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E-DRUG: Drug Detailers (cont)

E-drug: Drug Detailers (cont)
I have a copy of the article from the New York Times.  According to it, the
number of detailers in the U.S. has increased from 35,000 in 1994 to 56,000
in 1998 and companies spent $5.3 billion in the first 11 months of 1998 on
detailers and an additional $1 billion on holding marketing events for
doctors.  The article discusses the influence that detailers have over
doctors prescribing habits and cites a 1995 JAMA article where detailers
presentations to interns and residents were taped and how there were errors
13% of the time.  The background of detailers is changing, with many now
coming from other health care jobs (e.g. nursing) or with science

Hospitals have different policies regarding access to
detailers.  The story cites one hospital where residents were presenting a
case to a detailer in the hopes of getting some treatment advice.

The article discusses the ethics of accepting gifts from detailers.  Some
doctors are willing to take gifts with educational value such as textbooks
(the AMA says this is all right) but other doctors are uncomfortable with

The director of research in one family practice residency program
has changed his approach from one of refusing to let residents see
detailers and now invites them to twice-monthly seminars where residents
criticque their sales presentations for logic and usefulness.  This
particular doctor says he no longer sees any "moral outrage" among
residents about receiving biased information disguised as education.

Some doctors are quite willing to see detailers.  Another doctor sees about
6 a week, spending up to 1/2 hour with each.  He said that one detailer
told him about a safety warning on a new drug that still hasn't been
officially announced. Finally, the story quotes a detailer from Du Pont who
said that only a single doctor among 385 in her territory refuses to speak
to detailers, but through tracking prescribing practices of doctors, she
knows that even that doctor is prescribing Du Pont products.

Joel Lexchin

Joel Lexchin MD
121 Walmer Rd.
Toronto, Ontario
Phone:  (416)-964-7186
Fax:  (416)-923-9515
e mail:  joel.lexchin@utoronto.ca

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