Thomas A. M. Kramer, MD


Medscape General Medicine. 2004;6(1):e31 

In This Article

Understanding the Bias

Collecting information from pharmaceutical representatives in a similar fashion can be enormously useful for both the practitioner and the patient, as long as one understands the inherent biases. Drug reps are paid to talk to doctors about their products, just as car dealership salespeople are paid to talk about their cars. It is my firm belief that pharmaceutical representatives should be made to earn their money. In their interactions with me, I demand that they teach me something. I will tell them what their competitors are saying about their product and listen to them respond to it, and I will ask them why I should prescribe their product instead of their competitors' and listen to what they have to say. More often than not, I learn something useful from this process. Whatever their bias may be, the representative has access to information from the company that can be quite useful.

Here is an example of this process to illustrate the point. While meeting with a representative of a company that makes a relatively new SSRI, I asked the representative why I should prescribe their product instead of generic fluoxetine, which, because it was off patent, would save my patients money. He pulled out pricing sheets from the biggest chain pharmacies in the area to show me that his product, despite being on patent, was slightly cheaper for the usual therapeutic dose than generic fluoxetine. This influenced my prescribing in ways that saved my patients a little bit of money, even though it certainly was biased on his part to tell me this.