Monday, December 23, 2019

Doctors Prescribe More of a Drug If They Receive Money from a Pharma Company Tied to It

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Pharmaceutical companies have paid doctors billions of dollars for consulting, promotional talks, meals and more. A new ProPublica analysis finds doctors who received payments linked to specific drugs prescribed more of those drugs.

Doctors who receive money from drugmakers related to a specific drug prescribe that drug more heavily than doctors without such financial ties, a new ProPublica analysis found. The pattern is consistent for almost all of the most widely prescribed brand-name drugs in Medicare, including drugs that treat diabetes, asthma and more.

Tyrone's Commentary:

My pharmaceutical career began as a drug sales rep for Eli Lilly and Company in 2002. Detailing is a marketing technique used by pharmaceutical companies whereby drug sales reps educate a physician about a drugmaker's products in hopes that the physician will prescribe the company’s products more often. 

Detailing is not a perfect concept. I would say, however, detailing is a necessary sub-step in the continuum of care. I recall several times when a new product hit the market and the physician had not even heard of it. I was his/her first introduction to the new product. These were products for which some of their patients would benefit from right away. 

It is when less costly therapeutic alternatives are not prescribed in favor of more costly prescription drugs I have a problem. At Lilly my first product was Actos an oral anti-diabetic for type 2 diabetes. My message to physicians was to use it as a second line agent after a patient failed on Metformin or Sulfonylurea. Because Actos was a branded product and much more expensive than Metformin, this was the right thing to do and proof detailing can be positive.

A cost-effective formulary takes precedence over physician detailing so much of the criticism is misdirected. If you want to prevent drugs from being prescribed, which have lower cost therapeutic alternatives, tighten up your benefit design.   

The financial interactions include payments for delivering promotional talks, consulting and receiving sponsored meals and travel. The 50 drugs in the analysis include many popular and expensive ones. Thirty-eight of the drugs have yearly costs exceeding $1,000 per patient, and many topped the list that are most costly for the Medicare Part D drug program.

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