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[e-drug] Pharmaceutical advertisements in prescribing or EHR software

E-DRUG: Pharmaceutical advertisements in prescribing or EHR software

Dear E-Drug colleagues,

I should be most grateful for information concerning whether or not 
pharmaceutical promotion has infiltrated prescribing &/or electronic 
health record software in your country.

Also, is anyone aware of any research on the impact of this practice on 
prescribing habits?

In Australia, in 1999, the uptake of computers by general practitioners 
(GPs) was stimulated by the Australian government. A one-off grant of 
around $10,000 was offered to those practices that purchased a computer, 
acquired Internet connectivity (an E-mail address) and promised to use 
computer prescribing software to write the majority of their 
prescriptions. This increased the numbers of GPs writing prescriptions 
with the aid of a computer from around 50% in 1999 to more than 90% in 
2004. Legible, printed prescriptions were one of many positive outcome 
of this initiative. However, problems have also resulted.

One software vendor (Medical Director) rapidly became dominant in the 
market place because its business model relied on selling advertising 
space within the software to subsidise the cost of purchasing and 
updating the program. This business model facilitated software uptake 
but also exposed prescribers (and often their patients) to numerous 
advertisements throughout the day.

A preliminary analysis of Medical Director software showed 29 clinical 
functions where advertisements occurred ranging from prescribing, to 
entering blood pressure, to looking up patient information leaflets. 
Most advertisements were provided by research based pharmaceutical 
companies. Only one generic manufacturer was represented; the latter 
contributed 3% of drug advertisements

The possible impact of pharmaceutical advertisements on cost-effective 
prescribing has been the subject of vigorous debate in Australia. Some 
believe that pharmaceutical advertisements in prescribing &/or EHR 
software should be banned by the government. Others are concerned that 
such a ban would raise the price of the software, prevent otherwise 
lawful activity, inhibit free speech, etc.

It would be most helpful if we could learn what people in other 
countries have done about this problem.


Dr. Ken Harvey
Web: http://www.medreach.com.au Mobile: 0419 181910

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