Training to become more proactive in interactions with drug salespeople

"We developed a curriculum that is based on the traditional one-on-one drug detail. Its goals are to improve the efficiency of residents in dealing with pharmaceutical representatives and, ultimately, to improve their prescribing habits.

In 1960 we initiated a curriculum to encourage family practice residents to be more proactive in their interactions with pharmaceutical representatives. It is presented to residents in pairs during their practice management rotation. The objectives are to develop skills in controlling the interview, to enhance the ability to analyze drug-promotional material critically, and to discuss and understand the ethical issues involved with gifts and the like. The course is presented over 3 hours and consists of a needs assessment, readings, and discussion, a 1-hour seminar with videotape examples, two practice sessions with pharmaceutical representatives, and a final observed test session with evaluation and feedback.

Common sales tactics used by pharmaceutical representatives are presented, such as "use this drug because everyone else does", "use this drug because all the experts are using it (name dropping), "try this drug and see for yourself," "do me a favor and prescribe this drug,: and others. We also discuss the use of drug samples as marketing tools. We distribute promotional materials and discuss how the data and presented, pictorially and literally, to enhance the positive aspects of a drug.

Therapeutic efficacy has to be balanced with adverse effects. Since adverse effects are discussed by pharmaceutical representatives less that 50% of the time, it is imperative for the physician to address them. It is helpful to make the distinction between the general frequency of adverse effects and adverse effects that result in discontinuation of the agent under discussion. These data allow the physician to make some judgment regarding the clinical relevance of the information. It is important for the physician to understand the difference between side effect profiles found in well-controlled clinical studies and those seen when a drug is in general use.

Suggested questions: What are the drug’s adverse effects? How many patients discontinue the drug? What laboratory values should I monitor? What are possible drug-drug interactions?"
- Anastasio (1996)

Anastasio GD. Pharmaceutical Marketing: Implications for Medical Residency Training. Pharmacotherapy 1996;16(1):103-107