. My previous posts were not unfounded. http://hspm.sph.sc.edu/Courses/ECON/CLASSES/Friedman.html The fresh pool of ill-managed money available from government programs has hurt us. A lot. Giving control of healthcare to the feds is like giving a bottle of gin and car keys to a pack of… Read more »

jack daniels
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jack daniels

I agree Berry, which is why drug research should be run by the federal government, not by private enterprise. TAke all the money we spend on drugs, and restructure it. Have the NIH fund all drug trials and drug research at all levels, from conception to phase IV clinical trials. Currently the modus operandi is that NIH funds all the basic science research, which big pharma picks up on and funds all the way thru clinical trials. Its well documented that the vast majority of truly revolutionary drugs were developed in academia by NIH funded research, NOT by big pharma.… Read more »

Barry Carol
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Barry Carol

I agree with Tom that there is not a lot of gold to be mined here. As he has pointed out more than once, prescription drugs are only about 10% of healthcare spending. DTC advertising is about $4 billion or so out of $200 billion+ spent on drugs. Drug retailers and PBM’s are already incentivized to switch brand scrips to generics if one is available and the doc has not specified DAW. When a me too drug is far more expensive than its competitor for little or no incremental efficacy, insurers can and do either exclude it from their formulary… Read more »

jack daniels
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jack daniels

http://www-rohan.sdsu.edu/dept/schlcomm/-Riskier.pdf#search='most%20commonly%20advertised%20drugs‘ Most consumers are successful in obtaining the requested drug. Survey data estimate that between half and three-quarters of all requests are approved by a physician (Brody, 1998, ““National Survey,ÏÏ 1998). Moreover, there are indications that consumers who are unable to obtain an advertised drug from their own physician meet the denial with “suspicion and hostility” (Neergaard, 1999) and “shop around” until they Ðnd a physician willing to prescribe the desired drug (Cohen, 1990 ; She†et & Reece, 1994).” The research on big pharma marketing to doctors is clear and conclusive: 1) It changes script habits of doctors (duuhhh, big… Read more »