No Free Lunch: Saying No to Drug Reps
April 26th, 2008 by Matthew Anderson
Under the banner “Just Say No to Drug Reps” the No Free Lunch campaign challenges doctors to give up their dependency on drug companies.
The site uses a alcoholism motif, beginning with a modified CAGE screening test:
- Have you ever prescribed Celebrex?
- Annoyed by people who complain about lunches & free gifts?
- Is there a medication loGo on the pen you are using right now?
- Do you drink your morning Eye-opener out of a Lipitor coffee mug?
Two or more “yes” answers may indicate a problem. But fortunately the campaign can help you with your dependence problem. Visitors can take a pledge to abstain from accepting gifts from drug companies and be listed on a “drug free doctor” database. There is even a “pen amnesty”!
No Free Lunch is the brainchild of Dr. Bob Goodman, a New York internist. Among the other resources on the site are:
- A FAQ page explaining why physicians should not accept gifts from drug representatives.
- A list of suggested advocacy activities.
- Slide presentations and an extensive bibliographic listing regarding physicians and drug promotion.
- An opportunity to purchase “No Free Lunch” themed pens, mugs and t-shirts.
- Links to resources for unbiased information on drugs and resources.
- Links to resources for patients who are having trouble purchasing their medicines.
- Links to other sites critiquing big Pharma, including the British and Italian “No Free Lunch” campaigns.
So, it’s really not all that complicated to deal with drug representatives. Just say no.
Are Drug Reps Really Necessary?
One of the main functions of pharmaceutical representatives is to provide free samples to doctors’ offices instead of what has historically been their vocation: implementing authentic and ethical persuasion via presentations.
Yet presently, samples are a priority and delivering them is the primary function for drug reps, 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 the healthcare provider. Let me be clear on that point: it is the samples, not a representative, as the true catalyst of establishing the prescribing habits of a prescriber.
When one considers that drug promotion cost, overall, is approaching $20 billion a year, which includes the approximately $5 billion spent on drug reps themselves, what if there is another way for doctors to get free drug samples? What if prescribers could, with great elation, avoid drug reps entirely, yet still receive drug samples for their patients?
A recent survey by Sermo revealed that most doctors desire with what these representatives lack, which is education relevant to their vocation, unbiased training, and clinical experience. 90 percent of doctors surveyed desire only clinical trials related to evidence based medicine.
In addition to preferring pharmaceutical representative not be within their practice, 70 percent are opposed to the team selling model of some pharmaceutical companies. Finally, 80 percent of these doctors only want valid literature relevant to drugs and samples for their practice.
With some select, smaller pharmaceutical companies, doctors have the ability to order samples by printing order forms obtained on certain drug company sites on the internet for medications associated with the manufacturers. Examples of such branded medications that can or have be ordered in this way are Keflex, Extendryl, and Allerx.
Possibly several more can or are available to prescribers in this way. Others, however, cannot be acquired by this method, yet this method may be the most preferable both from a business and efficiency point of view. Customer satisfaction would clearly be elevated.
So in some situations, a doctor can go online, print off a sample order form, fax it into a designated fax number after completion of the form, and the samples are shipped directly to the doctor’s office. There is no review of the doctor’s prescribing habits nor are there any possible embellishments from reps.
And that appears desirable to many health care providers, yet most drug companies apparently place unneeded value on the impact potential of a sales rep of their company to a level of some sort of delusion based on metrics that are possibly categorized as types of fantasies with the copious amounts of drug reps today.
Now, why is this not done more often? Apparently, it is legal. If samples are the number one influencer of prescribing habits, why spend all the money on drug reps to deliver samples personally, as this is essentially their primary duty?
It’s worth exploring, possibly, since the drug rep profession has evolved essentially into those who become a specialized delivery person, dressed in a nice suit, one could say. In other words, and in my opinion as a drug rep, most doctors will not and prefer not to dialogue with you during your visit to their medical clinic.
Think of the money that could be saved if more pharma companies offered samples to doctors in this manner. Furthermore, there is no interruption of the doctor’s practice. And again, there is no risk of bias presented to the doctor.
Doctors again would be able to order and utilize samples according to their discretion, and would be free of interference from the marketing elements of various pharmaceutical corporations. Patients benefit when this occurs, likely.
For example, health care providers would be free of possible embellishments and exaggerations voiced by reps on their promoted meds. Inducements would not be offered or accepted.
Reciprocity would not be so insisted upon with the absence of drug reps, possibly. In fact, doctors may write more scripts for shipped samples than delivered samples because their discretion is free from interference they have experienced to some degree, and doctors are or would be possibly thankful for this.
Considering the high costs associated with the pharmaceutical industry, having samples shipped directly to doctor’s offices should be utilized more than it is presently — regardless of the size of the pharmaceutical company, perhaps. And the pharmaceutical companies would save quite a bit of money as well without a sales force that may likely not be needed after all. Drug prices may improve.
Something to think about as one ponders cost savings regarding this issue, and improving the efficiency of patient care and treatment.
The new source of power is not money in the hands of a few but information in the hands of many.
— John Naisbitt
Dan Abshear