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Peter Rost, M.D., is a former Pfizer Marketing Vice President providing services as a medical device and drug expert witness and pharmaceutical marketing expert. Judge Sanders: "The court agrees with defendants' view that Dr. Rost is a very adept and seasoned expert witness." He is also the author of Emergency Surgery, The Whistleblower and Killer Drug. You can reach him on rostpeter (insert symbol) Please read the terms of use agreement and privacy policy for this blog carefully.

The Rx Files

I know you have been wondering how pharma sales reps can keep track of physicians and what they prescribe. And many journalists have asked me the same thing. Here's a recent article on the topic and what happens to your prescription after you give it to the drug store and who buys your data.

The RX files
California tries to restrict drug-company access to your prescription records

By Jake Whitney

Pharmaceutical companies are using prescription records to target doctors. A new California program would give some docs the right to "opt out" of disclosing this information.

When Dr. David Mitchell was a third-year medical student in 1998, he attended a lunch thrown by a group of Aventis pharmaceutical representatives. Mitchell was short on money and went along solely for the free food. But the purpose of the lunch, he soon discovered, was to discuss Aventis’ high-blood-pressure medication, Cardizem CD.

During lunch, one of the representatives turned to a family-practitioner friend of Mitchell’s who had accompanied him and asked her why she wasn’t prescribing much of their drug. The doctor told her hosts they had nothing to worry about and that she was prescribing Cardizem.

The inquiring Aventis representative then pulled out a palmtop computer and confronted the physician with exactly how little Cardizem CD she had prescribed the previous month compared with competing high-blood-pressure medications.

The data on the computer screen, Mitchell noted, included the names and quantities of every drug Mitchell’s physician friend had prescribed in the previous three months.

“It was,” Mitchell said, “my first exposure to the tracking.”

Story continues here.


Anonymous Gary said...

My wife asked about this very thing a few days ago. How do the reps get paid on sales if they depend on the docs writing prescrips? Since I alway have an answer for everything, I simply said, "Oh, they have their ways of tracking these things". Of course, I had no idea what I was talking about, per usual.

Not supprising, considering every carton of milk is neatly tracked by the local food store.

Anonymous GMoney said...

While the Aventis rep described in the article was certainly "a little" (ahem) over zealous, pharmaceutical manufacturers and distributors have a valid interest in tracking prescription trends so that they can forecast inventory and production needs. It seems to me that if California's proposed "opt out" legislation is enacted more broadly the accuracy of this type of forecasting could be rendered much more difficult. Without understanding the prescription trends wouldn't distributors be forced to carry larger inventories to prevent shortages? Excessive inventories could result in higher SRA reserves at the manufacturers as outdated product is returned or price competition among manufacturers results higher allowances and "shelf stock" discounts. Surely there must be a way to track prescription trends on an aggregated basis that preserves not only patient but also physician privacy.

Blogger shooter45 said...

To gmoney,.....inventory control really is not involved here. Distribution companies of all types, not just pharma, have very sophisticated ways to track and manage inventory. This program is simply Marketing 101. By tracking Doctors' history of prescribing specific brands of meds and their quantities, they will formulate programs to offer their competing meds in the best light. Unless security or illegal bribes are involved, it's just the way business is done.

Anonymous Gmoney said...

shooter45 - I understand that the distributors can track trade channel inventory easily, but how can they forcast future trade demand and build or reduce inventory without analyzing prescriptions? It seems to me that trade channel sale data alone wouldn't be sufficient.

Certainly part of the tracking is the development of marketing programs - an my solution of "aggregate" prescription tracking would not give them that advantage. Which probably explains why the "opt out" legislation will never fly. The doctors who "opt out" won't get any of the fancy perks pharma likes to throw to the doctors.

Blogger shooter45 said...

gmoney, when a doctor writes a prescription for 30 lipitor tabs, it is filled by a pharmacy almost immediately. The volume of pills that make up the spread between writing and filling is infinitesimal when divided by the total usage. Forcasting future trade demand is accomplished using any one of many forecasting models used by any product manufacturer. I guess I don't understand what you mean by "analyzing prescriptions." But you're "right on" with your "opt out" statement. I guess it's the same reason supermarkets charge $2.00 for a $1.00 product to induce you to sign up for one their "courtesy cards." It's not the total usage they're tracking but "your" particular preferences so they can target you for deals, specials, or substitutes. I used it in my business career before it was common practice, using custom proprietary software, and got tremendous results.

Anonymous Anonymous said...

Well, if I read this correctly, what is included in the tracking is the names of the drugs and the quantities prescribed, but not yet the names of the patients? Also, a doctor should be able to have a retort to such questions, such as, you do not know the history of my particular patients, allergies, etc. A number of such responses can probably NOT be tracked, such as a specific reaction to a product, or medication, causing anaphylaxis in the past, say? And then there is always an issue of affordability of a drug that can be introduced, and used as an inducement to specific programs, such as Together Rx. The Rep has only the statistical data and the talking points; he/she is not a physician. I think the doctor can stay on top of this issue.

Anonymous Rosethejet said...

Frightning at the very least.

Although I understand we have become a society where your every move is analized, studied, worked upon, and finally marketed back to you.

Something very wrong with that.

As for inventory control all the pharma companies need, if indeed that is the excuse they may use, is check the movement of the pharmacies. If a product is moving well then simply up the sale. Not moving, take a second look, BUT to go after doctors and attempt to either berate or embarrass them into selling a specific brand, then that is very very wrong.

Personally this is nothing but the love of money pushing this.

And we all know that is the root of all evil.

Blogger Peter Rost said...

The reason this is done is not inventory. It is done to track performance of sales reps AND doctors, so that, i.e., bonus payments can be made to reps, and doctor information can be used to invite high presribers to other functions.

Blogger shooter45 said...

I was just gonna write, but the CEO of Organon, The largest Dutch research-based pharmaceutical company is on the phone. He's getting to be a pain in the butt. I get him out of a Jam once, now it's nag, nag, nag. What do I do about this? What do I do about that? Lemme get rid of this "pain" and I'll be right back to 'splain it all to you nice folks.

Blogger shooter45 said...

O.K. I'm back. Whew, straightened him out. Now, where were we? Somebody help me out here. hello. hello. heloooo. Anybody here? Hey, where'd everybody go? Was it something I said? Aw, c'mon. You're hidin, right? Rosie? Beeta? Damn!! This is weird. C'mon, this ain't funny no more. Sista-Moo-Chick, where you hidin? All right. That's the way we're gonna play this game? You got it! Humph!!. Next time you all get your knickers in a knot, you ain't gonna have ole shooter to bail out your sorry butts. That's it! I'm outta here! And Peter, I'm takin the rest of the donuts with me!

Anonymous Daniel Haszard said...

Eli Lilly is a big drug company that puts profits over patients.

Daniel Haszard Bangor Maine zyprexa caused my diabetes


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