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Forbes -
Med Schools Warn of Drug Sales Pitches
By DAVID B. CARUSO 11.02.06, 5:02 PM ET

Medical schools in several states are boosting programs that teach doctors and students to challenge the sales pitches of drug companies and avoid being dazzled by them.
The pharmaceutical industry spends billions of dollars a year on marketing to doctors - sometimes throwing lavish events to seal the deal on certain medicines.
Critics say slick promotion is unduly influencing how drugs get prescribed, sometimes to the detriment of patients. A small number of schools are now adding lectures and continuing education seminars aimed at persuading doctors to challenge claims made during sophisticated sales presentations.
"We want to appeal to physicians' natural skepticism," said Dr. Ethan Halm, an associate professor of medicine and health policy at Mount Sinai School of Medicine.
The prestigious Manhattan school is including a new type of training at its Morchand Education Center, famous for its use of actors to play patients.
For these sessions, the actors will play pharmaceutical company sales representatives. The students will be taught "how to effectively spar with the drug reps" by asking aggressive questions, Halm said.
Another part of Mount Sinai's program will advise health care providers how to tactfully deal with patients who see a drug on television and demand a prescription for it.
Almost daily, Halm said, doctors prescribe wonderful but lesser-known medications, only to have patients react as if they've been offered a second-rate imitation.
"They say, 'What about that thing the actor was using on TV? Can I get that instead? My insurance company is paying. Don't give me the cheap stuff,'" Halm said.
Drug makers say there is nothing nefarious about having salespeople meet with doctors to discuss a new drug, and many physicians may there is nothing wrong with listening to a sales pitch over dinner.
Adriane Fugh-Berman, an associate professor at the Georgetown University School of Medicine, said she lectured fourth-year medical students last year about drug company influence on doctors, and got a hostile response.
"Physicians do not believe that they are affected by pharma," she said. "They all say the same thing: 'We are too smart to be bought by a slice of pizza.'"
The number of medical school professors even willing to broach the subject with students in a significant way is still small, she added.
Stanford University in September joined a short list of institutions that have banned doctors from accepting gifts from drug industry sales reps. Others include Yale University and the University of Pennsylvania.
Dr. Jerome Kassirer, a professor at the Tufts School of Medicine and a frequent critic of the doctor-pharmaceutical relationship, said schools need to do more than just lecture.
"The question to ask yourself about these programs is: What are the faculty doing? Because if the students walk away from those sessions and find out their faculty are off speaking for Pfizer (nyse: PFE - news - people ), what are they going to think?"
An industry lobbying group, the Pharmaceutical Research and Manufacturers of America, said sales reps help busy doctors understand the proper use, benefits and side effects of drugs.
"They are providing information that is both informative and important for physicians to know about new medicines," said Diane Bieri, the group's deputy general counsel.
Money for some of the university programs about drug advertising comes from a $430 million legal settlement over promotion practices at pharmaceutical giant Pfizer Inc.
The company was accused of illegally paying doctors to prescribe its drug Neurontin for uses that had not been approved by the U.S. Food and Drug Administration. Doctors may generally prescribe pills for whatever use they see fit, but drug companies are barred from promoting medicines for ailments they have not been specifically approved to treat.

The settlement has so far awarded $11 million to 28 institutions. This week nearly $2 million in grants were awarded to Mount Sinai, the University of Arkansas, Florida International University, the University of Minnesota and the Institute on Medicine as a Profession, affiliated with Columbia University.

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Generic Competition to 2009 - The impact of patent expiries on sales of major drugs

The period 2005 to 2009 will see the expiration of patent protection for 39 major drugs in the United States, an average of 8 a year. With 2004 seeing a decline in the number of NCEs approved done to 23 from 27 in 2003, there is clear evidence that the loss of revenue from patent protected drugs will impact upon the growth of the industry when so few new drugs are reaching the market.
Once patent protection and periods of marketing exclusivity expire for a branded drug, sales tend to decline dramatically as generic substitutes capture market share.
Patent expiration for a major product can see revenues for the supplier fall ten-fold within two years. The loss of patent protection for key products is increasingly significant in assessing the future performance of major pharmaceutical companies. The decline of revenues to generic substitutes is a major influence on the financial performance of such companies. Conversely the successful identification and exploitation of the opportunities afforded by patent expirations provides a major growth driver for the pharmaceutical companies who focus their business on the provision of generic therapeutics.
With this background Urch Publishing has commissioned a study into the effect of patent expiries on some of the major branded pharmaceutical products.
Generic Competition to 2009 provides the concise and accurate overview of forthcoming generic competition.
Key features of this report.
Reviews of over 40 major drugs that will come off patent btweeen 2005 and 2006
Listing of generic regulatory filing activity
Solid overview of market for generic drugs over the next four years
Global product sales figures for years 2000-2004 with share by company revenue & market segment
Use this report to:
Forecast the market share that will be lost to generic competition
Understand which global companies are under pressure from generics
Consider the effect of expiry on the patent holder’s competitors
See whether there are any outstanding litigation issues
Learn which generic companies are active in filing
Remember!
The increasing use of generic therapeutics, which combine high volumes with low prices, has led generics to capture 14% of the global healthcare market in 2004, with combined revenues of $58 billion. The imminent patent expirations of many major drugs, 42 in the period 2005 to 2009, in a major market will provide a major growth stimulus for the generics companies as they compete to capture market share from multi-billion dollar drugs whose patents expire in this period.
You have been warned!
Author Dr P. Norman

Publication date September 2005
ISBN 09546981-9-3
Pages 94
Format: PDF
Table of Contents
Price: $1,595.00 / GBP861.30