NCPA - National Center for Policy Analysis

How Academic Detailing Could Limit Access to Pharmaceuticals

April 9, 2012

The practice of pharmaceutical companies marketing directly to prescribing physicians is known as drug-detailing, says Byron Schlomach, director of the Goldwater Institute's Center for Economic Prosperity.

  • According to the Congressional Budget Office (CBO), almost 60 percent of the $20.5 billion spent on drug promotion -- $12 billion -- was spent on detailing.
  • CBO numbers indicate that drug companies more than doubled their spending on detailing, even when adjusted for inflation, from 1989 to 2008.
  • There is academic research to show that doctors do in fact alter their prescribing habits to favor drugs the detailers offer, offering financial incentive for the practice.

Provisions of the massive health care overhaul, however, would seek to limit this practice by introducing the practice of academic detailing into the sector.  Through this policy, independent, government-appointed representatives would make similar visits to physicians to present objective information regarding drug options.  The drawbacks to such a practice, however, are substantial.

  • Academic detailing seeks to substitute the drug-selecting judgment of a few government technocrats for that of actively practicing physicians working directly with patients.
  • By limiting the efficacy of marketing practices, academic detailing would cap profits on new drugs, thereby discouraging investment in research and development of additional drugs.
  • Also, by attempting to push drug advocates out of the market, the government policy inherently reduces physicians' access to drug information, thereby limiting treatment options.

A number of recommendations can be made going forward that could make academic detailing more palatable or replace the need for it entirely.

  • If academic detailing is deemed absolutely necessary, it should at least not be funded by fees on pharmaceutical companies (as Maine has elected to do), as this essentially forces those companies to pay for services that can support their competitors.
  • Broad efforts to encourage doctors to report fraudulent claims would discourage dishonest practices by drug representatives and improve transparency.
  • Similarly, urging patients to interact with pharmacists directly in considering substitute treatment options would offer a powerful check on drug detailing efforts.

Source: Byron Schlomach, "A Pound of Cure: How Academic Detailing Could Limit Access to Pharmaceuticals," Goldwater Institute, March 27, 2012.

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