Harvard Health Letter

In Brief: Attention to detailing

In Brief

Attention to detailing

Drug companies spend billions on marketing their wares, but the industry still depends on sales representatives — its more polished version of the door-to-door salesperson — to persuade doctors to prescribe its products. The sales representatives have been nicknamed detailers because they provide details about medications — not, supposedly, just a sales pitch. Industry critics say they distort prescribing so patients wind up taking newer, more expensive medications when more effective (and often less expensive) alternatives are available.

Dr. Jerry Avorn, a Harvard Medical School professor, is trying to beat the detailers at their own game. Under a contract with the Pennsylvania Department of Aging, Dr. Avorn has created the Independent Drug Information Service. About 10 nurses and pharmacists work for the program as "academic detailers." Instead of pushing a particular product, they go over research results. Their "market" is doctors who have patients enrolled in the state's subsidized drug program.

Dr. Avorn — whose book, Powerful Medicines: The Benefits, Risks and Costs of Prescription Drugs, covers the issues surrounding detailing — says part of the problem is that doctors in academic medicine who might serve as objective sources are "lousy communicators" who overdo it: "We give practicing physicians a 12-course meal when all they want is a snack." For the Pennsylvania program, he and his colleagues have written brief brochures and longer documents so doctors can pick whether they want a quick summary or a longer explanation.

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