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1 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE The following presentation contains some items that are covered by copyright and are used under Fair Use for education and the federally legislated TEACH Act. Any use for other purposes must follow U.S. copyright rules. The contents of this module are accurate at the time of publication.

2 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 1. I prefer to avoid all interactions with pharmaceutical representatives. A. Strongly Agree B. Agree C. Disagree D. Strongly Disagree 2. I don’t mind talking with pharmaceutical representatives. A. Strongly Agree B. Agree C. Disagree D. Strongly Disagree Questions

3 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 3. Pharmaceutical representatives can be a useful resource. A. Strongly Agree B. Agree C. Disagree D. Strongly Disagree 4. I get useful information from pharmaceutical representatives. A. Strongly Agree B. Agree C. Disagree D. Strongly Disagree Questions

4 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Click to edit Master title style Click to edit Master text styles Pharmaceutical Marketing

5 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Prescribers will be able to: Demonstrate understanding that pharmaceutical representative visits are part of a highly structured marketing campaign with the goal of increasing product sales. Recognize the marketing techniques used by pharmaceutical representatives and their impact on prescribing. Objectives

6 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE It is noon-time in your busy clinic Curious and hungry you head to the door and see the rep from GBU pharmaceuticals You are having a busy day and your stomach starts to grumble... Case

7 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE What would you do? (Please choose an answer below) A. Try to slip into the room and get some food without talking to anyone? B. Go into the room to get some lunch, and listen to the pharmaceutical representative’s talking points? C. Come up with a specific question about the pharmaceutical representative’s product to ask before going in to get your lunch? D. Go to the café for lunch?

8 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Pharm Rep Training Focused biomedical and product training Marketing, sales and persuasion

9 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Pharm Rep Job Description “The physician is eating with a friend. You are eating with a client.” -Shahram Ahari Fugh-Berman A, et al. PLoS Med. 2007;4(4):e150.

10 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Detailing Detail - n. [di-′tāl, ′dē-tāl ] - extended treatment of or attention to particular items Detailing - v. [di-′tāl, ′dē-tāl ] - to report minutely and distinctly Merriam-Webster, Incorporated. “Detail." Merriam-Webster online dictionary Available at: webster.com. Accessed January 22, 2008.http://www.merriam- webster.com

11 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Promotion of Prescription Drugs $27.7 billion Targeting Physicians Targeting Consumers Springen, K. Newsweek Available at: Accessedhttp://msnbc.msn.com/id/ /site/newsweek/ October, It is estimated that drug companies spent $7.3 billion dollars on sales rep contacts (including free lunches and pens) Over 100,000 pharma sales reps

12 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Pharmaceutical Branding of Resident Physicians Sigworth S, et al. J Am Med Assoc. 2001;286(9):

13 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Percentage of Physicians with Physician-Industry Relationships According to Benefit Received Campbell E, et al. N Engl J Med. 2007;356:

14 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Average number of meeting with industry representatives per month Campbell E, et al. N Engl J Med. 2007;356:

15 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Physicians say… How useful is information from drug industry representatives about diseases or treatments? Kaiser Family Foundation. National survey of physicians. March %

16 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE In general, how accurate is the information that drug industry representatives provide about diseases and treatment options? Physicians say… 81% Kaiser Family Foundation. National survey of physicians. March 2002.

17 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Quote from Prescriber –“Sometimes we don’t even talk about drugs, we just chat about the kids and it’s good to have a relaxed and friendly lunch.” Fischer MA, et al. Unpublished data; Manuscript in submission.

18 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE How does this make you feel? (Please enter your answer below)

19 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE “I must admit that for all the years that I have been prescribing drugs and practicing, I have always been conflicted about that, especially when I look at … some of the perks that some of the physicians get.” Quote from Prescriber Fischer MA, et al. Unpublished data; Manuscript in submission.

20 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Detailing Pharma industry research suggests “quality” detailing retains its value in changing prescriber behavior Pharmaceutical Executive, IMS Health. From message to prescription: new techniques for determining message impact. Special Reports. Executive Summaries of IMS & Pharmaceutical Executive Webcasts. Broadcast live on November 15, Available at: Accessed January 23, 2007.http://pharmexec.findpharma.com/pharmexec/form/formDetail.jsp?formId=440205

21 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE “We can’t do it like we always did, with a cookie-cutter approach” - Suneet Varma Pharmaceutical Executive, IMS Health. From message to prescription: new techniques for determining message impact. Special Reports. Executive Summaries of IMS & Pharmaceutical Executive Webcasts. Broadcast live on November 15, Available at: Accessed January 23, 2007.http://pharmexec.findpharma.com/pharmexec/form/formDetail.jsp?formId=440205

22 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE What do pharm reps know about you? Prescribing patterns Demographics of practice Personal information Greene JA. Ann Intern Med. 2007;146:

23 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE How do you feel about the fact that pharmaceutical reps have this information about you? (Please enter your answer below)

24 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Physicians say… Do drug company representatives receive information about how often you prescribe certain drugs? Kaiser Family Foundation. National survey of physicians. March 2002.

25 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Suppose that drug company representatives do receive this information, which of the following statements comes closest to your opinion of this practice? Physicians say… 74% Kaiser Family Foundation. National survey of physicians. March 2002.

26 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE A Physician Survey of the Effect of Drug Sample Availability on Physicians’ Behavior 131 of 154 general medicine and family physicians (University-based clinics, 79 residents, 52 attendings) questionnaire. Three hypothetical clinical scenarios: Patient with uncomplicated urinary tract infection, hypertension, depression. Chew L, et al. J Gen Intern Med. 2000;15:

27 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE A Physician Survey of the Effect of Drug Sample Availability on Physicians’ Behavior 92% said they would prescribe a diuretic or b- blocker as initial therapy. When samples were made available, 32 of the 35 (91%) physicians who said they would give a drug sample selected a drug that differed from their preferred choice. Chew L, et al. J Gen Intern Med. 2000;15:

28 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Patient now has health insurance, blood pressure controlled on sample drug. 69% said they would write a prescription for the sampled medication rather than switch therapy. A Physician Survey of the Effect of Drug Sample Availability on Physicians’ Behavior Chew L, et al. J Gen Intern Med. 2000;15:

29 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Types of Prescribers (Defined by Pharma) Independents Transactionals Knowledge Seekers Relationship Seekers Stievater DN, et al. Pharm Exec. 2006, Sep 1.

30 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Independents For more information on practicing evidence-based medicine, see the EBM module

31 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Transactionals For more information on this please see the Provider- Pharmaceutical Representative (PR) Communication module

32 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Knowledge Seekers

33 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Relationship Seekers

34 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE What ‘type’ of prescriber are you? (Please choose an answer below) Independent Transactional Knowledge Seeker Relationship Seeker

35 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Other Types of Marketing to Prescribers s Faxes CDs in mail Thumb Drives in the mail

36 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Professional Societies and Conferences 2006 showed that pharmaceutical companies spent up to $65 million annually on CME Averaged $15 million per company 70% said they would maintain or increase that spending in the following year Lab Business Week (via NewsRx.com). Continuing medical education spending to increase in , Sep 25. Available at: Accessed March 8, 2007.http://www.newsrx.com/article.php?articleID=359443

37 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Peer-reviewed Journals Fugh-Berman A, et al. PLoS Med. 2006;3(6):e130.

38 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Campbell E, et al. J Am Med Assoc. 2007;298: Academic Medical Centers

39 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE The Development of Direct-to-Consumer Prescription Drug Advertising Kessler D, et al. Ann Fam Med. 2007;5(1):4-5.

40 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Power of Drug Advertising Langreth, R et al Available at: Accessed October, 2006.http://www.forbes.com/forbes/2006/0508/094a –$236 million spent ‘03-’06 –Sales $1.2 billion in ’04 –Est. 10 million Americans –Lamisil cures 38%

41 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Direct to Consumer Advertising Medical Marketing & Media. Available at: Accessed October 22, 2007.http://www.mmm-online.com/Exploring-alternate-media-avenues/article/24909/

42 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Patient Support Groups Ginsberg T. Philadelphia Inquirer. 2006, May 28;A:01; Restless Leg Syndrome (RLS) Foundation. Restless Leg Syndrome Foundation 2007annual report. Available at: Accessed August 13, 2008.http://www.rls.org/NETCOMMUNITY/Document.Doc?&id=1282

43 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE sdfdsfasdfasdfasdfasdfasdfsdfasdfasdfasdfas dfasdfasdfasdfasdfasdfasdfasdfasdfasdfasdf asdfasdfasdfaasdfsddfasdf Monitoring sdfdsfasdfasdfasdfasdfasdfsdfasdfasdfasdfas dfasdfasdfasdfasdfasdfasdfasdfasdfasdfasdf asdfasdfasdfaasdfsddfasdf Pew Foundation. Available at:

44 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Academic Detailing Presentation of data on clinical pharmacology and cost issues Presented by trained pharmacists or other professionals without links to the pharmacy industry Shown to improve prescribing decisions and reduce costs Avorn J, et al. N Engl J Med. 1983;308(24):

45 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE PR visits are part of a highly structured marketing campaign with the goal of increasing product sales –Prescriber detailing, sponsored CME programs, professional society, conference and academic center grant support, DTC advertising, sponsored patient support groups are all marketing strategies –Industry monitors prescribing patterns and patient usage often without public knowledge Key Points

46 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE –Be alert to marketing techniques –Know yourself –Talk to patients and office staff about the involvement of pharma –Consider approaches to limit personal and professional contact –Contact local institutions/professional societies to learn about local academic detailing Recommendations

47 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE –For more information, resources, and skills on managing pharmaceutical marketing see our modules on: Provider-Pharmaceutical Representative (PR) Communication Communicating with Patients Evidence-Based Medicine (EBM) Recommendations

48 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE It is noon-time in your busy clinic Curious and hungry you head to the door and see the rep from GBU pharmaceuticals You are having a busy day and your stomach starts to grumble... Case

49 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE What would you do? (Please choose an answer below) A. Try to slip into the room and get some food without talking to anyone? B. Go into the room to get some lunch, and listen to the pharmaceutical representative’s talking points? C. Come up with a specific question about the pharmaceutical representative’s product to ask before going in to get your lunch? D. Go to the café for lunch?

50 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE  Avorn J, Soumerai SB. Improving drug-therapy decisions through educational outreach: a randomized controlled trail of academically based “detailing”. N Engl J Med. 1983;308(24):  Campbell E, Gruen R, Mountford J, Miller L, Cleary P, Blumenthal D. A national survey of physician–industry relationships. N Engl J Med. 2007;356:  Campbell E, Weissman J, Ehringhaus S, et al. Institutional academic–industry relationships. J Am Med Assoc. 2007;298:  Chew L, O'Young T, Hazlet T, Bradley K, Maynard C, Lessler D, A physician survey of the effect of drug sample availability on physicians' behavior. J Gen Intern Med. 2000;15:  Fischer MA, Keough ME, Baril J, Saccocio L, Mazor KM, Ladd E, Von Worley A, Gurwitz J. Attitudes of prescribers towards pharmaceutical marketing: needs assessment and implications for training and policy. Unpublished data; Manuscript in submission.  Fugh-Berman A, Ahari S. Following the script: how drug reps make friends and influence doctors. PLoS Med. 2007;4(4):e150.  Fugh-Berman A, Alladin K, Chow J. Advertising in medical journals: should current practices change? PLoS Med. 2006;3(6):e130.  Ginsberg T. Donations tie drug firms and nonprofits: many patient groups reveal few, if any, details on relationships with pharmaceutical donors. Philadelphia Inquirer. 2006, May 28;A:01.  Greene JA. Pharmaceutical marketing research and the prescribing physician. Ann Intern Med. 2007;146:  Kaiser Family Foundation. National survey of physicians. March, References

51 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE References  Kessler D, Levy D. Direct-to-consumer advertising: is it too late to manage the risks? Ann Fam Med. 2007;5:4-5.  Lab Business Week (via NewsRx.com). Continuing medical education spending to increase in , Sep 25. Available at: Accessed March 8, 2007.http://www.newsrx.com/article.php?articleID=  Langreth, R., Herper, H. Pill pushers Available at: Accessed October, 2006.http://www.forbes.com/forbes/2006/0508/094a  Medical Marketing & Media. Available at: avenues/article/24909/. Accessed October 22, 2007.http://www.mmm-online.com/Exploring-alternate-media- avenues/article/24909/  Merriam-Webster, Incorporated. “Detail”. Merriam-Webster online dictionary Available at: Accessed January 22,  Pew Foundation. Available at:  Pharmaceutical Executive, IMS Health. From message to prescription: new techniques for determining message impact. Special Reports. Executive Summaries of IMS & Pharmaceutical Executive Webcasts. Broadcast live on November 15, Available at: Accessed January 23,  Restless Leg Syndrome (RLS) Foundation. Restless Leg Syndrome Foundation 2007annual report. Available at: Accessed August 13, 2008.http://www.rls.org/NETCOMMUNITY/Document.Doc?&id=1282  Sigworth S, Nettleman M, Cohen G. Pharmaceutical branding of resident physicians. J Am Med Assoc. 2001;286:  Springen, K. Saying no to big pharma. Newsweek Available at: Accessed October,  Stievater DN, Petersen A, Bhatia R. Sewing up new sales. Pharmaceutical Exec. 2006, Sep 1.

52 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Resources Consumer Reports Best Buy Drugs Journal Watch Medical Letter Medline (through the U.S. National Library of Medicine) Attorney General Consumer and Prescriber Education Grant Program Initiated Resources Brigham & Women's Hospitalhttp://www.rxfacts.org/http://www.rxfacts.org/ Georgetown Universityhttp://www.pharmedout.org/http://www.pharmedout.org/ MGH Institute of Health Professionalshttp://www.perxinfo.org/perx.htmlhttp://www.perxinfo.org/perx.html University of Kentuckyhttp://www.cecentral.com/http://www.cecentral.com/ University of North Carolina, Chapel Hillhttp://harryguess.unc.edu/http://harryguess.unc.edu/ University of Massachusetts Medical School/http://www.umassmed.edu/meyers/index.aspxhttp://www.umassmed.edu/meyers/index.aspx Meyers Primary Care Institute

53 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Resources  Communicating with Patients  Evidence-Based Medicine (EBM)  Organizational Influences on Prescribing  Pharmaceutical Development and Regulation  Provider-Pharmaceutical Representative (PR) Communication  Links to Web-Access and Downloadable Versions Available at: Additional Learning Modules in This Series

54 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 1. A 2002 Kaiser Family Foundation survey found that MOST physicians believe that the information from drug companies is at least somewhat accurate. A. True B. False Questions

55 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Answer 1. A: True. This 2002 Kaiser Family Foundation survey found that 74% of doctors report that the information provided by drug companies is at least somewhat useful, and an even larger margin, 84% feel that it is at least somewhat accurate. This may be one reason that so many prescribers rely on information from pharmaceutical companies to maintain and add to their knowledge of medications. Our module questions whether that is an effective approach.

56 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 2. Medline is funded by the pharmaceutical industry. A. True B. False Questions

57 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Answer 2. B: False. Medline is a service of the National Library of Medicine, and is freely available to all (prescribers or patients) over the internet.

58 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 3. The bulk of the money that the pharmaceutical industry spends on promoting prescription drugs is spent on promoting drugs to prescribers. A. True B. False Questions

59 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Answer 3. A: True. As reported in Newsweek in 2006, approximately 80% of the nearly $28 billion spent on promoting prescription drugs in the year 2004 targeted prescribers (this includes medical journal advertising, detailing and sampling).

60 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 4. Free samples influence prescribing. A. True B. False Questions

61 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Answer 4. A: True. A study of hypothetical cases published in the Journal of General Internal Medicine in 2000 reported that the availability of sample drugs changed the initial prescribing choices of 91% of physicians from guideline concordant to sample medication when treating hypertension in patients without insurance. The study also determined that if those same patients later acquired health insurance 69% of physicians would continue the sampled medication rather than switch to a guideline concordant treatment.

62 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 5. More than half of the promotional funds for prescription drugs are spent on samples. A. True B. False Questions

63 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Answer 5. A: True. The same Newsweek article mentioned above reported that the majority of the nearly $28 billion spent on promoting prescription drugs is spent on samples.

64 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 6. Pharmaceutical companies purchase detailed information on physicians’ prescribing practices. A. True B. False Questions

65 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Answer 6. A: True. Although some states have limited these practices, pharmaceutical companies can purchase information regarding physician prescribing practices. They can then use this information to target detailing to change these practices, and follow prescribing data to determine if their detailing is effective.

66 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 7. The major journals, such as JAMA, NEJM, and BMJ refuse drug advertisements that could be misleading. A. True B. False Questions

67 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Answer 7. B: False. Most journals would refuse drug advertisements that were overtly incorrect, however one objective of advertising is to highlight benefits of a drug, and as such many are misleading. Our module on Evidence-Based Medicine (EBM) offers several examples of misleading advertisements.

68 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 8. At least some pharmaceutical companies “type” prescribers in order to tailor their approach to the prescriber. A. True B. False Questions

69 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Answer 8. A: True. The types that have been described in pharmaceutical marketing trade magazines include Independent, Transactional, Knowledge Seeker, Relationship Seeker. Identifying the type that fits you most may help you to respond better to detailing and resist undue influence on your prescribing.

70 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 9. The information on Consumer Reports BestBuy website on drugs has been shown to be biased. A. True B. False Questions

71 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Answer 9. B: False. Consumer Reports BestBuy drugs website relies on independent and unbiased analysis of published drug efficacy data and is thus an excellent resource for clinicians and patients to learn about medications.

72 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 10. The term “academic detailing” refers to a special type of training session that is ONLY available to academic physicians. A. True B. False Questions

73 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE Answer 10. B: False. Academic detailing involves presenting objective data on clinical pharmacology and cost issues to prescribers. It differs significantly from pharmaceutical company detailing because it draws from a broad research base and material is presented by trained pharmacists or other professionals without links to the pharmacy industry. Academic detailing has been shown to improve prescribing decisions and reduce costs while improving drug therapy utilization.

74 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 11. I prefer to avoid all interactions with pharmaceutical representatives. A. Strongly Agree B. Agree C. Disagree D. Strongly Disagree 12. I don’t mind talking with pharmaceutical representatives. A. Strongly Agree B. Agree C. Disagree D. Strongly Disagree Questions

75 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 13. Pharmaceutical representatives can be a useful resource. A. Strongly Agree B. Agree C. Disagree D. Strongly Disagree 14. I get useful information from pharmaceutical representatives. A. Strongly Agree B. Agree C. Disagree D. Strongly Disagree Questions

76 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 15. Did completing this module help you to understand that pharmaceutical representative visits are part of a highly structured marketing campaign with the goal of increasing product sales? A. Yes, definitely B. Yes, probably C. Probably not D. Definitely not E. Not sure 16. Would you recommend this training module to a colleague? A. Yes, definitely B. Yes, probably C. Probably not D. Definitely not E. Not sure Questions

77 Click to edit Master title style Click to edit Master subtitle style UMASS MEDICAL SCHOOL MEYERS PRIMARY CARE INSTITUTE 17. Will you do anything differently in your practice as a result of this training module? A. Yes, definitely B. Yes, probably C. Probably not D. Definitely not E. Not sure 18. Please tell us about any changes you are considering or planning: Questions


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