Drugs cost more when manufacturers sell directly to physicians, study says

Drugmakers promoting their drugs directly to physicians affect prescribing quality and can raise drug prices, but the practice is more commonplace in smaller health systems with fewer physicians, according to a study published Jan. 27 in JAMA Internal Medicine

Drugmakers promoting their products directly to consumers through means such as TV commercials is the fastest growing segment of pharmaceutical marketing, but drugmakers still spend more to market directly to physicians. 

Drugmakers spent $18.5 billion to market to physicians in 2016, according to the study, conducted by researchers from Dartmouth Geisel School of Medicine in Hanover, N.H. 

When a representative from a drug company markets a product directly to a physician, it is often done through office visits, referred to as "detailing," and by giving physicians free drug samples.  

Drugmaker sales representatives tend to promote new, more expensive brand-name drugs over older, less expensive ones that are equally effective, raising drug costs. 

The researchers at Dartmouth found that weekly office visits by drugmaker sales representatives is more common in independent practices with fewer than 10 physicians than in those that are part of complex, large health systems. They also happen more frequently in Southern states and in practices that don't have an academic affiliation. 

It is likely that sales representatives target these kinds of practices because smaller practices have less ability to restrict promotional access, which many larger health systems have strict policies about. 

The researchers weren't able to figure out why Southern states were affected by more promotional visits than other states, but said it is worth mentioning that healthcare spending is higher overall in the South than other regions of the U.S. 

The researchers concluded that promotional activity from drugmaker sales representatives still has a substantial effect on prescribing practices, despite health systems restricting promotional access. 

Read the full news release here

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