During 39 percent of visits, the sales representative either gave or promised free drug samples to the doctor, says Steinman, who is also an assistant professor of medicine at UCSF.
During 38 percent of the visits, the "main message" involved discussion of at least one use of gabapentin that was not approved by the FDA at the time, he says.
"We can't say for sure whether these off-label uses were brought up by the sales representatives or the physicians," cautions Steinman, "but it's clear there was extensive discussion of uses that were not approved by the FDA which, in general, sales representatives are prohibited from discussing in an unsolicited manner."
Steinman observes that off-label uses for gabapentin "represented a much larger potential market" than the officially approved use, "so there was certainly incentive for Parke-Davis to encourage the use of gabapentin for these other conditions."
He notes that physicians were just as likely to say they intended to increase prescription of gabapentin whether or not visits included mention of off-label use. Neither the duration of visit nor the visit's perceived educational value made any detectable difference in intention to prescribe, he says. "We can't rule out small differences in effectiveness. That said, even short visits of mediocre educational value were about as effective as longer visits of high educational value," he concludes.
There was no indication of whether the physicians followed up on their stated intention to prescribe more gabapentin, he says. "We can only say what, at that moment, they intended to do in the future, which is a major limitation of the study. We can't say the doctors wouldn't have increased their use of gabapentin anyway, without the v
'"/>
Contact: Steve Tokar
steve.tokar@ncire.org
415-221-4810 x5202
University of California - San Francisco
23-Apr-2007