E-DRUG: Creating off-label uses (3) - sales reps
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Dear E-druggers
Sales reps are key promoters of off label-use of drugs, witness the
consistent findings of Prescrire sales reps monitoring network in France.
Biased treatment guidelines and promotion of costly drugs in hospitals are
other sources of off-label uses.
Prescrire sales reps monitoring network was created in 1991 at the
initiative of a group of subscribers. For 15 years, members of the Network
compared sales reps' claims with the information contained in the summaries
of product characteristics.
A variety of methodological precautions were taken to minimise the biases
inherent in any 'sentinel' type of observational system. Results were
remarkably consistent over the years.
Sales reps highlight the efficacy of the drugs they present, often for
unapproved as well as approved indications. In contrast, adverse effects are
not mentioned in three-quarters of visits.
A Prescrire review of the Network¹s findings ³Don't expect sales
representatives to help improve healthcare quality² can be found at:
http://www.prescrire.org/aLaUne/dossierVMbilanEng.php
Prescrire sales reps monitoring network stopped its activity because its
findings were pretty stable over 15 years. Many Prescrire subscribers who
were involved finally decided to stop receiving visits by sales reps. So
this sentinel network was also a kind of intervention study.
Conclusion: no thanks to sales reps in the community and in hospitals.
Christophe Kopp
Staff editor
La revue Prescrire/Prescrire International
www.prescrire.org
Christophe Kopp <ckopp@prescrire.org>