June 15, 2017 - Posts

Medical Journal Confirms What Whistleblowers Have Long Known – Pharmaceutical Sales Reps Can Influence What Doctors Prescribe

It should come as no surprise that pharmaceutical sales reps can and do influence doctors in prescribing particular drugs.  If a sales rep comes into a doctor’s office with slick promotional materials, a well rehearsed pitch, and plenty of free samples—not to mention the occasional free meal—the doctor is going to be more likely to prescribe that drug, even if the doctor doesn’t consciously intend to.  Marketing works, and the pharmaceutical industry spends billions on direct marketing to physicians each year.

While the relationship between sales reps and doctor prescriptions seems fairly self-obvious, there has been little research on exactly how much influence those sales reps can have.  That makes a recent study, published in the Journal of the American Medical Association (“JAMA”), all the more important.  In that study, researchers found that in academic medical centers that implemented policies to restrict sales rep visits, promoted drugs—as a share of total drugs prescribed—dropped by an average of 8.7% compared to what they had been before the restrictive policies were put in place.  Given that these promoted drugs (referred to within the pharmaceutical industry as “detailed” drugs) are almost always much more expensive than generics, prescribing fewer of these promoted drugs can collectively save patients and health plans—including Medicare and Medicaid—millions upon millions of dollars over time.

Of course, the relationship between sales marketing and medically unnecessary prescriptions is nothing new to False Claims Act whistleblowers.  Some of the biggest False Claims Act cases in history have involved kickbacks and off-label promotion schemes by major pharmaceutical companies.  For instance, GlaxoSmithKline paid a total of $3 billion in 2012 ($2 billion civil, $1 billion criminal) to settle allegations that it was illegally promoting nine different prescription drugs). Likewise, Johnson & Johnson paid $2.2 billion in 2013 ($1.72 civil, $485 criminal) to resolve allegations of paying kickbacks and off-label marketing of the drugs Risperdal, Invega, and Natrecor.

The full JAMA study is not available for free, but a summary can be found here:

Association Between Academic Medical Center Pharmaceutical

Detailing Policies and Physician Prescribing

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