Following the Script: How Drug Reps Make Friends and Influence Doctors

University of California, San Francisco, San Francisco, California, United States
PLoS Medicine (Impact Factor: 14.43). 05/2007; 4(4):e150. DOI: 10.1371/journal.pmed.0040150
Source: PubMed


This article, which grew out of conversations between a former drug rep and a physician who researches pharmaceutical marketing, reveals the strategies used by reps to manipulate physician prescribing.

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    • "Pharmaceutical lobbying is another controversial issue that affects many parts of the world [22] [23] [24] [25]. Among its many aspects, we focus on the marketing practices of large pharmaceutical companies which manipulate the opinions of doctors, health care providers and law-makers by providing biased information and through other tactics [26] [27]. There have been allegations that big drug companies influence physicians to prescribe their highly priced branded drugs even when other better or cheaper alternatives are available [28] [29]. "
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    ABSTRACT: With a vast number of items, web-pages, and news to choose from, online services and the customers both benefit tremendously from personalized recommender systems. Such systems however provide great opportunities for targeted advertisements, by displaying ads alongside genuine recommendations. We consider a biased recommendation system where such ads are displayed without any tags (disguised as genuine recommendations), rendering them indistinguishable to a single user. We ask whether it is possible for a small subset of collaborating users to detect such a bias. We propose an algorithm that can detect such a bias through statistical analysis on the collaborating users' feedback. The algorithm requires only binary information indicating whether a user was satisfied with each of the recommended item or not. This makes the algorithm widely appealing to real world issues such as identification of search engine bias and pharmaceutical lobbying. We prove that the proposed algorithm detects the bias with high probability for a broad class of recommendation systems when sufficient number of users provide feedback on sufficient number of recommendations. We provide extensive simulations with real data sets and practical recommender systems, which confirm the trade offs in the theoretical guarantees.
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    • "First and foremost, the distance approach, as formulated in this project, was not viewed as favorably as outreach delivered in person. This is consistent with the theoretical framework of detailing which stresses the importance of relationship building and credibility on affecting change [4,22]. Future work should either abandon this approach or supplement it with individual interaction. "
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    ABSTRACT: Background Academic detailing is an interactive, convenient, and user-friendly approach to delivering non-commercial education to healthcare clinicians. While evidence suggests academic detailing is associated with improvements in prescribing behavior, uncertainty exists about generalizability and scalability in diverse settings. Our study evaluates different models of delivering academic detailing in a rural family medicine setting. Methods We conducted a pilot project to assess the feasibility, effectiveness, and satisfaction with academic detailing delivered face-to-face as compared to a modified approach using distance-learning technology. The recipients were four family medicine clinics within the Oregon Rural Practice-based Research Network (ORPRN). Two clinics were allocated to receive face-to-face detailing and two received outreach through video conferencing or asynchronous web-based outreach. Surveys at midpoint and completion were used to assess effectiveness and satisfaction. Results Each clinic received four outreach visits over an eight month period. Topics included treatment-resistant depression, management of atypical antipsychotics, drugs for insomnia, and benzodiazepine tapering. Overall, 90% of participating clinicians were satisfied with the program. Respondents who received in person detailing reported a higher likelihood of changing their behavior compared to respondents in the distance detailing group for five of seven content areas. While 90%-100% of respondents indicated they would continue to participate if the program were continued, the likelihood of participation declined if only distance approaches were offered. Conclusions We found strong support and satisfaction for the program among participating clinicians. Participants favored in-person approaches to distance interactions. Future efforts will be directed at quantitative methods for evaluating the economic and clinical effectiveness of detailing in rural family practice settings.
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    • "Moreover, the emerging issues and increasingly inclusive understanding on drug coverage, drug utilization, health care costs, and diagnostics of non-compliance helped some scholars in reflecting upon the nature of globalism within the contemporary capitalist enterprise (Edberg, 2009:337–8; Adams et al., 2001; Whitmarsh, 2009; Biehl, 2007; Singer, 2008). Meanwhile, a number of studies from other disciplines continuously emphasized upon the importance of understanding the pharmaceutical industry-physician relationship, more precisely, its impact on health care professionals (Reekie, 1970; Campbell et al., 2007; Fugh-Berman and Ahari, 2007). Most such studies have indicated both the positive and negative (Wazana, 2000; Sierles et al., 2005; Coyle, 2002; Blumenthal, 2004; Holmer, 2001; Brennan et al., 2006; Brodkey, 2005) impacts of pharmaceutical industry on health care practices. "
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