Ensure Drug Quality and Safety – “Academic Detailing”


Doctors targeted by marketing schemes tend to prescribe more, newer, and pricier drugs regardless of the drug's efficacy compared to less expensive medications - sometimes with deadly consequences.  As The Prescription Project reports, Merck spent $209 million marketing the painkiller Vioxx, driving up utilization before the medical community had a full understanding of the drug's side effects.  The premature and rapid adoption of Vioxx resulted in up to 139,000 heart attacks, 40% of which were fatal.

States can establish "Academic Detailing" programs to save lives and reduce costs.  Academic detailing programs send highly-educated medical professionals to doctors' offices with scientific and unbiased information about which drugs are right for a given situation, countering the industry's direct-to-physician marketing and sales.  Studies have found that for every dollar spent on "academic detailing," two dollars are saved.  

Pennsylvania's Independent Drug Information Service program is a partnership between the state and Harvard Medical School.  Elsewhere, Maine, New Hampshire, and Vermont are creating a multi-state academic detailing collaborative with support from Prescription Policy Choices.  In addition to Vermont's existing program, Maine enacted Public Law Chapter 327 in 2007 and New Hampshire enacted HB 1513 in 2008 creating academic detailing programs.  Mississippi also established a program for physicians participating in Medicaid. 


The Prescription Project - Academic Detailing: Evidence-Based Prescribing Information
The Prescription Project - Cost-Effectiveness of Prescriber Education (Academic Detailing) Programs

Focus on Prescription Drug Reform

$287 billion -- that is how much the U.S. spent on pharmaceuticals in 2007, representing a significant driver of health care costs.  While spending on hospital and physician care surpass spending on prescriptions, drugs still account for 14% of all health care expenditures. Combine this with polls that show 70% of Americans believe the drug industry puts profits ahead of people, and it's no wonder that in 2008, at least 540 bills and resolutions are being considered by states across the country to reduce prescription drug prices, ensure the quality of medications covered by public and private health plans, and reduce the undue influence of pharmaceutical industry marketing - which itself tops out at $30 billion each year.

Health-Care-for-All On the Installment Plan

Incremental steps to improve the health care system can lay the foundation for comprehensive reform that provides health care for all. Comprehensive reforms enacted in Massachusetts, Vermont, Maine and San Francisco were, in large part, the result of pragmatic incremental steps those states had already taken. For example, a Families USA report discusses the many reforms Massachusetts put in place over the years that led to its comprehensive 2006 reform. Not every state is as far along in moving comprehensive health care reform, but each state does have numerous options for increasing access to coverage, reducing the growth of health care costs, and improving the quality of care.