A new study published in JAMA investigated physician prescribing behaviors following the implementation of limited pharmaceutical salesperson policies at U.S. academic medical centers.
Between 2006 and 2012, some academic medical centers established policies limiting pharmaceutical representative sales visits, or detailing, to physicians.
The study included 2,126 physicians at 19 academic medical centers in California, Illinois, Massachusetts, Pennsylvania and New York. Researchers analyzed physician prescribing behaviors for 262 drugs in eight drug classes before and after implementation of salesperson detailing policies, compared to a control group of 24,593 physicians unexposed to a detailing policy.
Here are seven insights:
1. Researchers identified 16.1 million prescriptions written during the time period.
2. Prior to policy changes, the sample mean market share at the physician-drug-month level for detailed drugs was 19.3 percent and for nondetailed drugs was 14.2 percent.
3. Enacted detailed policies correlated with a 1.67 percentage point decrease in the detailed drugs market share as well as a 0.84 percentage point increase in the nondetailed drugs market share.
4. Researchers found significant associations for these six drug classes for detailed drugs:
• Lipid-lowering drugs
• Gastroesophageal reflux disease drugs
• Antihypertensive drugs
• Sleep aids
• Attention-deficit/hyperactivity disorder drugs
• Antidepressant drugs
5. Eleven academic medical centers "regulated salesperson gifts to physicians, restricted salesperson access to facilities, and incorporated explicit enforcement mechanism." Of those academic medical centers, eight saw significant prescribing pattern changes.
6. Of the eight academic medical centers not implementing all three policies mentioned above, only one saw significant prescribing pattern changes.
7. Researchers concluded academic medical centers that enacted policies limiting pharmaceutical detailing saw "modest but significant reductions in prescribing of detailed drugs across six of eight major drug classes; however, changes were not seen in all of the AMCs that enacted policies."