Monday, November 26, 2007

A License to Push

Beware the pusher man. Not the one lurking in the shadows, or hanging around school yards. This one comes in a tailored suit and attends luncheons & cocktails.

Doc's are heavily recruited to push drugs. Some estimates say 25% of docs have a sideline business promoting meds.

So what's wrong with that? Doc's are being squeezed by managed care to see more patients and accept lower reimbursements. Is there anything wrong with recruiting doc's as pitch men (and women)?

What do you really know about your doc and the meds they push? Are they a decile 6 doc?

I received faxes before talks preparing me for particular doctors. One note informed me that the physician we’d be visiting that day was a “decile 6 doctor and is not prescribing any Effexor XR, so please tailor accordingly. There is also one more doc in the practice that we are not familiar with.” The term “decile 6” is drug-rep jargon for a doctor who prescribes a lot of medications. The higher the “decile” (in a range from 1 to 10), the higher the prescription volume, and the more potentially lucrative that doctor could be for the company.

Some docs are trigger happy when it comes to meds. Is it because they work or is there some other motivation?

How much information is gathered on your doc's scripting and how is it used? You may be surprised.

they received printouts tracking local doctors’ prescriptions every week. The process is called “prescription data-mining,” in which specialized pharmacy-information companies (like IMS Health and Verispan) buy prescription data from local pharmacies, repackage it, then sell it to pharmaceutical companies. This information is then passed on to the drug reps, who use it to tailor their drug-detailing strategies.

Guess who else is in the food chain.

The American Medical Association is also a key player in prescription data-mining. Pharmacies typically will not release doctors’ names to the data-mining companies, but they will release their Drug Enforcement Agency numbers. The A.M.A. licenses its file of U.S. physicians, allowing the data-mining companies to match up D.E.A. numbers to specific physicians. The A.M.A. makes millions in information-leasing money.

So what is the end result?

You may be taking meds that you do not need? Or perhaps your overall health (and wallet) could be better served with a different, possibly lower cost, med.

Are you taking additional drugs to offset the side effects of your primary medication?

Consumers are just as much to blame as the drug companies. More often than not patients fail to question their doc about prescribed meds. Is this the best med for you or simply one that comps your doc more than another?

Does the pusher man in your life have a sheepskin on his wall?

UPDATE: We asked fellow MedBlogger Dr John Ford about this issue, and he replied that it's "very real, very common, and very legal."
For more information on this, check out the doc's post on the issue.
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