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Steinman speculates that the real effectiveness of pharmaceutical sales visits lies primarily in the "relationship-building" that occurs during those visits. "Aside from free drug samples, the representative will often bring a gift lunch for the doctor and his or her staff, new pens and coffee mugs, offers to attend an educational conference. As a result, the doctor feels subtly, even subconsciously, indebted to the representative. This can lead to higher prescribing."

He adds, "This feeling of obligation to reciprocate a favor is not unique to doctors. It's human nature."

Steinman says that the form provides "a window into the sorts of things that can happen" during visits by pharmaceutical representatives to doctors' offices. "Today, many pharmaceutical companies officially discourage any and all discussion of off-label drug uses by sales representatives," he acknowledges.

"Nonetheless," he says, "physicians and the pharmaceutical industry don't have a great track record of self-policing in this area." He says that "there may well need to be a role for some sort of careful oversight to ensure that we don't slip back into practices that are problematic. We need to be careful of hidden forms of marketing."

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Contact: Steve Tokar
steve.tokar@ncire.org
415-221-4810 x5202
University of California - San Francisco
23-Apr-2007