The credibility of the source of your information is stressed when that source, pharma, has a natural bias and lots of money to reinforce that bias. It is time that an appropriate separation is enforced so the Doctor can focus on client health without making less than fully informed decisions on the appropriate medication (be it brand or generic).
It is the role of trained pharmacists to understand the drug options available supported by well designed benefit plan designs. Everyone has a role in ensuring that costs are contained and there is a cost effective means to deliver the appropriate drug at a fair price to the consumer. That includes a well informed consumer.
You realize that movies are just make-believe right? In this situation I feel the doctor is the one who is behind the times. I’ll point to the tenacious way the OMA guards its turf, if doctors are over worked and need less skilled sale reps to help them make decisions – true or not – then I would suggest they are the authors of their own fate. If some of their work was ceded to nurses perhaps they might find the time to stay current. Lately I have read a number of articles indicating mostly the same thing that the patient must be educated, the patient needs to be a better consumer and so on. Generally these are related to prescription drugs, the only area in our health care system where there is any form of competition or “consumer choice”. If you want a patient to behave like a consumer and make decisions based on price or cost then open the system up to market forces. People in a closed system won’t behave as if there is or are market forces at play if the system is closed. I personally feel the role of the doctor has to change and that the expectations of doctors is rising faster that their ability to stay ahead of that curve. I’ll site the British Medical Journal Study published on November 30, 2006 – wherein the researchers used Google to diagnose medical cases. In 54% of the cases Google – a simple search on the internet – returned the correct diagnosis. Asking the patient to be the second opinion or play the role of investigator or smart consumer after a doctor has been persuaded to use brand x as their weapon of choice for (insert disease or condition name here) places the horse squarely before the cart.
You raise some very good points and I enjoyed the article.
The pharmaceutical industry was in an arms race from the early 1990’s up until sometime just before 2008. In that time, many products were introduced to the market (often me too products). In most cases, if a new product launched they hired a full new slate of reps to call on primary care physicians and sometimes a new specialty force as well. This reach and frequency model eventually met with resistance from the prime target market, physicians, as some companies had as many as 10 reps calling on the same physicians. Once the law of diminishing returns was noticed, the companies began to scale back, so that 20% reduction was a result of that combined with a lack of significant new products. At the same time, the focus increased more on specialist to drive some of the newer specialized products. The number of reps was increased in that arena in recent years.
Pharma reps are, as you state, highly trained, personable and professional people in sales. They are also from very diverse backgrounds, everything from foreign physicians, pharmacists, phd’s , business, science , etc. But, you will not find a representative for a generic drug in any office. It simply is not existent. That may change with the eventual introduction of Biosimilar drugs.
The idea of trying to educate patients is I believe essential but I don’t believe that it will lead to a big change in your intended outcome. The best way is to work directly with physicians in a proactive and positive approach combined with a plan member education. After all it works for pharma!
Good article and one that I am sure will generate discussion. Also important to point out that many patients do not want to take a generic, the same way that most of us buy Heinz ketchup and not no-name brand. Physicians, in most cases, understand costs and utilize generics when possible, but also understand that brand name drugs lead to R&D dollars going back into developing new innovative products. The Montréal Economic Institute recently published a paper (Yanick Labrie, September 2011) that clearly showed a link between pharmaceutical rep promotion and R&D investments of pharmaceutical companies. Let’s not forget, R&D investment today leads to the treatments and cures for tomorrow …something that generic companies cannot offer.
Plans need to reimburse cost-effective medications at 90%+ and less cost-effective medications as low as 50%. Manage the formulary and the design, and plan members will drive change for the better.
Gren MacDonald:
The credibility of the source of your information is stressed when that source, pharma, has a natural bias and lots of money to reinforce that bias. It is time that an appropriate separation is enforced so the Doctor can focus on client health without making less than fully informed decisions on the appropriate medication (be it brand or generic).
It is the role of trained pharmacists to understand the drug options available supported by well designed benefit plan designs. Everyone has a role in ensuring that costs are contained and there is a cost effective means to deliver the appropriate drug at a fair price to the consumer. That includes a well informed consumer.
Wednesday, November 23 at 4:40 pm |
Scott Warner:
You realize that movies are just make-believe right? In this situation I feel the doctor is the one who is behind the times. I’ll point to the tenacious way the OMA guards its turf, if doctors are over worked and need less skilled sale reps to help them make decisions – true or not – then I would suggest they are the authors of their own fate. If some of their work was ceded to nurses perhaps they might find the time to stay current. Lately I have read a number of articles indicating mostly the same thing that the patient must be educated, the patient needs to be a better consumer and so on. Generally these are related to prescription drugs, the only area in our health care system where there is any form of competition or “consumer choice”. If you want a patient to behave like a consumer and make decisions based on price or cost then open the system up to market forces. People in a closed system won’t behave as if there is or are market forces at play if the system is closed. I personally feel the role of the doctor has to change and that the expectations of doctors is rising faster that their ability to stay ahead of that curve. I’ll site the British Medical Journal Study published on November 30, 2006 – wherein the researchers used Google to diagnose medical cases. In 54% of the cases Google – a simple search on the internet – returned the correct diagnosis. Asking the patient to be the second opinion or play the role of investigator or smart consumer after a doctor has been persuaded to use brand x as their weapon of choice for (insert disease or condition name here) places the horse squarely before the cart.
Thursday, November 24 at 10:21 am |
Ed Fedora:
You raise some very good points and I enjoyed the article.
The pharmaceutical industry was in an arms race from the early 1990’s up until sometime just before 2008. In that time, many products were introduced to the market (often me too products). In most cases, if a new product launched they hired a full new slate of reps to call on primary care physicians and sometimes a new specialty force as well. This reach and frequency model eventually met with resistance from the prime target market, physicians, as some companies had as many as 10 reps calling on the same physicians. Once the law of diminishing returns was noticed, the companies began to scale back, so that 20% reduction was a result of that combined with a lack of significant new products. At the same time, the focus increased more on specialist to drive some of the newer specialized products. The number of reps was increased in that arena in recent years.
Pharma reps are, as you state, highly trained, personable and professional people in sales. They are also from very diverse backgrounds, everything from foreign physicians, pharmacists, phd’s , business, science , etc. But, you will not find a representative for a generic drug in any office. It simply is not existent. That may change with the eventual introduction of Biosimilar drugs.
The idea of trying to educate patients is I believe essential but I don’t believe that it will lead to a big change in your intended outcome. The best way is to work directly with physicians in a proactive and positive approach combined with a plan member education. After all it works for pharma!
Thursday, November 24 at 2:14 pm |
Bill Ford:
Good article and one that I am sure will generate discussion. Also important to point out that many patients do not want to take a generic, the same way that most of us buy Heinz ketchup and not no-name brand. Physicians, in most cases, understand costs and utilize generics when possible, but also understand that brand name drugs lead to R&D dollars going back into developing new innovative products. The Montréal Economic Institute recently published a paper (Yanick Labrie, September 2011) that clearly showed a link between pharmaceutical rep promotion and R&D investments of pharmaceutical companies. Let’s not forget, R&D investment today leads to the treatments and cures for tomorrow …something that generic companies cannot offer.
Thursday, November 24 at 4:26 pm |
Hugh Paton:
Plans need to reimburse cost-effective medications at 90%+ and less cost-effective medications as low as 50%. Manage the formulary and the design, and plan members will drive change for the better.
Friday, January 20 at 3:46 pm |