25 June 2013

Will Breakup of Physician – Drug Co Reps Help?

How do I approach this topic? A new report written about in Science Daily suggests breaking up the relationship between physicians and drug company representatives. The report suggests this could improve health care and significantly reduce drug costs by this action. The drug company representatives promote the newest, more costly, and often unnecessary prescription drugs.

In the past, it may have benefited doctors by keeping them up to date on new medications, and always provided generous amounts of "free" samples to get patients started on the newest drugs, as well as other supplies and gifts. Now it has become a powerful marketing process into which the pharmaceutical industry pours tens of billions of dollars a year, (I had to reread this and do some investigation, but billions with a B is correct).  The article reports that there is one drug representative for every eight doctors in the USA. If you can understand how this best serves patients, I can't and believe this would help cut medical drug costs dramatically.

If you think the costs would be helped, then this international study involving Canadian, USA, and French Physicians should make you concerned. A majority of family doctors receive little or no information about the harmful effects of drugs when visited by drug company representatives. Consistent with prior research, these physicians are likely to prescribe drugs showing that they have been influenced by pharmaceutical promotion.

Even with laws in all three countries requiring drug sales representatives to provide information on harmful effects and well as benefits, no one monitors these visits and there are very few sanctions for misleading or inaccurate promotions.

If the breakup happens, the American Association of Clinical Endocrinologists (AACE) will probably not be happy about this because for years, they have been educating the drug company representatives. The AACE runs the AACE Industry Training and Certification Program for Pharmaceutical Personnel for endocrine related disorders. The primary purpose of the program is to enhance pharmaceutical and medical device company representatives’ knowledge as it relates to the endocrinologist’s decision making process for patient management and treatment. This will be accomplished through a case based curriculum utilizing the latest scientific guidelines, clinical information and individualized goals for patient treatment.

Is it any wonder why the AACE promotes their algorithm so hard? It will be taught to the drug company representatives to help them make sales. This is also another reason why the harmful effects are often conveniently not talked about and why people like Dr. Alan J. Garber of the AACE and Dr. Robert Ratner of the ADA are so quick to attempt to discredit research unfavorable to the different oral medications for those with type 2 diabetes.

The AACE is bold when they say, “The ultimate goal of the program is to establish a gold standard for knowledge and professionalism among industry representatives, with respect to the range of treatment therapies in the management of endocrine disease. Each participant will be recognized with a graduate certificate after successful completion of the course and passing the exam. The term of the certification is two years, subsequent re-certification will be offered after the term has expired.”

The PDF file describing the education can be found on the AACE website here. Once you have the home page, move the cursor to the “Education Tab” and then down to the last item in column two or “AACE Industry Training and Certification Program.” By clicking on it, this will download the PDF file.

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