The majority of family doctors receive little or no information about harmful effects of medicines when visited by pharmaceutical sales representatives, according to an international study involving Canadian, American, and French physicians.
Surprisingly, the same doctors report that they were likely to start prescribing the drugs anyway. These results substantiate previous research that doctor’s prescribing behavior is influenced by pharmaceutical promotion.
The study, published online today in the Journal of General Internal Medicine, asked doctors to respond to questions about how they promoted medication following sales visits.
Results showed that sales representatives failed to provide any information about either common or serious side effects or the type of patients who should not use the medicine in 59 per cent of the promotions.
“Laws in all three countries require sales representatives to provide information on harm as well as benefits,” says lead researcher Barbara Mintzes of the University of British Columbia. “But no one is monitoring these visits and there are next to no sanctions for misleading or inaccurate promotion.”
Serious risks were mentioned in only six percent of the promotions, even though 57 per cent of the medications discussed had US Food and Drug Administration black box warning or Health Canada boxed warnings—the strongest drug warning that can be issued by both countries.
“We are very concerned that doctors and patients are left in the dark and patient safety may be compromised,” says Mintzes, an expert on drug advertising from the University of British Columbia School of Public Health.
Possible side effects were more likely to be discussed with doctors in France, where regulations on promotion of medicines are stricter.
The crucial role of pharmaceutical companies
Pharmaceutical companies are essential to the investigative process and to healthcare. They develop, produce and market a wide range of therapeutic agents for common and rare diseases. Their reputation has taken quite a hit lately, with Glaxo SmithKline’s $3 billion settlement for healthcare fraud just one example. This new study will contribute their bad image and open the door even wider to generic drugs and their manufacturers.
The problem with generic drugs
Generic drugs may save consumers money, but companies that produce generics do not invest in research. They are like ambulance chasers, making money on the financial and human resources of pharmaceutical firms when their patents expire. Generics are controversial because inactive ingredients used in generics can affect delivery of the active ingredient, affecting potency, or causing side effects. Generic drugs simply are not equal to brand medications. They cause a host of problems and no party accepts responsibility when something goes wrong. The drug developer says they did not make the medicine and the generic manufacturer says they did not develop it, so they are not liable. Generic drugs are a hot potato that no one wants to claim when a patient gets sick or dies. Consumers in a quest to save money put their health at risk.
A system begging for repair
Pharmaceutical companies must reestablish trust with the American consumer. The doctors responded honestly to the questionnaire, which suggests they want to see a change in the status quo.
Doctors learn little about medications in medical school and rely on pharmaceutical sales representatives for information. Pharmaceutical companies must insist representatives sales are based on the communication of sound clinical information. The sales representatives should be held legally accountable for crucial information not shared. Add their name to the lawsuits. They aren’t selling Avon. No offense to Avon because an Avon representative won’t sell you a product too harsh for your skin or a bad color just to make a sale.
This needs fixing or all our medications will be soon be made internationally by employees with no training, little sleep, and no FDA oversight. Next time a pharmacist offers you a generic, ask where it was made. The shrug and the response may surprise you.
Pharmaceutical companies need longer patent times to recoup their costs to reinvest in the development and production of new drugs and train clinical sales staff without being chased by generic companies just waiting for the clock to run out.