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Docs slower to drop ‘black box' drugs when access todrug reps is restricted by 123wert sdfsf
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Docs slower to drop ‘black box' drugs when access todrug reps is restricted by 123WERT SDFSF
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| Article Posted: 12/05/2012 |
| Article Views: 62 |
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Docs slower to drop ‘black box' drugs when access todrug reps is restricted |
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According to a study published May 21 in The Journal of Clinical Hypertension , doctors whose access to pharmaceutical sales representatives islimited can take more than four times longer to changeprescriptions based on new information than their peers who havemore frequent contact. This longer response time holds true whetherthe physicians are responding to "positive news" relatedto an innovative therapy or "negative news" related to anewly discovered medicine risk. George Chressanthis, professor of healthcare management andmarketing and acting director for the Center for HealthcareResearch and Management at Temple University's Fox School ofBusiness, led the study in collaboration with ZS Associates, aglobal sales and marketing consulting firm with a very deeppresence in the health care industry. "This study analyzed for the first time -- and on a largescale -- what happens to physicians' prescription decisions whenyou decrease the access that pharmaceutical sales reps have todoctors," Chressanthis said. "We saw that increasingaccess restrictions affect physician decision-making in ways notanticipated by those at health care systems or large grouppractices who created these policies." Chressanthis, his research team and ZS consultants began to measurethe behavior of primary care physicians and specialists in 2008when Chressanthis was at AstraZeneca Pharmaceuticals LP.
They drewfrom ZS' annual AccessMonitor™ report, which since 2006 hastracked how frequently 300,000 physicians and other prescribersmeet with pharmaceutical sales reps. According toAccessMonitor™, the number of doctors willing to see reps hasdeclined about 20 percent since 2008. In 2010, about 11 percent ofAmerican physicians had "severe" or "no-see"restrictions on rep access, while 34 percent had "some"restrictions. The study measured prescription activity and behavior by primarycare physicians and specialists from 2006-2008 as it related to thefollowing three major product events: 1) The October 2006 launch of a first-in-class drug to treat Type 2diabetes (sitagliptin) (physician sample size: 65,088); 2) the August 2007 issue of a black box warning (i.e., the FDA'smost serious medication warning) for a drug (rosiglitazone) used totreat Type 2 diabetes (physician sample size: 58,647); and, 3) the January 2008 release of a negative outcome associated with atherapy that combined a cholesterol-lowering drug (simvastatin) andanother medicine (ezetimbe) to treat dyslipidemia (physician samplesize: 72,114). In the case of sitagliptin, physicians with a "very low"level of sales rep access took up to 4.6 times longer to introducethe new drug to patients than physicians who employed a"medium" level of access.
For the black box warning,physicians with "very low" access were up to four timesslower to reduce their use of this treatment than physicians with"low" access. In the clinical trial involving thenegative outcomes of a lipid therapy prescription, physicians wholimited sales rep access showed "significantly less"response in changing their patients' prescriptions than didphysicians in less restrictive offices. ZS managing principal Pratap Khedkar, co-author of the study, saidthe research demonstrated that most physicians should seek tobalance their information sources. "Though health care professionals work hard to minimizedistractions and maximize the time they spend with patients, it'sclear that sales rep access restrictions imposed by well-meaningphysicians and group practice leaders can result in seriousinformation gaps," Khedkar said. "Even thoughpharmaceutical sales representatives are not the only source ofinformation, they do help physicians stay current on therapydevelopments.
These findings should be carefully considered bythose who set policy -- whether it's at the physician grouppractice level or on the national stage." The study also showed primary care physicians rely more heavily onsales reps for drug information than do specialists. "Whenprimary care physicians reduce or eliminate contact with thesereps, it impairs their ability to stay current and affects theirprescription behavior," Khedkar said. "Becausespecialists concentrate in a narrow field, they can stay current byother means, including conferences, online forums, podcasts andacademic journals. Thus, the updates they receive from reps haveless impact on their prescribing abilities." Chressanthis provides these final notes about the importance ofthis study.
"Our study affirms simple intuition that whenphysicians have to make decisions involving complex issues withless than complete information available to them, and where theconsequence of a wrong decision is significant as seen often inhealthcare, unintended consequences are likely to appear," hesaid. "Policies that promote physician ignorance of newmedical information resulting from access limits runs counter toprotecting patient health." Beside Chressanthis and Khedkar, the report authors also includeNitin Jain, ZS principal; Prashant Poddar, ZS consultant; andMichael Seiders, formerly Director of Strategic Public PolicyPlanning at AstraZeneca. Lead author Chressanthis was employed atAstraZeneca from 2000-2009. He still retains stock grants inAstraZeneca. The research was funded by AstraZeneca PharmaceuticalsLP. I am Timepieces, Jewelry, Eyewear writer, reports some information about expensive diamond rings , fairy jewelry box.
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