Bad academic study on physician detailing

The majority of family doctors receive little or no information about harmful effects of medicines when visited by drug company representatives, according to an international study involving Canadian, U.S. and French physicians.   The study, which had doctors fill out questionnaires about each promoted medicine following sales visits, was published online today in the Journal of General Internal Medicine. It shows that sales representatives failed to provide any information about common or serious side effects and the type of patients who should not use the medicine in 59 per cent of the promotions.  What this study did not mention is whether the sales reps had already talked to the physician about the drug in a previous visit or the fact that most physician usually read or download the product label of new drugs BEFORE prescribing drugs.

Prof. Barbara Mintzes study would have us believe that as sales reps talk to physicians about drugs they run out and prescribe them.  Sorry this isn’t true anymore. It has been my experience, with 15 years industry experience, that physicians will go to pharma product websites to either download the label or read it online and that physicians will NOT prescribe drugs for more chronic conditions without doing their research.   She also neglected to mention that some classes of drugs, i.e. ED drugs, do not need a detailed explanation of side effects because they all basically work the same and that drugs which  have been on the market for longer periods of time are more studied and thus likely researched by physicians who are spending more time online with website like Medscape.

In addition, according to Cegedim, not only have product details decreased significantly in recent years, but the duration of sales rep visits has also declined. Almost half of the details to general practitioners and internal medicine were under 5 minutes in 2011, whereas 70% of details in 2007 were over 5 minutes. With managed care challenges and less reimbursement for physician visits, U.S. doctors have had to increase patient volumes to maintain income to meet overhead costs. Therefore, they have much less time to spend discussing products with sales representatives. Not only is the time spent per rep visit decreasing, but some offices are setting aside only a small, highly competitive window of time per week for details, while other offices are not allowing visits at all.

In addition physicians today access a wide range of resources for information to help diagnose and treat patients. General browsers such as Google and Yahoo are among the top three information resources used by physicians following professional journals and colleagues. Sales reps are at the bottom of the list.

Then there is the skepticism of physicians to believe drug company studies.  Again research shows that 34% of physicians search online for more information on drugs after talking with a pharma sales rep.

This studies conclusions are flawed at best.  They should have asked how many times the physician has talked to the drug about the drug being talked about and whether the drug was a new drug or one that has been on the market for several years.  They also would have done better to ask the study physicians if they went online to read information about the drug and potential side effects.  Sorry but this is what happens in academia when the study authors have no real world industry experience.

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