Doctors Say Info From Pharma Reps Is Stale

Ken Terry

August 07, 2017

Just over half of the time, pharmaceutical reps show physicians information they have already seen, according to a new DRG Digital/Manhattan Research survey of 1814 physicians in 25 specialties.

In some specialties, the detailers' data are stale more often. Medical oncologists said the reps provide information they're already aware of 68% of the time. Dermatologists said this occurs 62% of the time, the survey found.

The study pointed to a change in how doctors prefer to obtain information about drugs and other treatment options. For example, while 12% of physicians had exchanged emails with a pharma rep within the past 6 months, 36% of them said they wanted to. And while 9% of physicians were using "remote detailing" programs, such as a self-detailing app or a "click to chat" website feature, 35% of respondents said they would like to do that.

Other Manhattan Research surveys have shown that 74% of physicians use Internet search engines at least once a week, and 52% use pharma digital resources regularly. Although the report did not indicate why physicians use search engines, it's likely they do it partly to look up drug studies, John Abramson, MD, a lecturer in health policy at Harvard Medical School, told Medscape Medical News.

"Today's physicians are now adept at finding clinical information online, as they need it — and reps that focus too much time on basic product and promotional info risk boring them with info they already know," a press release on the new survey said.

According to the survey, 64% of physicians said they'd met with pharmaceutical sales reps over the past 6 months. This seems to represent a significant drop in the percentage of doctors who meet with these reps, Dr Abramson said. In his 2004 book Overdosed America, he estimated that 80% to 90% of physicians met regularly with detailers.

The Manhattan Research report urged pharmaceutical marketers to up their game in a couple of ways. First, it suggested that they use modern technology, such as computer tablets, in detailing meetings, because the survey found that doctors were more satisfied with those meetings when the reps used tablets.

Second, the report advised sales teams to follow the example of digital marketers for pharma companies, who are more focused on physician engagement and building long-term relationships with prescribers than on meeting sales goals.

"Sales and marketing teams need to get on the same page with regards to digital pull-through, so that they're providing a deeper level of support to physicians beyond product promotion and maximizing their investment," said DRG digital analyst Jeff Wray in the news release.

Unreliable Information?

Dr Abramson argued that physicians who now obtain their drug information online may be deceiving themselves into thinking that the information is reliable. Noting that the preponderance of drug studies are paid for by pharmaceutical firms, he said, "The odds are very high that the drug company is either directly or indirectly behind the information that is available on the Web."

Drug companies are still interested in selling drugs, Dr Abramson said. "What has changed are the ways in which physicians receive information. With mobile devices and mobile apps, more and more physicians are going to be receiving their information that way. Some of them will choose to receive the information they used to receive face to face through the Internet."

Jerry Avorn, MD, another critic of the pharmaceutical industry who is a professor of medicine at Harvard Medical School, told Medscape Medical News, "The real issue is that prescribers know a company sales rep is not the best source of unfiltered information about the drugs we prescribe, since their role and their message are all about increasing their employer's sales. That's particularly true at a time when doctors can increasingly access original research papers on our own."

Unlike Dr Abramson, Dr Avorn doesn't cite the drug company sponsorship of these articles as a drawback. The challenge, he said, is to help physicians "put that firehose of information into a practice-relevant context, to help them make more informed drug choices." He suggested that the solution might be "academic detailing," in which specially trained pharmacists are sent by a nonprofit organization to give doctors the evidence and the context they need to make good prescribing decisions.

One such organization, he said, is Boston-based Alosa Health, for which Dr Avorn is an unpaid consultant. Another cited by a Pittsburgh Post-Gazette article is Tennessee-based Axial Healthcare. The Veterans Affairs health system and Kaiser Permanente have also used academic detailing, the Post-Gazette said.

In response to the Manhattan Research survey, Holly Campbell, deputy director of public affairs for PhRMA, the drug industry trade association, told Medscape Medical News, "Collaboration between physicians and biopharmaceutical companies is critical to improving the health and quality of life of patients. Research shows that accurate information about disease and treatment options makes patients and healthcare providers better partners.

"Beyond increasing patient awareness of diseases and available treatments, collaboration between physicians and biopharmaceutical professionals increases awareness of the benefits and risks of new medicines, encourages appropriate use of medicines, and provides companies with real-world insights that may help inform the development of future treatment options," the PhRMA spokesperson said.

Dr Avorn is an unpaid consultant to Alosa Health and receives no financial benefit of any kind from any academic detailing services. Dr Abramson has disclosed no relevant financial relationships.

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