Their is a concept is the pharmacy world called academic detailing which essentially means educating physicians about the cost / benefits of prescription drugs. It can be done via letter, phone, and face-to-face. Many managed care companies and PBMs have tried it over the years. Does it work?…sometimes.
“It’s estimated the pharmaceutical industry spends about 90% of its $21 billion marketing budget on physicians each year.” (Journal of the American Medical Association article from January 2006)
Logically, it seems like a great idea. Get out and provide physicians with unbiased information about the drugs they prescribe. Provide them with published research. Show them how they behave versus their peers through benchmark data based on their prescribing habits.
Since I briefly owned academic detailing as a product line, I remember the challenge that our lead pharmacist had on proving the business case of why we should invest there. There were too many challenges:
- Why does the physician care about cost? They care about what works. If you can clearly prove the compliance is tied to out-of-pocket costs, they might get interested, but the cost to the patient (at least if they have insurance) has historically not been significantly different between different options. [I do believe consumerism and consumer-driven healthcare might change this.] I always compare this to the expression “no one ever got fired for hiring IBM”.
- To compete with the brand manufacturers who have 10′s of thousands of representatives out meeting with physicians, it would take billions of dollars. Who is going to fund this? You see change happen in small pockets where there is large marketshare by one dominant payor that can influence the physicians. With the government as the largest payor in healthcare, they could do this, but where is the money going to come from?
- Do the physicians have the time? There are 10,000+ drugs out there. Physicians are busy and under lots of pressure. Some physicians have stopped seeing detail representatives. Others charge for their time. This is not a 2 minute discussion. (I believe that is the average for a manufacturer’s representative with a physician.) This is a 30+ minute discussion of clinical and cost information.
Perhaps P4P (pay-for-performance) may change this. I know that when physician’s were capitated for both medical and pharmacy costs that it could impact their prescribing habits. I always here about different groups trying academic detailing for all the right reasons…BUT, I never see any great proof.