sales reps/drug reps

tallaght01

What does the panel think of them?

Do the docs/nurses etc here talk to them or take their wares?
Do the sciencey people let them come into their labs to show them new machines etc?

Just so the non medic people know what I'm on about.....

It's pretty common for a rep from a drug company to come in an organise a "meeting" at lunchtime in a hospital. They bring along posh food, and various "gifts" (ranging from pens, diaries and alarm clocks, to very expensive textbooks and medical equipment) to give to whoever turns up. When they visit GP Practices they often offer much bigger incentives,as they do with consultants.

So once you let them into your surgery/lecture theatre etc they give a talk, usually about the evidence base for a new drug that they're selling. They present a lot of data, and try to convince the audience that they should prescribe it.

They argue that they bring gifts as a courtesy, as we have given up our lunch times to listen to them.

Some argue that they are trying to bribe us into going to a meeting where they try and feed us misleading data

I personally don't trust drug reps. I don't accept anything from them, and I eat my packed lunch at their meetings, while others get stuck into the grub from marks and sparks. A good few of my colleagues don't either. I'll listen to what they say. But I always take away a copy of the original research paper. Often I'll just take a copy of the paper, and won't go to the talk. I've lost count of how many times these guys have tried to mislead me with data.

Now, some of my colleagues argue that they're no harm. They take the grub/gifts and grill these guys after they've spoken. If they don't answer the questions satisfactorily, then they don't prescribe the drug. End of. They argue that these guys are often talking about useful drugs, and that we should listen tot hem and make out own mind up. In fairness, they do often get quite a grilling. Though the drug companies are, I think, gettinbg past this by sending hot ladies to give the talks more often nowadays. Anecdotally, they seem to get asked less aggressive questions

So, I was just wondering do people take stuff from drug reps, or do they even let them speak to them.

Do the non medics think we shoud be allowed interact with them?

All views welcome from anyone. Would be good to hear what people think.

2Scoops

I don't think meeting with reps and hearing what they have to say should be disallowed. Accepting the free meal or other small freebies, while not perfect from an ethical point of view, isn't really a big deal - I mean would any self-respecting doctor prescribe a non-optimal drug for some free grub and biro?

Ultimately, the system relies on the integrity of the doctors, not the reps. The onus is on the doctor to assess the data and make an informed choice.

tallaght01

There's apparently evidence that it does effect prescribing behaviour. I don't know if it's a subconscious thing or what.

When I worked in Glasgow, a lot of doctors were members of a group called "No Free Lunch". They're a worldwide organisation that exists to campaign against this sort of thing.

I'm not a member.

But their website www.nofreelunch.org says the following, regarding the evidence base:

"We believe that there is ample evidence in the literature--contrary to the beliefs of most heath care providers--
that drug companies, by means of samples, gifts, and food, exert significant influence on provider behavior.
There is also ample evidence in the literature that promotional materials and presentations are often biased
and non-informative. We believe that health care professionals, precisely because they are professionals ,should
not allow themselves to be bought by the pharmaceutical industry: It is time to Just say no to drug reps and
their pens, pads, calendars, coffee mugs, and of course, lunch"

I've not read the evidence, but I'll have a look at it tomorrow to see if it's strong. I suspect it might not be. But I knew a few lecturers at uni (who were mad into their evidence based medicine) who were members of this group.

2Scoops

That website raises some interesting points. Drug companies spend an awful lot of money on this this type of thing, which is something I didn't really consider. I guess it is kind of indefensible!

They don't provide a huge amount of evidence but there seems to be the suggestion of an effect as well:
http://www.ncbi.nlm.nih.gov/pubmed/10647801?dopt=Abstract

It's surprising to me that doctors allow themselves to be manipulated like this (although some of it is probably subconscious). Non-rational prescription decisions are immoral.

BanzaiBk

I appreciate all the free pens/lanyards they give me if that counts:p

2Scoops

BanzaiBk wrote: »

I appreciate all the free pens/lanyards they give me if that counts:p

You're just a puppet of Big Pharma!

tallaght01

2Scoops wrote: »

You're just a puppet of Big Pharma!

Get Michael Moore in here to dole out the bateings to BanzaiBK

BanzaiBk

tallaght01 wrote: »

Get Michael Moore in here to dole out the bateings to BanzaiBK

He'll be blindsided by myself asking for the A&E charge for non EU/ non NHS patients, €200 odd isn't it? Anyways alls I know is some dude call Mike from *insert pharma company name* comes every so often and hands out pens/lanyards. I like pens and lanyards, I understand absolutely nothing about his *insert medincy thing here* medicine but hey I will have 4 pens if they're going. I feel ok being a pen puppet, whatabout all the free lunches the actual doctors/nurses go to? :eek::p

tallaght01

BanzaiBk wrote: »

He'll be blindsided by myself asking for the A&E charge for non EU/ non NHS patients, €200 odd isn't it? Anyways alls I know is some dude call Mike from *insert pharma company name* comes every so often and hands out pens/lanyards. I like pens and lanyards, I understand absolutely nothing about his *insert medincy thing here* medicine but hey I will have 4 pens if they're going. I feel ok being a pen puppet, whatabout all the free lunches the actual doctors/nurses go to? :eek::p

You'd be on the front of his DVD. You sick adminoid, fleecing Michael of his hot dog money, to pay for gold taps in the staff bathroom in A+E

BanzaiBk

By gold taps you mean gold pen drawers/lanyard hooks right?

DrIndy

I go to the drug lunches and get free loot - I always listen politely and question the drug reps - then I go check the price and the evidence base and keep on prescribing the generic brand unless there is a very good reason not to.

Tree

i've been to one or two of the lab equipment/assay reagent talks. some of it's interesting background before they start on their own specific agenda. and you never have enough biros around the lab so the free ones come in handy.

it's probably a bit different in comparison to the drugs reps in that the descisions to use the assay/equipment are essentially made by management with some consultation of hte lab staff.

Traumadoc

Yes it can be problematic, once there was a drug rep who was very popular with the junior staff and nurses- pens meals money for books etc. I was none too popular for banning the drug. ( it has recently been banned by the drugs board anyway).

It does have an affect on our prescribing, they would not do it if it did not.

wheresthebeef

u can never have enough free pens. but i do think some people are too quick to jump on a bandwagon. I saw a sales rep in an ICU department give a 5 minute spiel about a new ventilatory assistance function on a certain brand of ventilators, and within 5 minutes the anaesthetist and the unit manager were preparing to apply for the funding from accounts to buy over 10,000 euro of ventilator software upgrades all at the say so of someone who's interest lies in sales, sales, sales. He showed them a brochure of the product and literally pointed out the pictures, oh look there's a nurse operating one of our new ventilators, and there's a consultant, oh don't they look happy with their new ventilators.