Drug Reps

[stroodle]

Hey I was just wondering how do drug reps affect pharmacy? Are they a frequent thing to deal with (weekly) or is it more a rare thing. Also, what type of pharmacist will have to deal with them the most (hospital, independent, retail ect.)

I just ask because I think for the most part they can be a negative thing and was wondering if they are more a major problem or just an annoyance for pharmacists.

---

Members don't see this ad.

 

[RxWildcat]

They come in our retail pharmacy like 1-2 times a day. For the most part they get in the way for about 5 mins and then give you free pens and are out. There are a couple reps that buy us lunch about once a week. There is a big push around here now to prohibit reps from giving out free things. Personally, I don't think reps are very influential I they usually know just a minimal amount of biased information.

 

[Priapism321]

Hey I was just wondering how do drug reps affect pharmacy? Are they a frequent thing to deal with (weekly) or is it more a rare thing. Also, what type of pharmacist will have to deal with them the most (hospital, independent, retail ect.)

I just ask because I think for the most part they can be a negative thing and was wondering if they are more a major problem or just an annoyance for pharmacists.

I do not know your particular involvement with the profession of pharmacy, but if you are a student, go to the annual meeting for the American Society of Health-System Pharmacy and take a look at the exhibitor's hall. I'll give you a hint, it's big. I think drug reps mostly target clinical pharmacy specialists within hospitals because some have considerable influence on formulary decisions (at least where I currently work). Further, most round with medical teams and make recommendations at the front end of the prescribing process. I personally think sales representatives should be banned from the hospital and I actually take some pleasure when I report them for breaking the rules in my institution...

 

[Priapism321]

The involvement is substantial enough to warrant the American College of Clinical Pharmacy to release this Position Statement (published within the last few months):

http://www.accp.com/position/Guidelines_for_Ethical_Interactions.pdf

Give it a read...

 

[Priapism321]

Finally, an excerpt from a piece demonstrating the financial arrangements between health care professionals and the pharmaceutical industry:

"Bob Straka, a University of Minnesota pharmacy professor, earned $78,100 in speaking and other fees from 2000 to 2006, including $36,745 from Schering-Plough and $24,623 from Merck. Both insisted they weren’t influenced by money, but the lack of recorded votes in meeting minutes makes it difficult to track links between payments and policy."

"The information about Straka’s earnings might not have come out at all, because drugmakers aren’t required to disclose payments to pharmacists under the Minnesota law. Many did so anyway in his case, with some listing him as an “M.D.” in their reports."

Extracted from: http://www.pharmalot.com/2007/08/in-minnesota-docs-money-and-medicaid-drugs/

Dr. Straka: http://www.pharmacy.umn.edu/faculty/straka_robert/home.html

 

[Aznfarmerboi]

They definitely play a huge role in influencing pharmacy. I would usually at in service but decline any drug reps that wants to do lunch. I have nothing against them personally. Most of them are nice people trying to make a living. It is the drug companies that I hate.

 

[Caverject]

They definitely play a huge role in influencing pharmacy. I would usually at in service but decline any drug reps that wants to do lunch. I have nothing against them personally. Most of them are nice people trying to make a living. It is the drug companies that I hate.

why do you hate drug companies? Without them, we wouldn't have new novel drugs or research programs into disease states...

 

[stroodle]

thanks for the sites/info

I'm actually a Canadian (still in undergrad) but I'm sure Canada has its problems with them pesky drug reps too.


wow that thing with the Stratka guy is totally nutty

I also heard cheerleaders were also big in the whole being a drug rep thing...

 

[Priapism321]

why do you hate drug companies? Without them, we wouldn't have new novel drugs or research programs into disease states...

Yeah, I mean, what would we do without Xyzal, Clarinex, Lexapro, Vyvanse, Nexium, Invega, Pristiq, etc., etc. If you actually look at the facts, the pharmaceutical industry rarely comes up with novel drugs, and the ones they do are cherry picked from academic research centers or small start up companies. Just because they call every isomer they crank out onto the market "novel" and spend trillions of dollars to convince everyone it is true does not actually make them novel compounds.

 

[PharmDstudent]

Yeah, I mean, what would we do without Xyzal, Clarinex, Lexapro, Vyvanse, Nexium, Invega, Pristiq, etc., etc. If you actually look at the facts, the pharmaceutical industry rarely comes up with novel drugs, and the ones they do are cherry picked from academic research centers or small start up companies. Just because they call every isomer they crank out onto the market "novel" and spend trillions of dollars to convince everyone it is true does not actually make them novel compounds.

I think what's worse is the doctors who buy into the madness. We all have to pay for Medicaid/Medicare through the tax system. Why wouldn't a doctor be more likely to prescribe a generic if s/he knew it would save the patient and the system money?
I just boggles my mind. How can they be bought so easily? Doctors have the willpower to get through medical school, so why do some of the doctors' morals come crashing down when they practice? (Maybe they didn't have morals in the first place?... it's probably that whole god complex.)

The patients, their family members, and their pharmacists seem to be the only ones willing to fight the battle.

 

[Caverject]

Yeah, I mean, what would we do without Xyzal, Clarinex, Lexapro, Vyvanse, Nexium, Invega, Pristiq, etc., etc. If you actually look at the facts, the pharmaceutical industry rarely comes up with novel drugs, and the ones they do are cherry picked from academic research centers or small start up companies. Just because they call every isomer they crank out onto the market "novel" and spend trillions of dollars to convince everyone it is true does not actually make them novel compounds.

I never said I bend over and take it up the *** for drug companies...but we wouldn't have drugs like spycel, embrel, or some other unique drugs for complicated disease states if it were not for them. So what if they cherrypick academic institutions. I certainly don't see Harvard of JHU being able to pump out the drugs to meet demand.

 

[PharmDstudent]

I never said I bend over and take it up the *** for drug companies...but we wouldn't have drugs like spycel, embrel, or some other unique drugs for complicated disease states if it were not for them. So what if they cherrypick academic institutions. I certainly don't see Harvard of JHU being able to pump out the drugs to meet demand.

According to the video that was linked in the other thread, research used to be heavily funded by the government. When Ronald Reagan came into office, he cut the funds for drug research by a significant amount.
Now, the government is bending over for the drug companies, and the people of this country are paying for their profits.

I really liked the part in the video about the "me too" drugs. That's what everyone's complaining about!

We're not complaining about AZT or Rilutek. Even if we were, the problem is that the companies want to dig into everyone's pockets, because they want to make money on their "me too" drugs, since they can't make a huge profit on the more specialized drugs.

 

[Priapism321]

I never said I bend over and take it up the *** for drug companies...but we wouldn't have drugs like spycel, embrel, or some other unique drugs for complicated disease states if it were not for them. So what if they cherrypick academic institutions. I certainly don't see Harvard of JHU being able to pump out the drugs to meet demand.

Well, the problem is, the research at Hopkins and Harvard is publicly funded for the most part. I don't necessarily take issue with drug companies licensing products because they can satisfy the demands. My problem is that they claim the reason Americans are absolutely raped when it comes to paying for drugs is because it costs them so much to "innovate." We pay once for the scientists at Hopkins to spend decades coming up with a novel, useful molecule, and then we pay again when [insert drug company] claims they have no other option because they spend so much money on researching and developing these drugs. And meanwhile, if you look closely, their marketing budgets easily triple the R&D sector of the company.

 

[PharmaTope]

They definitely play a huge role in influencing pharmacy. I would usually at in service but decline any drug reps that wants to do lunch. I have nothing against them personally. Most of them are nice people trying to make a living. It is the drug companies that I hate.

gotta agree with you. pharm industry would also LOVE to have FDA shut down supplements and people require an Rx to get vitamins. thankfully that hasn't happened but they tried in 2001. i HATE big pharma.

 

[SpirivaSunrise]

Well, the problem is, the research at Hopkins and Harvard is publicly funded for the most part. I don't necessarily take issue with drug companies licensing products because they can satisfy the demands. My problem is that they claim the reason Americans are absolutely raped when it comes to paying for drugs is because it costs them so much to "innovate." We pay once for the scientists at Hopkins to spend decades coming up with a novel, useful molecule, and then we pay again when [insert drug company] claims they have no other option because they spend so much money on researching and developing these drugs. And meanwhile, if you look closely, their marketing budgets easily triple the R&D sector of the company.

Figure out where you're going for PGY2 Pri?

 

[Caverject]

gotta agree with you. pharm industry would also LOVE to have FDA shut down supplements and people require an Rx to get vitamins. thankfully that hasn't happened but they tried in 2001. i HATE big pharma.

completely different issue. you haven't been in pharmacy long have you? Suppliments should be regulated but they are not. Drug companies have to prove that their products are safe in order to be sold. Suppliment makers can do whatever the hell they want and the FDA has to prove they are unsafe to remove it from store shelves.

 

[SpirivaSunrise]

completely different issue. you haven't been in pharmacy long have you? Suppliments should be regulated but they are not. Drug companies have to prove that their products are safe in order to be sold. Suppliment makers can do whatever the hell they want and the FDA has to prove they are unsafe to remove it from store shelves.

Well...you left out the elephant in the room...efficacy.

 

[Caverject]

Well...you left out the elephant in the room...efficacy.

oops!

 

[RxWildcat]

what are you guys talking about, horny goat weed cured my like all my diseases, there may have been witchcraft involved though, I'm not sure yet b/c we haven't gotten there yet in therapeutics.

 

[Hels2007]

Well, the problem is, the research at Hopkins and Harvard is publicly funded for the most part. I don't necessarily take issue with drug companies licensing products because they can satisfy the demands. My problem is that they claim the reason Americans are absolutely raped when it comes to paying for drugs is because it costs them so much to "innovate." We pay once for the scientists at Hopkins to spend decades coming up with a novel, useful molecule, and then we pay again when [insert drug company] claims they have no other option because they spend so much money on researching and developing these drugs. And meanwhile, if you look closely, their marketing budgets easily triple the R&D sector of the company.

Yes, pharma is a for profit business (and show me a business that isn't! and what about the hundreds of millions of dollars of money those holier-than-thou so-called non-profit hospitals pocket every year?). However, coming up with a MOLECULE is pennies on the dollar. It's testing it in thousands of patients over years that costs millions. Try giving your patients a MOLECULE. Not formulated into a medication, just synthesized in a test tube.

Speaking of me-too drugs... sure, their primary purpose is extending the life of old molecule, but sometimes you stumble on real gems in the process... can't recall any really good ones right now, but Zyrtec was a me-too modification of Hydroxyzine, but it is an infinitely better antihistamine. Interestingly enough, I heard an ode to Xyzal from a friend of mine recently, and she is a pharmacist too. She thought "what would an enantiomer do if the racemate failed, like any other antihistamine before it?" but she is sold now that it is the only one that allows her to smell (her nose was constantly stuffy/runny for years with allergies, and her eyes watered pretty badly, not she says she is about 70% of normal, which is far better than with any other drug. I wonder how common such a difference in responce is...

And one thing that makes me laugh whenever I hear "why do we need five statins/so many beta-blockers/etc. from politicians is when I think that no one ever complains that there are hundreds of different models of sedans, and tens of models of SUVs and minivans and trucks around - and when I imagine their faces if there was just ONE car, ONE SUV and ONE pickup available, period, I just can't help chuckling. Choice is apparently the American mantra everywhere except medical care...

Returning to the original topic, I haven't seen a single drug rep in six years at Walgreen's (though we do have some pens with med names, so they must be coming occasionally) and the hospital where I did my rotations had half a day a month set up for them to meet with the drug info pharmacist... I can see an issue with sales reps becoming a burden on community pharmacists if they started visiting them en masse - pharmacists just cannot say no when someone asks to speak to them, and so much time would be lost. Most pharmacists I have known generally lack anything even remotely resembling a backbone when it comes to patients or management.

 

[Hels2007]

On the broader issue of money being wasted in healthcare, I have yet to see a system that is not badly broken, and US is one of the worse ones. No one spends so much per capita with so little to show for it. And it is being wasted on you and I too. If only lazy-*** patients took a bit more responsibility for themselves and used the one brain cell they have survive into adulthood, the need for pharmacists, especially retail pharmacists with six-figure income would drop significantly. Counting in fives? Mixing antibiotic suspensions? Spending an hour dealing with insurance company? No one does that in European pharmacies, where patients are considered perfectly capable of doing that. But then... my dark side takes over, I get off my soapbox and follow my signature.

 

[Priapism321]

Yes, pharma is a for profit business (and show me a business that isn't! and what about the hundreds of millions of dollars of money those holier-than-thou so-called non-profit hospitals pocket every year?). However, coming up with a MOLECULE is pennies on the dollar. It's testing it in thousands of patients over years that costs millions. Try giving your patients a MOLECULE. Not formulated into a medication, just synthesized in a test tube.

I think you are actually way off here. Let's talk about one example of true innovation (remember, I am talking about actual novel, life saving compounds here, not Xyzal because your friend says it helps her runny nose better than Clarinex, Allegra, Zyrtec, Claritin, etc.) and what the price tag was for the NCI to come up with the agent; I will choose paclitaxel. Bristol Myers Squibb licensed the MOLECULE after $183 million dollars (pennies on the dollar as you put it?) of PUBLICLY FUNDED RESEARCH (expensive test tubes perhaps?). This research began in the 1960's, so the dollar figure would be much higher if accounting for what the equivalent would be today.

So the oh so innovative BMS now has exclusivity rights to the drug. One problem, the source of the drug was an endangered tree, so the supply of the drug was rapidly diminishing. What did the drug company do (here's a hint, they didn't "innovate")? Well, they did what they always do, they headed to Florida State University where a publicly funded scientist had devised a method to synthetically produce the compound. They paid the school off, and they were back on their way to gouging cancer patients on the grounds of how much innovation it had taken them to develop paclitaxel.

 

[Priapism321]

Speaking of me-too drugs... sure, their primary purpose is extending the life of old molecule, but sometimes you stumble on real gems in the process... can't recall any really good ones right now, but Zyrtec was a me-too modification of Hydroxyzine, but it is an infinitely better antihistamine. Interestingly enough, I heard an ode to Xyzal from a friend of mine recently, and she is a pharmacist too. She thought "what would an enantiomer do if the racemate failed, like any other antihistamine before it?" but she is sold now that it is the only one that allows her to smell (her nose was constantly stuffy/runny for years with allergies, and her eyes watered pretty badly, not she says she is about 70% of normal, which is far better than with any other drug. I wonder how common such a difference in responce is...

Wow, a discussion on innovation and levocetirizine is the best agent you can come up with? Am I in the right thread?