It’s in the Details (or is it?)
At the Pfizer annual shareholder meeting at the end of April in New Jersey, Pfizer’s CEO Ian Read agreed with comments that the Obama administration’s academic detailing program operates from a conflict of interest.
Pharmaceutical interests have come out of the wood work crying “foul” and want the project scrapped. The conflict of interest arises as government consultants push evidence for generic drugs over branded formulas as a means of saving itself money.
The academic detailing program, created by the 2009 American Recovery and Reinvestment Act which allocated 1.1 billion dollars for comparative effectiveness research (also referred to as Patient-Centered Outcomes Research) is overseen by the Agency for Healthcare Research and Quality (AHRQ) of the Department of Health and Human Services.
It sends professional government consultants to doctors’ offices and pharmacies to provide “evidence based research findings” on prescription drugs and treatments as a way of helping doctors choose the best solutions for their patients. Approximately 1,300 clinician sites and 200 hospitals and health systems will be targeted.
Critics claim the project allows the federal government to guide doctors towards cheaper generic drugs for their patients thus keeping healthcare costs low for the Affordable Healthcare Act. They also take issue with the lack of similar regulatory oversight of which pharmaceutical company reps are subject to when visiting doctor’s offices or medical facilities to sell their company’s latest product.
Subject to full disclosure, reps are scrutinized for every word uttered, whereas academic detailer meetings are not made public. Critics are asking: isn’t wanting to save money when you are the one footing the bill, the same conflict of interest as found in a rep trying to make money by selling a product? Are generic formulations receiving an advantage over name brand drug treatments?
Not to sound like a Saturday Night Live skit or anything but really…? Are generic drugs really benefiting from extra marketing help when 70% of all current prescriptions are for generic versions of popular drugs? Currently, generic versions of Lipitor, Zocor and Pravachol account for 64% of cholesterol-lowering drug sales.
According to a March 2008 paper entitled, Cost-Effectiveness of Prescriber Education (“Academic Detailing”) Programs by the Prescription Project, “every dollar spent on an academic detailing program, returns two dollars in reduced drug costs. This number is from an economic model developed by researchers at Harvard Medical School and the Brigham and Women’s Hospital.”
With the majority of people this program will affect consisting of minority, low-income, senior, and other limited healthcare access populations, isn’t saving money for them and us (as taxpayers), a good thing?