November 1st, 2006
Medical Schools Train Doctors to Resist Marketers' Siren Songs
By David B. Caruso
Medical schools in several states are strengthening programs that warn doctors and students not to be dazzled by drug company marketing practices.
The pharmaceutical industry spends billions of dollars a year on advertising and lavish sales pitches to doctors, prompting concerns that slick promotion is unduly influencing how medications get prescribed.
The Mount Sinai School of Medicine announced Wednesday that it would use a $400,000 grant to remind doctors to question sophisticated sales presentations and rely on solid science when deciding which medications to give patients.
“We want to appeal to physicians’ natural skepticism,” said Dr. Ethan Halm, an associate professor of medicine and health policy at Mount Sinai.
The program is one of five receiving $1.9 million from the Attorney General Consumer and Prescriber Education Grant Program, which has awarded $11 million to 28 institutions interested in cautioning health care workers about pharmaceutical sales techniques.
Grants also were announced Wednesday for the Institute on Medicine as a Profession, the University of Arkansas, Florida International University and the University of Minnesota.
One of the programs being implemented at Mount Sinai will be a new type of class at its Morchand Education Center, famous for training exercises that use actors to play patients. For these new sessions, though, the actors will be playing pharmaceutical company sales representatives.
Halm said doctors need better skills to navigate those sales meetings, which can be seductive affairs in which health care providers are treated to free meals and showered with data about a drug’s benefits.
“We want doctors to learn how to effectively spar with the drug reps” and question what they have to say, Halm said.
The Pharmaceutical Research and Manufacturers of America group, which represents the country’s top pharmaceutical research and biotechnology companies, said those companies naturally have the most comprehensive information about the medicines they research and develop.
“And their sales representatives _ many of whom are health care professionals themselves _ are well-trained technically and are prepared to answer the questions of health care providers about the benefits, proper use and side effects of drugs,” PHRMA general counsel Scott Lassman said in a statement.
He added that sales representatives must comply with federal guidelines and the industry group’s own guide on ethical interactions.
“Restricting the ability of sales representatives to give health care professionals valuable drug usage and safety information _ which is designed to benefit patients _ would be a serious mistake,” he said.
Another part of Mount Sinai’s program will advise health care providers how to tactfully deal with patients who see a drug on television and demand a prescription.
Almost daily, Halm said, doctors prescribe wonderful but maybe lesser-known medications, only to have patients react as if they had been offered second-rate imitations.
“They say, ‘What about that thing the actor was using on TV? Can I get that instead? My insurance company is paying. Don’t give me the cheap stuff,”’ Halm said.
Money for the education programs comes from a $430 million settlement that resolved charges that pharmaceutical giant Pfizer Inc. illegally paid doctors to prescribe its drug Neurontin for uses that had not been approved by the U.S. Food and Drug Administration.
Doctors may generally prescribe drugs for whatever use they see fit, but drug companies are barred from promoting medicines as cures for ailments they have not been federally approved to treat.
The next $6.5 million in grants will be for initiatives aimed at educating consumers about how drugs are prescribed and marketed, said the Center for Evidence Based Policy at Oregon Health & Science University, which administers the grants.