Pitts to Med Policy Pros: Academic Detailing Is Not a Panacea

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In a recent blog entry on, Peter Pitts, president of the Center for Medicine in the Public Interest, called out the federal government for putting its focus on and committing its dollars to programs that support “academic detailing,” a practice largely conducted by pharmacists to help healthcare professionals better understand medical treatment effectiveness (and supposedly to counter detailing done by pharmaceutical companies).

According to Pitts, although the federal government has awarded five academic detailing grants, funded in part with $29.5 million under the American Recovery and Reinvestment Act, “only a few small studies demonstrate that academic detailing reduces overall healthcare costs (direct and/or indirect) – and most only demonstrate reduced prescription drug expenditures.”

Further, he explains that measuring only drug expenditures and not health outcomes is a flawed premise. “Skimping on a more expensive medicine today but paying for an avoidable hospital stay later is a fool’s errand,” Pitts notes. Indeed, he cites a New England Healthcare Institute estimate that $290 billion in healthcare Viaga sales in canida expenditures could be avoided if medication adherence were improved.

In Pitts’ view, there are number of unasked and unanswered questions regarding academic detailing, including what safeguards are in place to make sure unbiased information is disseminated, which information should be allowed in academic detailing programs, and what the ramifications of off-label academic detailing and other enforcement issues are. “The worst part about rushing headlong into academic detailing is that there is no clear articulation or transparency regarding the specific rules and regulations that will govern the behavior and activities of…detailers.”

Another important idea has been advanced by Ken Berkowitz, veteran industry activist and member of the Legacy Board of the Coalition for Healthcare Communication. Berkowitz has called for FDA regulation of academic details, including limits on off-label discussion. It is unfair and bad public policy, Berkowitz argues, to allow non-sponsors to include messages not approved by the FDA.

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