Tuesday, October 8, 2013

Update: What Drug Reps Know About Docs’ Prescribing—and Patients

A colleague just alerted me to a New York Times business article by Katie Thomas from last May:
--which provides an update on the data that drug reps can download on the prescribing habits of the physicians they are selling to.

To briefly recap:

  • The old old days: Drug reps would schmooze with the local pharmacist to get a sense of what docs were prescribing what drugs.
  • The old days: Firms such as IMS Health would buy up prescription lists, in which physicians were identified by code number, and with patient names presumably redacted. The firms would then turn to the AMA and buy their master file of physician identifiers, allowing them to match the docs with the prescriptions they wrote. Before going into Dr. Welby’s office, the rep would download the records of how often Dr. Welby prescribed both the rep’s company’s drug and the competitor’s drug in the last month or so, with a lag time of about 1-2 weeks to get the data.
So what about today? Thomas reports that IMH Health recently bought out a firm called SDI Health, which is able to match insurance claim data with individual patients. Again presumably without divulging patients’ names (which would be illegal), these insurance data allow the rep to see the patient’s key health history, including lab tests and hospital admissions. This allows the rep to create a much fuller profile of when and on whom the doc prescribes that particular drug.

The article is somewhat complicated and notes several recent trends. First, Thomas reports that (good news for people like me), more and more docs are refusing to take time to see reps. Companies in cost-cutting moves have on their side laid off a lot of reps. So some of what drives this data searching is the felt need to be a lot more targeted once a rep is able to get a foot in the door.

But another trend noted is that a lot of this data-searching seems not to be about the rep-physician relationship at all; some claim that what is going on is how drug companies are marketing themselves not only to docs, but more to the big insurers, trying to show that the insurer would save bucks if they used more of a certain drug on certain groups of patients, or that some of their patients are going off their drugs too soon, or whatever.

The bottom line seems to be that drug marketing is the proverbial balloon which, pushed in at one spot, bulges out someplace else. You never hear of companies cutting back on marketing, maybe to go back into the laboratory and discover a new generation of true breakthrough drugs. Instead they stop marketing one way and spend even more money marketing in some other way, always trying to push their existing drugs, which far too often are merely more expensive without being any better or safer.


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