I may not have seen a pharmaceutical rep for over five years, but still the branded pens they gift to medics continue to infiltrate my house and my handbag. I conciously throw out the drug company pens I find, but they just seep back in: every time I lose my own plain biro, there is another pen somewhere near, in a ravishing colour or with streamlined design, beckoning to take its place.
The reasons why I don’t like seeing drug reps are several. But mainly they come down to this: time is precious, and unbiased appraisals of evidence are better delivered elsewhere. Reps are there to sell, and fair evidence should not need ‘sold’.
But this may not be quite enough. An interesting paper in the Archives of Internal Medicine has examined the effect of exposing medical students exposure to brand logos on equipment – stickers on clipboards or branded notepaper – prior to being asked about the implicit attitudes towards these drugs. The students who had been exposed to the promotional material held higher implicit values for the promoted drug compared with the control group.
There are obvious limitations to this study - it is a single study performed with one cohort of students, and it does not necessarily mean that prescribing is going to vary with the presence of promotional gifts. Yet we don’t know that it doesn’t. Here is a report in Pharmaceutical Field magazine calling on reps to find those ‘rare but lovely creatures’ – GPs who see reps daily. We now have the internet and excellent sources of information. I do not think that pharmaceutical sales reps are needed, or advantageous to patient care.
A couple of other potential harms bother me. First, pharmaceutical reps are usually highly qualified and very able individuals. They are utterly wasted in being drug reps. And second, do people seeing their doctor feel any differently for the presence of branded goods in the consulting room?