Drug Prescribing by Physicians

By September 30, 2016Commentary

Drug companies are masters of marketing.  For many years they have had expansive sales forces which targeted physicians most likely to prescribe their products and wooed them with a variety of tactics.  As a recent survey from SK & A confirms, more doctors are refusing to see pharmaceutical sales reps.  (Survey)   Over 36% of doctors won’t schedule appointments with them in 2016, up from 23% in 2010.  For physicians employed by hospitals or health systems, a rapidly growing trend, the number is over 50%.  New regulatory disclosure requirements likely have something to do with the change, as does a general perception that such visits may lead to unnecessary prescribing.  There is geographical variation, with only 31% of doctors in the south saying no and 42% in the west doing so.  By state, Minnesota, Vermont and Maine all have well over half of physicians not allowing sales rep visits, while North Dakota, New Jersey and Mississippi only have a quarter rejecting such meetings.

But fear not, a number of years ago the drug companies found a counter to this trend–direct-to-consumer advertising.  These ads are intended to use patients to put pressure on their physicians, in essence turning the patient into a sales rep.  A study in the Journal of Clinical Psychiatry conducted a meta-review of studies on the effects of such advertising on the prescribing of psychiatric drugs.  (JCP Study)   Sixty-nine studies were included and the overall consolidated findings were that requests from patients based on direct-to-consumer ads seen by the patients were granted most of the time, that such ads prompt higher prescribing volume and that they result in over-prescribing in relation to what guidelines would suggest is appropriate.  On the positive side, DTC ads also seemed to be associated with greater adherence to prescribed regimens.  Hard to fight the drug companies; somehow those huge profit margins just keep coming.  As we have suggested before, save everybody a lot of money if DTC were banned and sales interactions more tightly regulated, for both drugs and devices.

Author Kevin Roche

The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry through Roche Consulting, LLC. Mr. Roche is available to assist health care companies through consulting arrangements and may be reached at khroche@healthy-skeptic.com.

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