Tuesday, March 14, 2006

 

"Unselling" of Generic Drugs to Physicians

Automated information exchanges between the FDA, drug companies, physicians and pharmacies promise to save money and time and also lots of lives, because lots of people die from errors with prescription drugs (see To Err is Human: Building a Safer Health System."). I've been reading a lot about healthcare automation lately, and I've used the problem of designing a handheld "prescription writer" as a homework assignment in my Document Engineering course at UC Berkeley. I'd like to imagine that physicians would make decisions about what drugs to prescribe on the basis of information from objective sources... but of course that's a little naive.

So a somewhat disturbing article in the Wall Street Journal on 13 March 2005 about how Pennsylvania is trying to reduce its exploding drug costs for state employees by having "unsellers" visit doctors to pitch generic drugs reminds us that some information exchanges may not be completely trustworthy and automatable. Drug firms have long used people called "detailers" to pitch free samples to doctors, and this article reports how seriously the drug companies track each doctor's prescription habits by mining transaction data from pharmacies. These detailers are very effective at getting doctors to prescribe proprietary and hence more profitable drugs. Pennsylvania is now fighting back using the same techniques against the drug companies.

-Bob Glushko

Comments:
Interesting article. I am really concerned about how little the generic drugs are being regulated. They are not exactly the same thing. Bioavailability between generic and brand name varies.

I am currently taking a medication and while on the name brand did great. Then I switched to generic and I am experiencing some negative side effects. I'm going to switch back to brand to see if I feel better.

Other people have shared the same story with me as well.
 
Check out this article:

http://pharmacy.creighton.edu/pha443/pdf/pkin08.pdf
 
Dear girl from Texas -- I'm sure you're right that not all generic drugs are exactly equivalent in all respects to the proprietary ones. I have been fortunate to almost never need to take any medication so I have little first-hand experience about your concerns. But I do have concerns about the vast price differences between proprietary and generic drugs, and the most amazing part of the story I commented about was that a state government can make a business case for hiring people to counteract the efforts of the drug firms to lobby physicians.

Like I said, I was naive enough to think that physicians got their information from objective sources. But what would be an objective source, anyway?

bob glushko
 
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