https://goo.gl/QvYthb
Background: Whether drug promotion helps or hinders appropriate prescribing by physicians is debated. This study examines the most heavily promoted drugs and the therapeutic value of those drugs to help determine whether doctors should be using promotional material to inform themselves about drugs.
Most of the money spent on promotion in the form of journal advertisements and visits by sales representatives in Canada goes to drugs that offer little to no therapeutic gain. Similarly, most of the top-selling drugs offer little to no therapeutic gain. The finding that there was a difference in therapeutic distribution between the most-promoted drugs and the top-selling drugs in only 1 of the 3 years studied may mean that there are few therapeutically significant products that can be promoted. It is, of course, possible that this group of drugs is being promoted through other methods or that the minority of drugs with a high therapeutic value may sell well without the need to promote them.
Promotional material does not appear to be a way for doctors to learn about therapeutically important products. Other factors besides therapeutic gain, including patient preferences, adverse reactions to specific drugs, insurance coverage and other medications a patient is taking, enter into decisions about what drug to prescribe to an individual patient. However, none of this information is available through promotional channels.
The pharmaceutical industry spent almost $563 million in total on journal advertising and sales representative visits in 2015, with unknown amounts going to the 14 million samples left behind,
10 engaging key opinion leaders to give talks, meetings, direct-to-consumer advertising, booths at medical conferences and other forms of promotion. In 2015, just over a third of Canadian doctors were not seeing sales representatives, but 11% saw 6 or more a month,
14 and in that year there was a total of 3 720 000 visits.
10The comprehensiveness of the safety information provided by sales representatives when they visit doctors was investigated in a study involving primary care practitioners in Vancouver and Montréal.
15 Minimally adequate safety information, defined a priori as the mention of 1 or more of approved indications, serious adverse events, common nonserious adverse events or contraindications
and no unapproved indications or unqualified safety claims (e.g., "this drug is safe"), was provided in 5/412 (1.2%) promotions in Vancouver and 7/423 (1.6%) in Montré
al.Representatives did not provide any information about harms (a serious adverse event, a common adverse event or a contraindication) in two-thirds of interactions.