Pharmaceutical sales representatives, patient safety and cost-effectiveness of care: comparative cross-sectional survey

Prescription medicines are a common and important form of treatment offered by family doctors. The information that doctors receive about the effectiveness and safety of medicines helps to determine their prescribing choices. Most doctors in Canada see pharmaceutical sales representatives regularly. Previous research has demonstrated that sales representatives influence prescribing choices and that doctors often underestimate the extent to which they are influenced. A recent example of this influence emerged in the US with the arthritis drug Vioxx. Despite a 2001 Food and Drug Administration advisory committee recommendation that doctors be warned of heart attack risks associated with the drug, sales staff were advised not to inform doctors of. By the time Vioxx was withdrawn from the market in 2004, it had been linked to between 88,000 and 140,000 heart attacks. Dr. Barbara Mintzes is investigating whether information critical to safe prescribing is provided to doctors by sales representatives. She is gathering data from three countries: Canada (British Columbia and Quebec), the US, and France. She aims to identify best practices in regulation of drug promotion, and to understand how the messages doctors receive from sales representatives can be incorporated into education to improve prescribing. Ultimately, her goal is to improve prescribing safety and appropriateness. A key component of the research will be discussions of the implications of the results with policy-makers, physicians, medical educators and industry.