E-drug: Re: No Free Lunch (cont'd)
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Blaine Carmichael may well be correct when he says that drug products are
becoming increasingly more sophisticated and that doctors need more
education about them. The question is what is that best source for that
education. Studies done over the past 25 years consistently show that the
more that doctors rely on commercial sources of information, (i.e.,
information that comes directly from drug companies in the form of ads,
sales representatives, etc.) the less rational they are as prescribers. I
don't know of a single study that shows that use of promotional material
leads to better prescribing. With respect specifically to sales
representatives there are four studies that rely either on audiotaping of
interactions between doctors and sales reps (with the sales reps
permission) or where doctors have filled out surveys immediately after a
visit. I have done a review of these studies and the basic finding is that
while the reps usually mention the trade name, generic name and indication
for the drug they rarely discuss safety issues and when they do it is
usually in order to put their drug in a good light compared to another
product. Furthermore, there are frequent inaccuracies in the information
that reps transmit when compared to the information in objective sources
such as drug bulletins, textbooks, etc. My article is: Lexchin J. What
information do physicians receive from pharmaceutical representatives?
Canadian Family Physician 1997;43:941-5.
If doctors, physician assistants, nurse practitioners want to see sales
reps they should not expect to get objective information from them.
Joel Lexchin
Joel Lexchin MD
121 Walmer Rd.
Toronto, Ontario
CANADA M5R 2X8
Phone: (416)-964-7186
Fax: (416)-923-9515
e mail: joel.lexchin@utoronto.ca
[Note from moderator: There is also an article in the latest issue of
Prescrire summarising the French experience: Sales representatives. A
damning report by Prescrire's reps monitoring network. Prescrire
International 1999;8(41):86-9 (June 1999) Kirsten Myhr]
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