A new report suggests that improved health care and significant reductions in drug costs might be attained by breaking up the age-old relationship between physicians and drug company representatives who promote the newest, more costly and often unnecessary prescription drugs.
This system, which has been in place for decades, at one time benefitted doctors by keeping them up to date on new medications, and always provided generous amounts of “free” samples to get patients started on the newest drugs, as well as other supplies and gifts.
But it’s actually a powerful marketing process into which the pharmaceutical industry pours tens of billions of dollars a year, with more than 90,000 drug representatives providing gifts and advice. There is one drug representative for every eight doctors in the
In one of the first reports of its type – titled “Breaking Up is Hard to Do” – researchers from
The study found that avoiding conflicts of interest and becoming “pharma-free” is possible, but not easy.
“This is a culture change, one that’s already happening but still has a ways to go, especially in smaller private practices,” said Dr. David Evans, now with the Department of Family Medicine at the
“The relationship between physicians and drug company representatives goes back generations, and it took a methodical, deliberate campaign to change it,” Evans said. “We ultimately decided something had to be done when our medical clinic was visited by drug reps 199 times in six months. That number was just staggering.”
Part of what allows the change, the researchers said, is that information on new medications is now available in many other forums. These may have less bias and be more evidence-based than the material traditionally provided by the pharmaceutical industry, which wanted to sell the latest product. In the
“In the past 5-10 years there’s been more of a move toward what we call ‘academic detailing,’ in which universities and other impartial sources of information can provide accurate information without bias,” said Daniel Hartung, assistant professor in the OSU College of Pharmacy. “This is being supported by some states and the federal government, and it’s a move in the right direction.”
Moves to separate the drug industry from the practice of medicine have been more aggressive in large medical teaching hospitals, Hartung said, but much less so in smaller private practice. Of the 800,000 physicians in the
The stakes can be high, the researchers said. In the study example, the “sample cabinet” of medications at the
The new analysis explored the necessary steps that a private clinic can take to help address this concern, including quantifying the clinic-industry relationship, anticipating clinician and staff concerns, finding new ways to provide up-to-date information, and educating patients and the public.
About the OSU College of Pharmacy: The College of Pharmacy prepares students of today to be the pharmacy practitioners and pharmaceutical sciences researchers of tomorrow by contributing to improved health, advancing patient care and the discovery and understanding of medicines.
Commentary by David Stauth, 541-737-0787
Contact: Daniel Hartung, 503-494-4720 or hartungd@ohsu.edu; Dr. David Evans, 541-460-3334
This story is available online: http://bit.ly/Z2278Y
The study this story is based on is available in ScholarsArchive@OSU: