Internet-based programs help decipher marketing practices

Aggressive marketing of prescription drugs by pharmaceutical manufacturers to medical students and physicians is of growing concern among health professionals. With rising drug development costs and manufacturers’ desire to maximize investments, efforts to affect prescribing habits have escalated.

“Physician opinion leaders are the first target for drug companies,” says UAB preventive medicine expert Maribel Salas, MD, who notes that pharmaceutical representatives’ access depends on the policy of individual institutions. “Although manufacturers’ ultimate goal is changing prescribing behavior, they also provide useful information. Training helps physicians analyze data, sift out what is important, and make appropriate prescribing decisions.”

Salas is 1 of 28 grantees funded by the Attorney General Consumer and Prescriber Education Grant Program, a national effort aimed at developing and disseminating a curriculum providing critical skills for evaluating prescription drug information and industry marketing techniques. The program grew out of a 2004 settlement resolving allegations that a Pfizer, Inc subsidiary violated state consumer protection laws when promoting gabapentin (Neurontin) — approved as a supplemental antiseizure drug for epilepsy — for off-label use as a treatment for a number of conditions, including attention deficit disorder and neuropathy.

In September 2006, Salas began developing the program, which will recruit medical students, residents, and practicing physicians in the Alabama Practice Based Research Network. The randomized controlled trial involves case-based online education programs, followed by physician-reported understanding of evidence-based medicine, their awareness of industry marketing strategies and influence, and their ability to evaluate promotional campaigns.

Internet Curriculum
The resulting Internet educational curriculum will be disseminated through the Alabama Chapter of the American College of Physicians. A public Web site will be developed for this project, also designed as a distance learning course that takes into account busy physicians’ schedules.

“Physicians will be better able to assess sources of drug information, and therefore can more carefully identify and select unbiased information,” Salas says. “Our ultimate goal is helping them apply new knowledge to their prescribing practices.”

Salas and colleagues are working on the premise that online programs can produce comparable or superior gains in knowledge compared with in-person teaching methods. A Journal of the American Medical Association editorial says electronic teaching methods represent the future in medical education and notes that medical students are currently taught in a “conflicted web of pharmaceutical influence” (2005;294:416-417).

“Helping medical students evaluate sources of drug information prepares them to provide optimal care,” Salas says. Until these tools are available, the Food and Drug Administration provides an online, voluntary pharmacovigilance system at www.fda.gov/medwatch, where adverse drug events should be reported by prescribers, patients, and manufacturers. “Many physicians are unfamiliar with the FDA’s system for adverse-event reporting, which is especially important for off-label uses of drugs,” she says.

For more information
Dr. Maribel Salas
1.800.UAB.MIST
mist@uabmc.edu