Drug promotional activities and critical appraisal of drug advertising

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Drug promotional activities and critical appraisal of drug advertising

  1. 1. Drug Promotion and Critical Appraisal of Drug Advertisement Dr. Gyanendra Raj Joshi PharmD, RPh 1
  2. 2. Drug Promotion/Advertisement  Journal advertisements  Mailings  Company representative visits  Gifts ( medical samples , cash , personal gifts , cultural courtesy gifts , promotional aids, reminder items , medical utility items )  Sponsorships ( travel , meals , accommodation, registration fees)  Direct-to-consumer advertising 2
  3. 3. Traits of a medical representative  Must be adequately trained  Must not give misleading information  Must not offer inducement to gain interview  Must not cause inconvenience  Provision of hospitality 3
  4. 4. Guidelines for MRs  Appointment system for meeting clinicians  Leaving samples of medicines  Sponsorship of educational meetings  Frequency of meetings 4
  5. 5. Meeting with Medical representative  What’s in it for me?  Be selective  By appointment with time limits  Be in control  Prepare standard questions  Beware of bold statements 5
  6. 6. Information from representatives  Can be misleading  Promotes non-rational prescribing  Decreases generic prescribing  Increases awareness of new drugs but without the evidence  Increases prescribing costs 6
  7. 7. Oral presentations  At least one inaccurate fact in 81% of presentations  On average, at least 11% of statements made in an oral presentation maybe inaccurate  All inaccuracies are likely to favour promotion of the drug 7
  8. 8. Critical Appraisal  Supporting Evidence  Words and phrases  Appeal to Authority  Colours, pictures and emotion  Graphs 8
  9. 9. Written literature  Protocols as evidence of clinical benefits  Publication in non-peer reviewed / obscure journals  Graphs with misleading axes!  Surrogate endpoints  Claims of superior potency  Data from in-vitro studies, healthy volunteers  Claims from emerging or scientific opinions  Price comparisons  Statistics 9
  10. 10. What printed material should contain:  Name of the product  Active ingredient  Name and address of manufaturer  Date of production  Abbreviated prescribing information 10
  11. 11. Abbreviated prescribing information  Approved indications  Dose  Method of use  Contraindications  Side effects  Precautions 11
  12. 12. S T Tolerability E Effectiveness P 12 Safety Price
  13. 13. Commonly misused shortcuts for choosing therapies  Newer is better  Experts know best  If there is a mechanism for how a drug works, then it works  If my peers are prescribing the drug then so should I.  If the patient improves after the drug is prescribed, then the therapy must have worked.  If the manufacturer gives gifts, I should support them in return 13
  14. 14. Free samples and promotional materials 14
  15. 15. Countering misleading drug promotion 15
  16. 16. Healthy skepticism 16
  17. 17. 17
  18. 18. Drug companies know how to manipulate our main motivations Burnt out Dodo Caring Bunny Conservative Sheep Entrepreneurial Wolf Branthwaite A, Downing T. Marketing to doctors – the human factor. Scrip Magazine 1995 March;32-5 18
  19. 19. Your ability to cope with potentially misleading promotion depends on your understanding of:  Medicine  Pharmacology, Epidemiology, Public Health, Evidence Based Medicine, Drug Evaluation, Pharmacovigilance  Social sciences  Psychology, Economics, Sociology, Anthropology, Management, History, Politics, Communication Studies,  Humanities  Logic, Rhetoric,Linguistics, Literature, Art  Marketing  Product Management, Advertising Account Planning, Public Relations  Statistics 19
  20. 20. 20
  21. 21.  Is it ethically acceptable for doctors to receive gifts from drug companies? 21
  22. 22.  Will you accept visits from drug company representatives? 22
  23. 23.  Will you accept gifts from drug companies? 23
  24. 24.  How often is information from drug companies reliable? 24
  25. 25.  Will you be vulnerable to being misled by drug companies? 25
  26. 26. 26

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