How nurses are becoming integral to pharma marketing: 7 notes

A new marketing tactic is emerging in the pharmaceutical industry — hiring nurses to boost prescription rates, medication adherence and profits, according to a new blog published in Health Affairs.

The blog is written by Quinn Grundy, RN, a registered nurse and assistant professor with the faculty of nursing at the University of Toronto in Canada and Elissa Ladd, NP, a family nurse practitioner and associate professor at the MGH Institute of Health Professions in Boston.

Here are seven key insights from the blog:

1. The new tactic is highlighted in a recent lawsuit against AbbVie, which involves its blockbuster rheumatoid arthritis treatment Humira. The complaint alleges AbbVie used an elaborate network of nurses to ensure prescriptions for Humira were regularly filled. The registered nurses were hired by AbbVie to visit patients at home and help administer drugs, but instead the nurses were used to boost refills and downplay potential risks of the drug, the complaint alleges.

2. The use of nurses in marketing builds on a central idea in health: People trust nurses. It ranked as the most trusted profession in 2017, according to the annual Gallup poll on honesty and ethical standards, and nurses have topped the list since 2001. 

3. Over the last several decades, nurse practitioners have been increasingly involved in the drug industry, and surveys have found their prescribing patterns are increasingly influenced by pharma marketing, according to the blog.  Nonprescribing registered nurses attend more sponsored dinners and serve as paid "key opinion leaders" more than ever before.

4. While  drug companies hiring nurses is not uncommon, there has been almost no research on the role of nurses who directly work for these companies.

5. The bloggers  say that nurses working for the drug industry is not necessarily unethical, but when profit incentives are linked to those nurses' decisions, it could be.  "When nursing care is used as a marketing mechanism, the pharmaceutical industry is capitalizing on the trust the public places in nurses and potentially putting patients at risk for serious harm. This harm can occur when patients' adherence is driven by profit incentives," the bloggers write.

6. The AbbVie lawsuit highlights the problem when profit incentives are mixed with treatment decisions and nursing care. Part of a nurse's job is educating a patient on medication and the proper adherence. However, if the nurse counsels the patient to remain on a drug to boost sales of his or her employer, "it is not only a conflict of interest, but also may pose an untoward and unnecessary risk to the patient," the authors write.

7. AbbVie is not alone in using nurses to market drugs. Eli Lilly, Bayer, Amen, Gilead and Astra Zeneca have been cited for using nurse educators in a similar fashion. However, the authors note that AbbVie's is particularly problematic as the nurses provide direct patient care.

Read the full blog post here.

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