States Act to Counter Rx Drug Sales Reps
Faced with drug cost increases of 15% to 20% in their Medicaid programs, states such as Alabama, Arkansas, Florida, Maine, Michigan and Oregon have begun sending pharmacists to "urge doctors to write fewer prescriptions and to switch to cheaper drugs, such as generics," the Wall Street Journal reports. Mississippi and Washington plan to start their own efforts soon. The move is aimed to counter pharmaceutical companies' practice of "detailing," in which an "army of sales representatives" visits doctors' offices to deliver free samples and other "freebies" to encourage doctors to prescribe a particular brand. Last year, drug companies spent $4.8 billion on detailing in the United States, an increase of 11% over the previous year, and sales reps made 61.4 million visits to doctors. In contrast, "counter-detailers" in Florida made 740 visits to doctors between October and June of this year. The Journal profiles pharmacist Ileana Soto, who visited 88 Florida doctors who "tended to prescribe" Vioxx and Celebrex, costly anti-inflammatory drugs, instead of cheaper generics. During her visits, Soto explained that ibuprofen or naproxen could be "just as effective" and less expensive than the brand-name drugs. By January, doctors were writing fewer prescriptions for Celebrex and Vioxx, a move expected to save Florida's Medicaid program $196,000 per year. Soto now is working on other drug classes, "with similar results."
Pharmaceutical Research and Manufacturers of America spokesperson Jeff Trewhitt said that the drug industry does not object to counter-detailing, adding, "They have the same First Amendment right to educate physicians that we have." Detailers and counter-detailers often compete with each other for doctors' time, but doctors "are often more willing to talk to pharmacists" instead of sales representatives, Soto says. One market research firm found that doctors give counter-detailers an average of 13 minutes to "make their case," compared with 90 seconds to five minutes for sales reps. A number of claims-data-management firms have sprouted up to help states, insurers, employers and other entities that want to control health costs. For example, Florida pays ACS State Health Care LLC of Atlanta $11.7 million per year for services such as scanning prescription records to identify physicians who "rely heavily on" brand-name drugs (Gold, Wall Street Journal, 8/22).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.