Fewer pharma rep vis­its linked to lower mar­ket share for their drugs

Modern Healthcare - - NEWS - By Alex Kacik

Phar­ma­ceu­ti­cal com­pa­nies have long sought to bol­ster mar­ket share by pro­mot­ing spe­cific med­i­ca­tions to doc­tors dur­ing sales vis­its and events that may in­clude gifts such as meals and free sam­ples, a prac­tice known as drug de­tail­ing. A grow­ing num­ber of aca­demic med­i­cal cen­ters have sought to curb that prac­tice by re­strict­ing vis­its by drug­mak­ers.

The ef­forts seem to be pay­ing off; physi­cians pre­scribed fewer drugs that were be­ing pro­moted by sales reps when their hos­pi­tal lim­ited vis­its by sales reps, ac­cord­ing to a new study.

Be­tween 2006 and 2012, the mar­ket share of de­tailed drugs pre­scribed by aca­demic med­i­cal cen­ters dropped 8.7% rel­a­tive to the level prior to en­act­ing the pol­icy changes, ac­cord­ing to the study pub­lished last week in JAMA. Pre­scrip­tions shifted away from de­tailed drugs largely to­ward generic ones, the study found. Prior to the pol­icy changes, de­tailed drugs held an av­er­age of 19.3% of the mar­ket share.

“There has long been con­cern that drug mar­ket­ing to physi­cians might in­flu­ence their pre­scrib­ing, in­clud­ing—and maybe es­pe­cially—for psy­chi­atric drugs,” said one of the study co-au­thors, Michael Schoen­baum, a se­nior ad­viser for men­tal health ser­vices, epi­demi­ol­ogy and eco­nomics at the Na­tional In­sti­tute of Men­tal Health, which sup­ported the study. Ac­cord­ing to the study, there is lit­tle re­search on the de­fin­i­tive im­pli­ca­tions of drug de­tail­ing—mostly be­cause the for­mi­da­ble phar­ma­ceu­ti­cal in­dus­try pre­vents it from com­ing to light.

And that’s not the only place drug­mak­ers spend money. The phar­ma­ceuti-

Be­tween 2006 and 2012, the mar­ket share of de­tailed drugs pre­scribed by aca­demic med­i­cal cen­ters dropped 8.7% rel­a­tive to the level prior to en­act­ing the pol­icy changes.

cal in­dus­try spent more than $24 bil­lion on mar­ket­ing di­rectly to physi­cians in 2012 com­pared with $3 bil­lion a year to con­sumers, ac­cord­ing to a study pub­lished by the Pew Char­i­ta­ble Trusts. About $15 bil­lion of that was face-to-face sell­ing and around $6 bil­lion was in free sam­ples. As of 2012, the U.S. had about 72,000 phar­ma­ceu­ti­cal sales rep­re­sen­ta­tives; there were 916,000 li­censed physi­cians.

Pro­vid­ing free sam­ples to health­care pro­fes­sion­als led to sig­nif­i­cant in­creases in new pre­scrip­tions for the sam­pled drugs, per the Pew study. While drug com­pa­nies ar­gue that the sam­ples are es­pe­cially im­por­tant to pa­tients who couldn’t af­ford them oth­er­wise, re­search shows that most are given to in­sured pa­tients.

The de­cline in pro­moted drug pre­scrip­tions was more dras­tic fol­low­ing the im­ple­men­ta­tion of stricter poli­cies, in­clud­ing bans on sales­peo­ple in pa­tient care ar­eas; re­quire­ments for sales­per­son regis­tra­tion and train­ing; and penal­ties for sales­peo­ple and physi­cians for vi­o­lat­ing the poli­cies.

Re­searchers stud­ied 19 cen­ters that im­ple­mented the new poli­cies, in­clud­ing 2,126 physi­cians who prac­ticed in California, Illi­nois, Mas­sachusetts, New York and Penn­syl­va­nia, com­pared with a con­trol group of 24,593 physi­cians. They an­a­lyzed more than 16 mil­lion pre­scrip­tions of eight ma­jor drug classes: lipid-low­er­ing drugs, gas­troe­sophageal re­flux dis­ease drugs, anti-di­a­betic agents, anti-hy­per­ten­sive drugs, sleep aids, at­ten­tion deficit hy­per­ac­tiv­ity dis­or­der drugs, an­tide­pres­sant drugs and an­tipsy­chotic drugs.

“Im­por­tant next steps in­clude as­sess­ing the eco­nomic im­pact of these poli­cies and whether they af­fect pa­tients’ clin­i­cal out­comes,” Schoen­baum said.

Soar­ing drug prices have taken a sig­nif­i­cant chunk out of hos­pi­tals’ bot­tom lines. An­nual in­pa­tient drug spend­ing rose an av­er­age of 23.4% from 2013 to 2015, and 38.7% on a per ad­mis­sion ba­sis, ac­cord­ing to a 2016 study from Amer­ica’s big­gest hos­pi­tal lob­bies.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.