Forbes Article Shines New Light on “Academic” Detailing

Oct. 29, 2012 – A recent op-ed piece in Forbes about the federal government’s sponsorship of “academic” detailing reiterates what industry proponents have been saying for some time: This government program may “gloss over the fact that less-expensive treatment options that are effective for most patients often won’t work for some of them,” and “can be harmful to patients who don’t respond to medicine in the same way as a majority of patients.”

“Bringing widespread attention to this issue, which is likely to result from this op-ed in a major publication, is vital to ensuring that there is not a double standard for the biopharma industry, whereby the industry’s hands are tied but the government gets a helping hand and patients have reduced access to drugs that can really benefit them,” said Coalition for Healthcare Communication Executive Director John Kamp.

The Oct. 24 Forbes article, authored by Henry I. Miller and Jeff Stier, states that a House Appropriations subcommittee has voted to support legislation that would eliminate funding for the Agency for Healthcare Research and Quality (AHRQ) and therefore put an end to the AHRQ’s academic detailing program. The program, which sends government representatives into the offices of healthcare providers “to offer a supposedly more disinterested viewpoint,” … “sounds good in theory, but a glaring lack of transparency in the program makes it hard to know how it functions in practice,” the article states.

Peter Pitts, president and co-founder of the Center for Medicine in the Public Interest, has been critical of academic detailing from the start. In his view, the program, which “is not academic detailing or government detailing, but counter detailing, is ill-advised and poorly constructed.”

Pitts told the Coalition that two significant problems in the program lead to an unlevel playing field:

(1)   The government can offer free continuing medical education credits as enticements for scheduling appointments with government detailers (which cannot be offered by industry); and

(2)   Government program materials do not have to be vetted by the Food and Drug Administration (FDA), even though industry materials are subject to FDA review.

“The ACCME has stated that the federal government has no conflicts warranting greater transparency, even though it is the largest payer of health care technology,” Pitts said. “That’s like saying an insurance company has no conflicts and it’s just the wrong position.”

In an article published earlier this year in the Drug Information Journal, Pitts stated that the government program’s supposed goal of cutting costs has not been proven, noting that “a strategy that’s good for payers” often is “bad for patient outcomes.” The program and other policies like it “are pernicious to both the public purse and the public health,” Pitts wrote. To view the full Pitts article, go to:

Miller and Stier underscore this point: “The program is plagued by the same sort of conflict of interest as drug detailers, just in reverse. The law exempts the feds from the same transparency standards applied to the drug industry.”

The authors also cite concerns about several issues: the government failing to note that drugs may be metabolized differently by certain individuals; a lack of reporting requirements for government detailers; and a lack of transparency. The government’s agents “should have to abide by the same degree of scientific oversight and transparency standards demanded of others,” they state.

Pitts is pleased that the Forbes authors have taken up this issue. “I am glad there are now more voices in this argument,” he said.

To view the Forbes article, go to: