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Παρασκευή 23 Μαΐου 2014

The Rise Of The Pharmaceutical Un-Sales Force


Forbes | Cory L. Andrews   


In a variation on the old saying “if you can’t beat ‘em, join ‘em,” a number of states have initiated programs where purportedly independent clinicians, pharmacists and other medical personnel pay visits to physicians as a way of countering the information delivered to health care providers by drug company sales people (who are known as “detailers”).  States such as Pennsylvania and South Carolina are funding this “academic detailing” as a tool to reduce those governments’ prescription drug-related health care expenses.  Counter-detailers reportedly inform doctors that older drugs or less expensive generics can be as or more effective in treating some conditions than newer, patented products.  Thanks to the 2009 federal stimulus bill and the ObamaCare law, the federal government is now looking to get into the academic detailing business.


We’re all for more information in the marketplace, and especially more health care information.  But we don’t particularly appreciate it when government puts its massive thumb on the information scales in the way we are seeing with academic detailing.  For instance, through the state law being challenged in the Supreme Court Sorrell v. IMS Health case (argued before the Justices tomorrow, more on that here), Vermont is encumbering drug detailing by prohiting drug companies from using “prescriber identifiable” prescription data for detailing purposes.  The Vermont law says nothing, however, about the state’s own counter-detailing program.  So Vermont’s academic detailers are free to use such data, while drug companies cannot.  That is one, among many reasons, why the Supreme Court should strike down Vermont’s law as unconstitutional.

Another way government places its thumb on the scales regarding drug company detailing vs. counter-detailing is described in a just-released WLF Legal Backgrounder by Dr. Joshua D. Lenchus, Assistant Professor of Clinical Medicine at the University of Miami Miller School of Medicine.  As Dr. Lenchus relates, federal and state governments impose a growing network of rules and regulations on the promotional activities of pharmaceutical companies in the interests of ensuring that the information doctors receive is correct and credible, and that company reps don’t unduly or unethically influence doctors’ decisions.  Drug company and medical trade associations also demand that their members conform to voluntary codes of conduct.

Government-sponsored academic detailers, on the other hand, do not currently have to conform to any such regulatory oversight standards.  Their information providing process is entirely opaque, Dr. Lenchus notes, and no clear rules exist to govern state counter-detailers’ practice of providing lunches or continuing medical education credits for their doctor targets.  The paper lists a number of unanswered questions along these lines, arguing that, “Policy-makers must address these issues to ensure that medical professionals, and in turn their patients, are confident in the accuracy and reliability of the academic detailing initiative and the information it disseminates. ”

WLF is also filing comments today with the Department of Health and Human Services which requested public input on Dissemination of Comparative Effectiveness Research to Patients and Providers to Increase Adoption advancing its position that if a regulatory regime is to exist for company dissemination of information, government-sponsored detailers should face similar oversight.

In sum, if government is taking the stance of “if you can’t beat ‘em, join ‘em,” then we must urge that (pardon our reliance on another worn-out saying) “what’s good for the goose is good for the gander.”