Drug rep. Kennedy was in the other day and we were shooting the breeze.

One of the banes of our lives - or one of the high points, it depends how you look at it - is visits from drug reps.

They come in all shapes and sizes - from old guys who are grossly over assertive and you cringe when you see them in the waiting room, to some extremely attractive young ladies who have developed a very enticing “come hither” manner.
Whatever, a fairly universal feature is their use of statistics from clinical trials with which they try to persuade you that their product is superior - and to viciously bad mouth the competitors.

You know what they say about statistics. That one about “lies, damn lies and statistics”. If you carefully select out some factoid, you can usually find something that looks good about your product. For example the Lipitor ads note that the product “reduces the risk of heart attack by 36%”. Sounds dramatic. But looked at in another way, as pointed out in a rather derogatory recent article in Business Week*, the study showed those taking placebo over the 3 1/3 years course of the trail had a 3% heart attack rate whereas those on Lipitor had a 2% rate.

Which doesn’t sound quite so persuasive, and translates into the “number needed to treat” (which is the statistic that many experts think is what we should be looking at) of 1 in 100  - or in other words you need to treat 100 people for 3 1/3 years for one person to benefit.

Now I apologies to the Pfizer rep for singling out her product (she’ll probably never bring me coffee again), but it’s really the same for many, or all products - the careful use of one particular stat to sell the doctor - presented in some glossy, glitzy colorful pamphlet.

Any field as prevalent as hypertension - which is of course a lifelong disease, so you “capture” the patient for life - is a big market for the drug companies. So we have zillions of reps coming with their various products, with their persuasive reasons why we should prescribe them - other than that you will ingratiate yourself with some simpering, big breasted blond.

The latest wave of “me too” medicines (ones that follow on from some trailbreaker original product, trying to get a slice of the pie) are the angiotensin receptor blockers (ARB’s).

I was joking with Kennedy  - yes they do have a sense of humor and even some of the guys get to be ones buddy to some extent. I was telling him I would like to set up what would be the medical professions equivalent of dog fighting - and get all the ARB reps in a room together.

Maybe I could interest Michael Vick.

Jan 28th 2008

Leave a Reply

You must be logged in to post a comment.