E-DRUG: Med-reps and irrational medicine use in sub-Saharan Africa
----------------------------
Fellow e-druggers,
I feel saddened to report of several instances where
prescriptions for some particular slow-moving
medicines are received in pharmacies from medical
prescribers only when the med-reps visit the doctors
in their consulting rooms. What is prescribed at any
point in time depends much on which company's rep came
around, and a discerning mind can almost always
ascertain which product rep was around from the most
recent prescription patterns.
There seems to be an over-reliance on sometimes-biased
information (intended to maximize product sales) from
pharmaceutical promoters and marketers, and the medics
feel too arrogant in many cases to clarify or obtain
information from resident Pharmacists, although most
of the latter too may be guilty of not being up- to
-date on current drug issues. Often, there is some
element of pecuniary consideration involved-the reps
are most probably more effective than resident
Pharmacists because they not only offer information
but also pass on their companies good-will, which is
quite an obvious added advantage in a financially
desperate environment.
May I further add that this observation is not limited
to my institution alone.
Thank you, and stay blessed.
Fondest regards from
Olutayo Adetokunbo Moronkeji, B. Pharm., MPSN, MNIM, CEDP (Hons.)
Deputy Chief Pharmacist, Obafemi Awolowo University
Teaching Hospitals Complex (OAUTHC), Ile-Ife &
Head of Pharmacy, OAUTH Wesley Guild Hospital, Ilesa Unit
NIGERIA.
E-DRUG: Med-reps and irrational medicine use in sub-Saharan Africa (2)
-------------------------------------------------
Olutayo,
Your observation is not limited to your region.
Increasingly around the world people are realising that pharmaceutical
promotion is a major problem that deserves high priority.
Many doctors deny that they are adversely influenced however:
Observational studies done in Europe and the USA have also found that drug
reps are a powerful influence on prescribing.
see: http://www.healthyskepticism.org/harm.php
At the International Seminar on Drug Promotion in Brasilia 4-7 April 2005 it
was clear that the situation is much the same throughout North and South
America.
When teaching about drug promotion, if there are community pharmacists in
the audience, I ask them to raise their hands then keep them up if they have
never noticed the local doctors prescribing changing in response to a single
drug rep working in their area. So far 100% of Australian community
pharmacists are aware of the power of drug reps.
regards,
Peter
Dr Peter R Mansfield
GP
Research Fellow, Department of General Practice, University of Adelaide
peter.mansfield@adelaide.edu.au
NHMRC Public Health Postgraduate Scholarship 250465
On study leave from Healthy Skepticism Inc during 2005 to write PhD thesis
www.healthyskepticism.org Countering misleading drug promotion.
34 Methodist St, Willunga SA 5172 Australia
Med-reps and irrational medicine use in sub-Saharan Africa(3)
-----------------------------------------------------
Dear e-drugers,
It is understandable that pharmaceutical producers have to create a
market for their products and using drug reps is only one of the means
that their marketing departments beat the competitors. Like everybody
else profoundly interested in promoting the appropriate use of
medicines, I fully agree that drug reps are very successful in their
mission; they reach prescribers better than anyone else and convince
them to prescribe the medicine they promote regardless of the pros and
cons of the existing evidence. Drug reps have excellent communication
skills and are well trained in using strategies that work best; they
know how to make doctors listen without irritating their professional
dignity (that sometimes borders on arrogance); they dont just drop
some brochures and use words like you should but instead help doctors
feel important, dedicate time to each of them individually and
convince them that they are in some form of partnership and sometimes
even more.
Instead of continuing to demonize drug reps, I think that we should
also be a bit more self-critical about our interventions. With all my
respect for the efforts and achievements that were made so far by
various governments, organizations and agencies in promoting rational
drug use, as Olutayo mentioned, very often drug reps are the only ones
that keep doctors up-to-date about new products in the market. I
wonder what is the proportion of impartial drug information to
marketing drug information that is printed, successfully disseminated
and regularly updated? I assume there is a huge gap in favor of
marketing information.
If we want to change the precribers behavior, the lessons are there.
Drug reps teach us some very good tips how to do that. Did we ever try
to promote rational drug use by adapting similar strategies as drug
reps? It is obvious that it will require much more financial and human
investment but ultimately the benefits could be greater to any health
system in containing overall costs and increasing the quality of
health care if we sent our own reps to prescribers.
Cordially,
Dardane Arifaj
MPH graduate student
Boston University
Email: dardane@bu.edu