Title: The Pharmaceutical Industry and You
1The Pharmaceutical Industry and You
- Stacie Beck Pete Karlin
- (Jake Donaldson Alana Benjamin)
January 22, 2007
2Why should pre-medical students, medical students
and residents even care about the pharmaceutical
industry?
31
We
- have young, impressionable minds
- are the future generation of prescribers
Therefore, we are HUGE targets for
pharmaceutical marketing!
42
Its in the news our patients might ask us about
it
5- It presents a challenge to our professionalism.
3
6- I havent accepted THAT much free stuff from
drug reps. - -- Fill in your name here?
7Pharmaceutical Branding of Resident Physicians
- Survey of 181 primary care residents 164 (91)
responded. - First asked to complete survey, then asked to
empty pockets of white coats. - 98 had eaten drug company-sponsored meal within
the past year. - 97 of residents were carrying at least one item
with pharmaceutical insignia.
JAMA 20012861024
8Pharmaceutical Branding of Resident Physicians
JAMA 20012861024
9- That stuff doesnt influence me at all. I dont
even know what drug is on my pen. I just go for
the food.
10Perceived influence of pharmaceutical reps on
prescribing practices
You
Other Physicians
P
Am J Med 2001110551
11Influence of pharmaceutical reps on prescribing
practices
JAMA 2000 283378
12Physician Influence, concluded
- The evidence available today, therefore, seems
conclusive on 2 pointsfirst, that we are indeed
heavily influenced by reps and second, that we
ourselves are very poor judges of the extent of
that influence. - -- Howard Brody, Ann Fam Med, Jan-Feb
2005
13 Well, at least the free samples are good for
my patients.
14A Physician Survey of the Effect of Drug Sample
Availability on Physicians Behavior
- HTN scenario When samples were made available,
32 of the 35 physicians who said they would give
a drug sample selected a drug that differed from
their preferred choice. - LATER Patient now has health insurance, blood
pressure controlled on drug sample - 69 said they would write a prescription for the
sampled medication rather than switch therapy. - 88 of sample users would have written a
prescription for a drug that differed from their
preferred choice.
J Gen Int Med 200015478
15- The reason that drug prices are so high is
because drug companies spend a lot of money on
researching new drugs, right?
16Comparison of median revenue dedicated to RD,
profits, and marketing/administration, Fortune
500 drug companies, 2000 (n11)
Source Public Citizen, 2001
17Research and Development?
Percentage of scientific articles cited in patent
applications, 1998
Angell, p. 65
18Research and Development?
- Of the 415 new drugs approved by the FDA from
1998 to 2002 - 14 were truly innovative
- 9 were old drugs that were changed to make
them significantly improved (according to
the FDA) - 77 were me-too drugs classified by the FDA
as being no better than drugs already on the
market to treat the same condition
Angell, p. 75
19Comparison of median revenue dedicated to RD,
profits, and marketing/administration, Fortune
500 drug companies, 2000 (n11)
Source Public Citizen, 2001
20Drug Company Profits, 1995-2002
www.pnhp.org
21Comparison of median revenue dedicated to RD,
profits, and marketing/administration, Fortune
500 drug companies, 2000 (n11)
Source Public Citizen, 2001
22Pharmaceutical Marketing
- The marketing expenditures of the drug industry
have been estimated variously at 12 billion to
15 billion yearly, or 8,000 to 15,000 per
physician. - In 2001, there were 90,000 drug detailers total.
That is 1 salesperson per 4.7 office-based
physicians.
N Engl J Med 351(18) 1886-1890
23It is up to us!
- In many ways, the ultimate arbiter of the nature,
extent, - and consequences of interactions between drug
- companies and physicians is the medical
profession - itself. As a for-profit business, the
pharmaceutical - industry should be expected to market its
products - aggressively within legal boundaries. It is then
up to - physicians to decide whether to accept the
proffered - information and enticements.
- -- David Blumenthal, MD, MPP
24References
www.nofreelunch.org www.pnhp.org Angell, Marcia
The Truth About the Drug Companies
Random House, 2004. Kassirer, Jerome. On the
Take Oxford University Press, 2005. UCSF Med
Students. Pharmatrix. AMSA video, 2004.
http//www.ufpremed.org/pharmatrix/ Brody,
Howard. The Company We Keep Why Physicians
Should Refuse to See Pharmaceutical
Representatives. Ann Fam Med. 2005 Jan-Feb
3(1)82-5. Sierles, F. et al. Medical Students
Exposure to and Attitudes about Drug
Company Interactions. JAMA. 2005
2941034-1042.
25References, Contd
- Blumenthal, David. Doctors and Drug Companies N
Engl J Med 2004 351(18) 1886-1890. - Caudill TS et al. Physicians, pharmaceutical
sales representatives and the cost of
prescribing. Arch Fam Med 19965201-6. - Chew LD et al. A Physician Survey of the Effect
of Drug Sample Availability on Physicians
Behavior. J Gen Int Med 2000 Jul 15(7) 478-83. - Lurie N et al. Pharmaceutical representatives in
academic medical centers J Gen Intern Med
19905240-3. - Peay MY et al. The role of commercial sources in
the adoption of a new drug. Soc Sci Med 1988
261183-1189. - Sigworth SK et al. Pharmaceutical Branding of
Resident Physicians. JAMA 2001 Sep 5 286(9)
1024-1025. - Steinman MA et al. Of principles and pens
attitudes and practices of medicine housestaff
toward pharmaceutical industry promotions. Am J
Med 2001 110(7)551-557. - Wazana A. Physicians and the pharmaceutical
industry is a gift ever just a gift? JAMA 2000
283(3)373-380.