This article in BusinessWeek Online on the Vioxx fiasco and DTC advertising adds an interesting twist:

    One way to offset the effects of so much advertising would be to take a page from one of the Big Pharma's own tried-and-true methods. A "detailman" in industry parlance is one of the pharmaceutical business' most effective foot soldiers. These salespeople visit doctors door-to-door, bringing free drug samples (and probably free lunch and other handsome carrots) and a sales pitch about the product. This marketing tactic has become, for many doctors who are increasingly swamped with patients and paperwork, a primary source of information about new treatments.

    Avorn, in a demonstration project funded by the National Institutes of Health, helped pioneer a practice called "counterdetailing" in the 1980s, in which a nonindustry set of detailmen were sent to doctors' offices to counter the drug company sales rep's come-ons.

    "We would advocate for drugs that met criteria for evidence-based medicine," Avorn says. Doctors welcomed the clear and unbiased information, which looks every bit as polished as industry advertising but doesn't hawk any particular product, says Avorn.

    Counterdetailing has reemerged in the last few years, says Avorn, who heads a successful effort at Boston's Brigham & Women's Hospital. The health systems of Pennsylvania and Kentucky will launch their own programs in the coming months, and large HMOs have also heavily invested in similar plans. "It's becoming a fairly widespread approach," says Avorn, who adds that such programs have been shown to save $2 for every dollar spent on the program.

Sounds like door-to-door CME to me--and very effective education at that. My question is: Would it be too expensive to do, and how would a CME provider pay for it? Shame that its practical application comes down to money questions, but I have a hard time picturing pharma supporting this type of education. Or maybe not??

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