And saving health care dollars at the same time.
As most know by this time, one of the core reasons for the widespread use of opioids is the overprescribing of pain medication leading to the initial addiction. And at least a good deal of this prescribing was by well meaning physicians who were lulled into complacency by the drug company representatives. There are now reports showing how the addiction potential was way underreported when things like OxyContin were pushed by the drug companies.
In the same way, expensive medications are often prescribed by physicians when an inexpensive older medication may be as good or better.
Much of the blame for both of these is due to the drug company representatives who frequent physician offices.
How many times have you been in an MD’s office and seen a smoothly dressed person arrive at about lunch time with trays of good food? This is a drug company representative most of the time. As a health care professional I have received invitations to continuing education and educational materials sponsored by a drug company. To read more about the way this works and its impact you can look here. But today, I want to propose a solution.
This idea comes from Australia, where it is only partially implemented. While there is also outcry about the undue influence of drug companies on prescribing practices in that country, the Australians have at least some counter to the physicians reliance on the representatives’ visits for information about drugs.
Australia has established the government-funded National Prescribing Service (NPS), an independent non-profit organisation for quality use of medicines.
The NPS provides independent information to doctors, including a small program of educational visits by NPS drug detailers (the independent equivalent of drug company reps).
At one time a few years ago I read about an extension of this program that used medical students to make some of these visits. I couldn’t find a reference to that now, but it would serve double duty — to educate the students and the physicians at the same time. It would also be a great role for pharmacy students.
I know in this era of corporate dominance, it is unlikely we can fund such a program. It would probably be best run by medical centers of excellence with government funding. The idea would be for each physician to receive a visit at least quarterly from a publicly funded drug expert who would review the latest drugs in his or her field, the drugs with the best evidence for effectiveness, and leave literature on current research. Physicians have trouble keeping up with so many new advances and that is why they rely on drug representatives in the first place. Having an alternative, easily accessible means of education would make a difference.
Imagine if five years ago, physicians were visited by someone who said
Drug companies are urging the use of opioids for pain and saying they are not addictive. However, the evidence shows that there is inherent danger in use of these drugs. Alternatives for pain treatment are available as outlined in this paper. We can help you learn more about these. Opioids should be used only when other alternatives are not working and then for the shortest time possible except with terminal illness and cases of chronic pain. Choices have be be made on an individual basis and there is no one size fits all, but many people have suffered from inappropriate prescribing.
Right now, in some physician’s office a drug rep may be selling the next drug to disrupt society — all in the name of good medicine. As always, I believe it is the job of the public commons to counter the negative influence of corporate money in our society. This would be a way to do that.