Washington, DC Difficult-to-remember generic drug names. Unregulated continuing medical education talks for physicians. These are only two of the strategies used by some in the pharmaceutical industry to influence the prescribing habits of doctors, according to a Georgetown University Medical Center researcher and director of PharmedOut, an initiative aimed at increasing physician access to unbiased information about drugs. These and other marketing efforts are explored in a newly created, free, web-based, accredited course to help prescribers assess how marketing affects their own beliefs about drugs and to increase awareness of pharmaceutical promotional techniques. The project was created by PharmedOut and funded through the Attorney General Consumer and Prescriber Education Grant Program.
"We want to educate doctors about the many ways pharmaceutical companies attempt to influence our knowledge of drugs and our prescribing behavior," said the course's co-creator, Adriane Fugh-Berman, MD, director of PharmedOut and associate professor of Physiology & Biophysics at GUMC.
The online course, titled "Pharmalyzer -- -- Are You Prescribing Under the Influence?" is accredited for three continuing medical education (CME) credits.* The module may be accessed through PharmedOut.org or the Federation of State Medical Boards (FSMB).
On the site, the authors outline the many marketing tactics used by pharmaceutical companies, which they say "attempt to influence our knowledge of drugs and our prescribing behavior though many channels, including personal relationships, publications, meetings, and events."
In one section of the online course, viewers are asked to name drugs associated with highly recognizable images from TV and print advertising without drug names are shown and viewers are asked to name the drug being representing.
"The fact that we can name the products means that the ads have served their purpose," explain the authors.
Another compelling example demonstrating the influence of pharmaceutical marketing is a list of diseases and conditions the course says were created by the pharmaceutical industry such as GERD, erectile dysfunction, excessive sleepiness, restless legs syndrome, overactive bladder syndrome, social anxiety disorder and osteopenia.
The authors explain, "We associate these conditions with a specific drug because the companies that made each of these drugs invented or renamed the condition. In marketing, this is called disease branding. GERD, for example, used to be called heartburn, and Social Anxiety Disorder used to be called shyness."
In another section, viewers are asked for the generic names of popular drugs such as Lipitor, Nexium, Advair, Plavix, and Singulair, and note that marketing techniques used by pharmaceutical companies make brand names of drugs easier to remember.
"Pharmaceutical companies prefer generic names that are difficult to remember, pronounce, and spell to encourage the use of the brand name," says Tony Scialli, MD, adjunct professor of Obstetrics and Gynecology at GUMC, and a member of PharmedOut. Scialli is also vice-president of Tetra Tech Sciences.
The course also includes information about "detailing," a term used to describe visits made by drug sales representatives to prescribers. The authors suggest, "Barring drug reps from your office is the best way to avoid being influenced."
The authors also alert physicians about CME talks and grand rounds, "although often funded by industry, [CME talks and grand rounds] are not regulated by the FDA. Presentations at industry-funded CME are often laced with marketing messages."
"This comprehensive course explores the tools the pharmaceutical industry employs to sell their drugs," says Fugh-Berman. "Most patients trust their doctors to recommend the best therapies, but patients and their doctors may not be aware of the influence this powerful industry is having on their care."
In addition to Fugh-Berman and Scialli, Scott Pegler, B Pharm, principal pharmacist and medicines information manager for Swansea NHS Trust in the U.K., is a co-author of this CME module. The authors make the disclosures that follow. Fugh-Berman occasionally testifies as a paid expert witness in litigation involving pharmaceutical marketing practices. Scialli has been a paid consutant for Merck, Theravance, Toyama, AMAG Pharmaceuticals, Abbott, Hollis-Eden, Cynthus, Procter & Gamble and GlaxoSmithKline. Pegler reports no potential conflicts.
|Contact: Karen Mallet|
Georgetown University Medical Center