Today U.S. Senate Special Committee on Aging Chairman Herb Kohl (D-WI) held a hearing to consider an alternative to the current prevailing practice of doctors receiving the latest information on new drugs from the drug manufacturers themselves. Pharmaceutical sales representatives are currently one of the only ways doctors can learn about new drugs on the market. The industryÃ¢â‚¬â„¢s educational outreach is essentially a marketing program, and evidence shows that doctorsÃ¢â‚¬â„¢ prescribing patterns can be impacted by pharmaceutical sales representatives. WednesdayÃ¢â‚¬â„¢s hearing considered the implications of creating a federal Ã¢â‚¬Å“academic detailingÃ¢â‚¬Â program, which would provide physicians and other prescribers with an objective source of unbiased information on all prescription drugs, based on scientific research.
Ã¢â‚¬Å“Pharmaceutical reps often confuse educating with selling, and evidence shows that doctorsÃ¢â‚¬â„¢ prescribing patterns can be heavily influenced by these sales representatives,Ã¢â‚¬Â said Chairman Kohl. Ã¢â‚¬Å“Without academic detailing, physicians may not have access to information about the full array of pharmaceutical options, including low-cost generic alternatives. However, research has shown that when they do, doctors prescribe the best drugÃ¢â‚¬â€not just the newest oneÃ¢â‚¬â€and healthcare spending is lowered.Ã¢â‚¬Â
Chairman Kohl plans to introduce a bill with Senator Dick Durbin (D-IL) this spring to create a federal academic detailing program. The proposed legislation would create a grant program to fund the production of educational materials for doctors on the safety and comparative effectiveness of prescription drugs, including generic and over-the-counter alternatives. The policy would also create a second grant program to dispatch trained medical professionals (such as pharmacists, nurses, and other health care professionals) into physiciansÃ¢â‚¬â„¢ offices to distribute the extensively researched and independent information. Because academic detailing lowers healthcare costs for the government, the bill is expected to pay for itself.
The hearing began with testimony from Shahram Ahari, a former sales representative for the pharmaceutical company Eli Lilly. Mr. Ahari shared with the committee his experiences as a drug detailer and discussed the techniques he employed when marketing drugs to doctors. Next, Dr. Jerry Avorn, a Professor of Medicine at Harvard Medical School and consultant to PennsylvaniaÃ¢â‚¬â„¢s academic detailing program, outlined the concept of academic detailing and talked about state and international programs already underway. Nora Dowd Eisenhower, Secretary of the Pennsylvania Department of Aging, offered a government perspective on the impact of academic detailing initiatives at the state level. Allan Coukell, a pharmacist and Director of the consumer group The Prescription Project in Boston, testified about the cost savings of academic detailing programs and how patients stand to benefit when doctors have access to unbiased information. Last on the panel, Ambrose Carrejo, Assistant Director of Pharmaceutical Contracting and Strategic Purchasing for the managed-care organization Kaiser Permanente, spoke to the committee about KaiserÃ¢â‚¬â„¢s twenty-year history with fact-based drug information distribution and how it has impacted both doctors and patients.
Last June, the Committee held a hearing examining the relationships between physicians and the pharmaceutical industry. Following the hearing, Chairman Kohl and Finance Committee Ranking Member Charles Grassley (R-IA) introduced the Physician Payment Sunshine Act (S.2029) to require manufacturers of pharmaceutical drugs, medical devices, and biologics to disclose the amount of money they give to doctors through payments, gifts, honoraria, travel and other means. The drug industry has challenged the Grassley-Kohl bill, claiming that the legislation will potentially restrict their ability to inform doctors about new drugs. The academic detailing legislation under consideration by Chairman Kohl and Senator Durbin addresses this charge.