Shahram Ahari, a former drug company representative, and physician Adriane Fugh-Berman wrote that the estimated 100,000 representatives who visit doctors' offices look for details such as family photos or hobbies that they can use to forge a relationship. They use food, gifts and money to make often-overworked doctors feel more appreciated -- and more loyal to the company's drugs. If a physician will not meet with them, the representatives often woo the office staff with flattery and meals.
"Pharmaceutical gifting . . . involves carefully calibrated generosity," Ahari and Fugh-Berman wrote. "Many prescribers receive pens, notepads, and coffee mugs, all items kept close at hand, ensuring that a targeted drug's name stays uppermost in a physician's subconscious mind. High prescribers receive higher-end presents, for example, silk ties or golf bags."
Drug companies also purchase prescription records from pharmacies and, with the help of an American Medical Association database, identify individual physicians' prescribing patterns and rank doctors based on how many prescriptions they write, the authors wrote.
The tactics work. Another study in PLoS Medicine last week found that visits by detailers prompted nearly half of 97 physicians to increase prescriptions of gabapentin, a drug approved to treat seizures. In many cases, the drug representatives were pushing non-approved, or "off-label," uses of the drug, the study found.
