Pharmaceutical companies spend $11.4 billion each year on marketing. Much of that is spent on salespeople, known as "detailers", who visit doctor's offices to pitch the latest drugs, in order to increase prescriptions for their company's products-- usually at the expense of older, cheaper, and often more effective drugs.
States are catching on and starting to beat the drug companies at their own game. Working with academic institutions, several states are establishing "counter detailing" programs, also known as "academic detailing", to counter sales pitches from PhRMAceutical companies. They are sending out their own "detailers" armed with unbiased, scientific, and user-friendly information about the effectiveness of new and old drugs. Counter detailing saves states and health plans money by reducing unnecessary spending on costly prescriptions versus cheaper and equally effective generic medications. Additionally, counter detailing helps to ensure patients are being prescribed the most effective drugs for certain conditions, whether the drug is the cheapest or the most expensive.
- Pennsylvania's Independent Drug Information Service is supported by the state and run by Brigham and Women's Hospital, in affilation with Harvard Medical School. Over the past year, 10 counter detailers have made 1,200 visits to 500 doctors in Pennsylvania. While cost-savings data has not been compiled, the Boston Globe reported that counter detailers decreased unncessary prescribing of the heart drug Celebrex by highlighting less costly painkillers, comparing each drug's heart risks and stomach-sparing benefits.
- Vermont's Academic Detailing Program  is housed at the University of Vermont College of Medicine Area Health Education Center. Because the PhRMAceuticals are not involved and there is no financial incentive for the academic detailers, they can present unbiased and scientifically based information. Vermont presents a good model to states with its use of Area Health Education Centers  (AHEC), which were established by Congress in the 1970's to address medical staffing needs in under-served areas. Almost every state has an AHEC program.
- Oregon's Drug Use Research and Management program is housed at Oregon State University's College of Pharmacy. The program provides expertise to the state's Medicaid programs and includes a website with tools for prescribers.
- New York based non-profit No Free Lunch is an organization of physicians and other medical professionals who work to educate their peers about PhRMAceutical detailing and disseminate unbiased and evidence-based information about prescriptions.
In an effort to take counter detailing to the next level, Prescription Policy Choices , a non-profit focused on developing policies that reduce prescription drug prices and increased access to medications, is working with Maine, New Hampshire, Vermont and Massachusetts to develop a multi-state academic detailing project.
It is no surprise that PhRMA sales reps would have a huge impact on the prescribing practices of medical professionals, if they are the only people providing information. Counter detailing is an effective way to ensure the medical field is receiving up to date, scientific and unbiased information about prescription drugs, old and new. This is important to reducing prescription drug spending, as well as to ensuring the quality of prescriptions being written.
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