There is a lot of discussion lately about the influence of pharmaceutical representatives on the prescribing habits of doctors. To fully understand what the issue is it is important to understand the sales process commonly called “detailing”.
Usually very attractive pharmaceutical representatives visit doctors to “inform” them about the company’s product. This is called detailing, which can include presentations from other doctors, free lunches, or dinners, etc. Detailing revolves around a “core message” which are sound bites regarding the drug’s safety and/or efficacy. A pharmaceutical representative does not detail blindly. She or he is armed with data about doctors and answers to common questions.
Pharmaceutical representatives are able to target “key” doctors by looking at the amount of prescriptions a doctor writes and his/her specialization. Doctors that write a lot of prescriptions are highly sought after and are usually “flagged” for followup using aggressive sales tactics. Pharmaceutical companies get doctor’s prescribing information from companies who buy the information from pharmacies. Pharmacies usually do not give out doctor’s names, but will give out something that is called a drug enforcement number. The American Medical Association sells the companies the names associated with the drug enforcement number. Amazing right?
Pharmaceutical representatives are also armed with answers to common questions. These are questions that a doctor would likely ask a representative about the drug they are selling or a competitor drug. The answers always transition back to the drug’s “core message”. If the doctor’s question gets too scientific the representative will refer the question to the home office. A “medical affairs” department will respond with a scientific answer, usually by another doctor, that downplays the concerns of the doctor and transitions the topic back to the core message.
That is detailing in a nutshell.