FIGURE
Imagine the following scenario: you are a prescribing nurse practitioner (NP) spending a few minutes with a pharmaceutical sales representative. The drug rep says he knows you have been prescribing a competitors' drug and he wants you to switch to his product. When you ask how he knows this, he admits that his company purchases information about your prescribing habits from large pharmacy chains.
What is Prescriber Profiling?
This scenario could well happen according to a Boston Globe article ("Drug Companies' Secret Reports Outrage Doctors", May 25, 2003, Author Liz Kowalczyk, Globe Staff). Based on information from pharmaceutical company consultants, drug manufacturers are spending millions of dollars to develop reports about the prescribing habits of physicians.
Such "prescriber profiling" allows drug reps to tailor sales pitches to the specific prescribing practices of the clinicians they visit on sales calls. The article reported that many physicians are horrified at the amount of information the companies have about them, and many physicians view this practice as an invasion of the doctor-patient relationship.
According to the article, a drug company sales representative whistleblower is suing his former employer, alleging that the company provided a doctor's prescribing record for each month, enabling a drug rep to fine tune his sales approach to undermine a competitor's product. This data was also allegedly used to evaluate the drug reps' sales effectiveness.
Info for Sale
Several companies specialize in buying prescriber data and selling it to pharmaceutical companies. For example, Verispan (http://www.verispan.com) provides near real-time data on more than half of all U.S. prescriptions and over 20% of electronic medical transcriptions, including almost 100% coverage for specific targeted zip codes. Their product, Market Mover, provides pharmaceutical sales representatives the ability to precisely target their promotional efforts to react to changes in prescribing behavior. Verispan advertises that information about a prescriber's numbers of new patients, switched patients, and continuing patients is delivered to the sales reps 4 days after the close of each week. Verispan notes that drug company clients can assess whether their reps' last sales call was effective and whether last week's dinner meeting generated new patients for their product.
The emergence of this new data industry may have affected the results of a poll conducted by Accel Healthcare Communications (http://www.accelhealth.com) that noted significant problems in the physician/sales rep relationship. The Accel poll reported that a vast majority of physicians perceive today's sales reps as more focused on sales than science. According to the poll, physician respondents wanted more trustworthy, credible information. The majority of physicians (63%) reported that they would stop meeting with drug representatives if free samples were not provided, and nearly 70% viewed the information they received from sales reps as 'very unbalanced.'
As advanced practice nurses gain more autonomous prescribing authority (including independent prescribing identification numbers), pharmaceutical companies will likely evaluate NP prescribing habits. Pharmaceutical sales reps will know a lot about our prescribing habits. This is not inherently bad, as long as NPs recognize evidence-based science within drug sales literature. As the Accel poll reported, the value of the sales reps should be enhanced beyond samples to include 3rd party documentation of the fairness of the sales materials. This will allow all prescribers to maintain their professionalism by supporting prescribing decisions based upon the latest evidence-based knowledge (instead of on inappropriate sales pressure). What do you think about this? I'd love to hear from you-please write me at [email protected].