Monday, November 26, 2007

Dr. Drug Pusher

I was reading this article in the New York Times about pharmaceutical companies hiring doctors to help sell medications. Daniel Carlat relayed his experiences visiting other doctors and talking about the anti-depressant med Effexor. He said he never lied about the data on Effexor, but he spun the info in the best possible light. He received many $750 checks for talks he gave.

The drug reps that visit hospitals and clinics don't always have a medical background. Doctors would be much more likely to prescribe a med if another doctor recommended it, so it's no surprise that med-selling physicians and psychiatrists are becoming more common. I see drug reps in our hospital lobby at least once a week; they usually bring coffee (Starbucks!) and bagels (Einsteins!) with them, beyond the usual assortment of pens, pads, and kleenex boxes.

These two paragraphs are near the article mid-section:
Na├»ve as I was, I found myself astonished at the level of detail that drug companies were able to acquire about doctors’ prescribing habits. I asked my reps about it; they told me that they received printouts tracking local doctors’ prescriptions every week. The process is called “prescription data-mining,” in which specialized pharmacy-information companies (like IMS Health and Verispan) buy prescription data from local pharmacies, repackage it, then sell it to pharmaceutical companies. This information is then passed on to the drug reps, who use it to tailor their drug-detailing strategies. This may include deciding which physicians to aim for, as my Wyeth reps did, but it can help sales in other ways. For example, Shahram Ahari, a former drug rep for Eli Lilly (the maker of Prozac) who is now a researcher at the University of California at San Francisco’s School of Pharmacy, said in an article in The Washington Post that as a drug rep he would use this data to find out which doctors were prescribing Prozac’s competitors, like Effexor. Then he would play up specific features of Prozac that contrasted favorably with the other drug, like the ease with which patients can get off Prozac, as compared with the hard time they can have withdrawing from Effexor.

The American Medical Association is also a key player in prescription data-mining. Pharmacies typically will not release doctors’ names to the data-mining companies, but they will release their Drug Enforcement Agency numbers. The A.M.A. licenses its file of U.S. physicians, allowing the data-mining companies to match up D.E.A. numbers to specific physicians. The A.M.A. makes millions in information-leasing money.

If the government is going to become much more involved in healthcare, which it certainly will if we have a Democratic president in 2009, the pharmaceutical companies will play a major role.

As Instapundit says, read the whole thing.

1 comment:

  1. It frightens me that drug reps have access to names and prescription information (if if they have to do an end-run to sort out the data). What's not being mentioned is the possibility of implied threats (or blackmail, if you will). How would a physician react if he or she knew that information about prescriptions of controversial drugs is just one disgruntled sales rep away from becoming public? Perhaps I'm overreacting, but the possibility exists, does it not?