In many ways, they keep doctors on schedule. Many say they can’t operate without them. We’re referring to sales representatives, who introduce doctors and hospitals to pharmaceuticals and medical devices. A sales rep might even be in the operating room to teach a doctor how to use a new device. Keep in mind that they aren’t doctors, but sales folks.
A new study from CMI/Compas shows that half of doctors now refuse to see sales reps, with those in the most desirable fields for sales – oncologists and internists – least likely to have a face-to-face meeting. Among oncologists, 20 percent will refuse any meeting with a sales rep while 40 percent will limit access. Two-thirds prefer to learn about a new drug through email, direct mail or education from a peer. Half of cancer doctors said they would meet with a rep to talk about a new drug.
When it comes to drugs newly on the market, doctors are less resistant to a sales pitch. Among primary care doctors, only 24 percent do not allow sales reps make a pitch. That includes pediatricians and family practitioners. The majority of internists – 78 percent – prefer email or fax while 67 percent will meet with a rep.
Perhaps it is not surprising that urologists, cardiologists, neurologists and endocrinologists were the least resistant to a meeting with a sales rep. Setting out the welcome mat the most frequently were urologists with 86 percent saying they like their face-to-face meetings with reps. That may explain why so many were sold on polypropylene transvaginal pelvic floor mesh for women and hernia mesh for men and women. Thousands of lawsuits have been filed by women injured by mesh and injuries range from mesh migration to nerve pain, chronic infection and disability.
The access to physicians is actually narrowing thanks to the Physician Payment Sunshine Act which was finalized in February. Under the Act, a group sales force or drug/device manufacturer must be reported by any doctor or hospital they attempt to contact. In an effort to be transparent, all and any payments must be disclosed. Consumers deserve to know whether their doctor has received a fee as a consultant or any compensation from a drug or device maker. Additionally, the public deserves to understand whether research has been compensated by the subject of the research and how much. Payments or anything of value over $10 must be reported. Data collection began August 1.
Civil penalties for failure to report will not exceed $150,000. Combined penalties may not exceed $1,150,000.
One positive thing about a visit from a sales rep is they can point out any FDA black box warnings on the drugs they sell. Doctors may not always be aware of the latest warnings, innovations or even improvements because of their busy schedules.
The Sunshine Act promises to put even more roadblocks between manufacturers and doctors and is part of what the Food and Drug Administration says is a shifting focus back to the patient and away from years of a cozy relationship with manufacturers. The shift remains to be seen.