# \[e-drug\] Med-reps and irrational medicine use in sub-Saharan Africa **URL:** \ **Category:** e-drug\ **Created:** [April 20, 2005, 6:46pm UTC](https://talk.edrugplus.org/t/e-drug-med-reps-and-irrational-medicine-use-in-sub-saharan-africa/22242 "2005-04-20T18:46:41Z")\ **Posts on this page:** 3\ **Page:** 1
**Author:** ![Olutayo\_Adetokunbo](https://avatars.discourse-cdn.com/v4/letter/o/4da419/32.png) [@Olutayo\_Adetokunbo](https://talk.edrugplus.org/u/Olutayo_Adetokunbo)\ **Post date:** [April 20, 2005, 6:46pm UTC](https://talk.edrugplus.org/t/e-drug-med-reps-and-irrational-medicine-use-in-sub-saharan-africa/22242/1 "2005-04-20T18:46:41Z")
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. ---
**Author:** ![Dr\_Peter\_R\_Mansfield](https://avatars.discourse-cdn.com/v4/letter/d/c68b51/32.png) [@Dr\_Peter\_R\_Mansfield](https://talk.edrugplus.org/u/Dr_Peter_R_Mansfield)\ **Post date:** [April 20, 2005, 10:04pm UTC](https://talk.edrugplus.org/t/e-drug-med-reps-and-irrational-medicine-use-in-sub-saharan-africa/22242/2 "2005-04-20T22:04:48Z")
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](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 ---
**Author:** ![Dardane\_Arifaj-Blumi](https://avatars.discourse-cdn.com/v4/letter/d/9fc348/32.png) [@Dardane\_Arifaj-Blumi](https://talk.edrugplus.org/u/Dardane_Arifaj-Blumi)\ **Post date:** [April 23, 2005, 2:10am UTC](https://talk.edrugplus.org/t/e-drug-med-reps-and-irrational-medicine-use-in-sub-saharan-africa/22242/3 "2005-04-23T02:10:50Z")
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