# E-DRUG: Re: No Free Lunch (cont'd) **URL:** \ **Category:** e-drug\ **Created:** [May 27, 1999, 7:09pm UTC](https://talk.edrugplus.org/t/e-drug-re-no-free-lunch-contd/5142 "1999-05-27T19:09:06Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![joel.lexchin](https://avatars.discourse-cdn.com/v4/letter/j/e9c0ed/32.png) [@joel.lexchin](https://talk.edrugplus.org/u/joel.lexchin)\ **Post date:** [May 27, 1999, 7:09pm UTC](https://talk.edrugplus.org/t/e-drug-re-no-free-lunch-contd/5142/1 "1999-05-27T19:09:06Z")
E-drug: Re: No Free Lunch (cont'd) ---------------------------------------------------------- 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] -- Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'. Mail administrative requests to `majordomo@usa.healthnet.org'. For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.