Study finds when hospitals limit pharma sales representatives, doctors prescribe more generics

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When academic medical centers put restrictions on pharmaceutical sales representatives, their doctors tended to order fewer promoted brand-name drugs.

When academic medical centers put restrictions on pharmaceutical sales representatives, their doctors tended to order fewer promoted brand-name drugs and used more less expensive generic versions instead, a new study finds.

Efforts to regulate "detailing," or marketing by drug company sales reps, resulted in modest but significant changes in prescribing behavior for some but not all of the teaching hospitals, according to a study published in JAMA.

The study looked at prescribing behavior of 2,126 doctors at 19 U.S. academic medical centers before and after the hospitals enacted policies restricting when and how pharma reps were allowed to interact with physicians. They compared prescribing behavior with a control group of doctors from other medical centers without restrictive policies, focusing on prescriptions for 262 drugs in eight different classes.

The study is in line with previous research that found free meals for physicians pay off big for drug companies, as those doctors have an increased rate of prescribing the brand-name medication that the company is promoting.

The changes in prescribing seemed to be strongest at the hospitals that implemented the strictest policies that included enforcement, authors Colette DeJong and Adams Dudley, M.D., of the School of Medicine at the University of California, San Francisco noted in an accompanying opinion piece.

Physicians need to balance risks with the benefit of education about drugs, especially when the help comes from pharmaceutical companies whose interest may conflict with that of patients, they wrote.

Hospitals and physicians have become so wary of the pharmaceutical industry’s reported ability to change prescribing habits—even among doctors who don’t believe they’re being influenced—that they’re increasingly banning reps from their practices,