Tuesday, February 19, 2013

Big Pharma and Big Influence: Get the Reps Out of Med Schools

Two recently published studies suggest that big pharma's influence is real and that it starts very early in a doctor's career.  Medical schools have long been fertile ground for drug companies and their representatives to establish cozy relationships with doctors in hopes of influencing future prescribing habits.  Turns out, the tactic works.  More on that in a moment.   

In the interest of full disclosure, I began my career out of college working at a reputable management consulting firm.  The biggest client was a drug company and my first project was launching a new cardiovascular drug in the US market.  Medical schools were target rich environments - lots of young, relatively poor, impressionable future doctors all in one place.  Show up with some pizza and you had influence.  Host a nice dinner, be a consistent presence on campus, and perhaps even provide some gifts, then you had friends... and potential future prescribers.  This was a sales tactic I once advocated.  It works.   

American Medical News provides a nice overview of both pieces of research.  I'll highlight the results of the first study, published last month in a British medical journal, which showed a stark contrast between a group of 2,500 medical school graduates from 14 schools that had put pharmaceutical company gift bans in place starting in 2004 vs. a matching set of doctors from different schools that lacked such a ban.  The study looks at the prescribing habits of the two groups with respect to three separate drugs.  For one drug (an antidepressant from Pfizer), the statistical difference between the two groups was insignificant.  But for the other two drugs (an ADHD drug from Shire called Vyvanse and an antipsycotic drug from Janssen called Invega) the results were staggering: the med school graduates from the 14 school test group were 56% and 75% less likely to prescribe those two drugs, respectively. 

Percentage of medical schools with gift bans (from the American Medical Student Association):
2008: 13%
2009: 29%
2010: 43%
2011-12: 53%

We know the influence of big pharma has played a significant role in the over-utilization of prescription opioids in work comp and beyond.  Though it'll take the better part of two decades (and we certainly can't wait that long), I nonetheless find it comforting to know that the next generation of doctors may start out with a cleaner slate than their predecessors. 


(Thanks to Jeff Woldanski at Allsup for the link to the article.) 

On Twitter @PRIUM1

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