Pharma Under Fire for Fair Balance Failings

Unfair balanceUh oh! Seems like the Pharma industry is in trouble again.

Research published in the Journal of General Internal Medicine suggests that family physicians receive “little or no information” about adverse effects associated with medicines in the majority of drug promotions made by sales representatives.

In the study, 255 family doctors from urban practices in the US [Sacrameto], France [Tolouse] and Canada [Montreal and Vancouver] answered questionnaires following visits from sales representatives.  The primary outcome measure was “minimally adequate safety information” (mention of at least one indication, serious adverse event, common adverse event, and contraindication, and no unqualified safety claims or unapproved indications).

The findings showed that sales representatives did not provide any information about common or serious side effects, or identify the patients who should not be using the drug, in 59% of the promotions. In Canada, no potential side effects were mentioned for 66% of promoted products, according to the results.

yes no riskThe researchers also indicated that although 57% of the promoted drugs carried boxed warnings from the FDA or Health Canada, serious adverse events were only discussed in about 6% of the sales pitches.

Félicitations to the French reps who provided information on harm for 61% of the promotions, compared to only 34% in Canada and 39% in the US.

Despite this lack of “fair balance” overall, the doctors considered the quality of the scientific information to be good or excellent for 54% of the promotions and indicated that they would be willing to prescribe the drugs 64% of the time.

Laws in all three countries require sales representatives to provide information on harm as well as benefits,” says lead author Barbara Mintzes, Assistant Professor at the University of British Colombia. “But no one is monitoring these visits and there are next to no sanctions for misleading or inaccurate promotion.”

Despite widespread belief by physicians to the contrary, the information provided by pharmaceutical sales representatives has been shown to influence prescribing. Greater exposure to promotion is associated with higher prescribing volume and costs.  And while regulations in all three countries require sales representatives to provide information on the risks as well as the benefits of their drugs, there are differences.  It’s interesting, to correlate the above results with the fact that that France has the strictest information standards, whereas Canada relies on industry self-regulation.

However, across all three countries, the results of this study would appear to question if current approaches are adequate to protect patient health.

The Pharma Industry should take note.  Time to clean up your act before the Government and Regulatory Authorities do it for you.

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The Doctor Won’t See You Now

US Pharma reps think they have it bad?  Then they should spare are thought for their poor beleaguered colleagues on the other side of the Pond!

According to an article in the industry journal PM Live,  time-pressured doctors in the UK are increasingly refusing to see pharmaceutical sales reps altogether.

A study undertaken by Doctors.net.uk in April 2012 surveyed more than 1,000 General Practitioner’s (GPs). They found that 52% of GPs did not see any pharmaceutical sales representatives in a typical week, while 26% saw only one pharma sales rep during that period.

Lack of time was the most common reason cited by GPs for not seeing pharma sales reps (38%). Other reasons included a practice “no-see” policy and a perceived lack of reps’ impartiality.

At the same time, they learned that doctors are turning to digital channels for independent product information. Nearly a quarter (23%) of the GPs surveyed said they preferred to find their own product information via independent online resources.

Doctors.net.uk said its findings follow earlier studies it conducted that show only 3% of doctors think online pharma resources are credible. Worse still 42% said they never visit pharmaceutical websites.

This research would appear to be in line with other trends among healthcare professionals.  European doctors’ use of iPads and other mobile devices is increasing and US pharma execs expect to increase their future spending on digital marketing channels.

SRxA can help Pharma companies to navigate the promotional maze and get the best bang for those pharma dollar bucks. Contact us today to find out more.

Could “No See” docs be doing a disservice to patients?

One of the biggest challenges facing any Pharma rep is the increasing number of  doctors who won’t see them. Every week, more and more physicians are restricting, and some even eliminating, their face time with sales reps.

In fact, the number of doctors willing to see reps has declined by about 20% since 2008.  And while some clinicians chose to do this, others have had it thrust upon them by their institutions or employers who are concerned that medical practice may be unduly influenced by pharmaceutical industry representatives.

Although  “no see” advocates argue that removing commercial influence is better for patients, a new study suggests the practice has downsides too.

This should be good news for the Pharma, who has always maintained that the clampdown on reps amounts to overkill and that more than selling, reps  provide information that can benefit patients.

The study, published in the Journal of Clinical Hypertension, divided medical practices into four categories. Based on the degree of sales representative access to clinicians, they were classified as either very low, low, medium, or high.

The clinical decisions, and prescribing behavior of over 72,000 physicians were then statistically analyzed, with regards to the drugs listed below:

The authors found that after the FDA approved Januvia, docs who had little interaction with reps took longer to write prescriptions than docs whose access to reps was not as restricted. Meanwhile, physicians who rarely, if ever, saw reps were slowest to change their prescribing habits after negative news emerged about Avandia and Vytorin .

Specifically, the study found that docs with very low access to reps had the lowest adoption rates for Januvia. They took between 1.6 and 4.6 times longer to start writing prescriptions after the pill was launched than docs who had low, medium or high access to reps. Docs who had very low access to reps were also 4 times slower than those of their counterparts to reduce their use of Avandia, after the Black Box warning was issued in 2007.  There was also “significantly less” change in the prescribing habits of those who had less access to reps in response to controversial and disappointing trial results released in 2008 for Vytorin, than those with fewer restrictions on rep interactions.

The study authors commented, “These findings emphasize that limiting access to pharmaceutical representatives can have the unintended effect of reducing appropriate responses to negative information about drugs just as much as responses to positive information about innovative drugs.”

George Chressanthis, professor of healthcare management and marketing, and acting director for the Center for Healthcare Research and Management at Temple University Fox School of Business, agrees.

The study affirms simple intuition that when physicians have to make decisions involving complex issues with less than complete information available to them, and where the consequence of a wrong decision is significant… unintended consequences are likely to appear. Policies that promote physician ignorance of new medical information resulting from access limits, run counter to protecting patient health.”

Could increasing, rather than decreasing  sales representative access to physicians lead to better clinical decision making and better patient health? Let us know what you think.

Most Docs Not impressed by Reps Wielding iPads

While the iPad may be the hottest “must have” gadget for pharma sales reps, most doctors aren’t quite so thrilled when they are whipped out during presentations.

According to Manhattan Research while 38% of the 1,755 physicians surveyed have seen a pharma rep use an iPad or other tablet during a face-to-face meeting in the last 12 months, only 36% of physicians find the experience to be more beneficial than speaking with reps who use print materials or devices, such as laptops.

General surgeons, infectious disease or HIV physicians, anesthesiologists and OB/GYNs are the specialty groups that are most likely to agree sales reps should use iPads or other tablets for product discussions during office visits.

In contrast, rheumatologists and dermatologists are less inclined to feel that tablets are needed.

iPads are all the rage for pharma at the moment, which makes sense given the potential of these devices to support intelligent, nimble sales conversations,” says Monique Levy, VP of Manhattan Research. “Unfortunately, some of the detailing programs that are being rushed out the door are sub-par – really no better than something you’d see on tablet PCs six years ago. Doctors won’t waste their time with these.”

Despite this survey, Word on Health doesn’t expect to see reps giving up their high priced status symbol “toys” just yet. In fact, we’re pretty sure that the iPad is here to stay along with those other rep essentials – iPhone, expense account and shiny new car.

The challenge then is to create engaging medical apps and programs for the iPad.  SRxA can help companies do just that.  Contact us for more information and see how we can put the iPizzaz into the iPad!

Pharma-Physician Interactions Perceived Positively

According to a survey released last week, nearly eight out of 10 physicians view pharmaceutical research companies and their sales representatives as useful sources of information on prescription medicines.

That’s good news for pharmaceutical marketers who spent $24 billion between October 2009 and September 2010 on physician-targeted promotional spending, and an additional $1 billion on continuing medical education.

The telephone survey of more than 500 American Medical Association members found that physicians consider a range of sources useful for staying informed about medicines. In addition to sales reps and company-sponsored peer education programs, doctors also rated continuing medical education (CME) courses, peer-reviewed medical journals, and their fellow physicians as useful sources of information.

The survey also found that physicians consider a broad range of factors in making their prescribing decisions, with almost all respondents relying on their clinical knowledge and experience as well as a patient’s response to a particular medicine. More than 80% reported that they take into consideration a patient’s insurance factors, such as formulary and prior authorization requirements, with just under 70% using information provided by pharmaceutical company representatives

The survey, which was supported by PhRMA, also looked closely at how physician respondents view their interactions with pharmaceutical company representatives.

More than 90% responded that interactions with representatives allow them to learn about new indications for approved medicines, potential side effects of medicines, and both emerging benefits and risks of medicines.  In addition, 84% of physicians said that interactions with representatives allow them the opportunity to provide feedback to a pharmaceutical company about their experiences with a specific medicine.  Large majorities also found information from company representatives to be up-to-date and timely (94 %), useful (92%), and reliable (84%).

The survey also included several questions about company-sponsored peer education programs, in which physicians present to their peers. Nearly 9 out of 10 of physicians who reported attending these programs said the information was up-to-date, useful and reliable.

Physicians attending peer education programs reported gaining a range of information, including: improved clinical knowledge (98%), potential side effects of medicines (97% ), new uses of medicines (97%), the range of treatment options (97%), and emerging drug risks (95%). Importantly, 94% said the programs strengthened their ability to care for patients.

Peer education programs allow physicians to have important dialogues with their expert colleagues. This sharing of information ultimately benefits the patients they treat,” said PhRMA’s John Castellani.

SRxA and its team of independent Clinical Advisors specializes in providing support to the pharmaceutical industry and has developed a number of highly successful and unique peer-to-peer education programs. For more information, contact us today.