During my time as a nurse practitioner student I was placed in multiple family practice clinical sites. Everyday I woke up at 7am, rushed to shower and leave the house at 7:30 to make it to my clinical site by 8. I never worried about bringing a lunch- I knew it would be provided to me free by a pharmaceutical rep. No snack either. If I got hungry, I could just have the office manager call someone on our long list of visiting pharma reps and one would surely stop by in the afternoon with some treats. Dinner tonight? Yes… pharma rep dinner at Watermark, regarded as one of the top restaurants in the city. One of the percs of family practice clinics is free food every day!
These ‘kickbacks’ from pharmaceutical companies can make life as a healthcare provider a little sweeter (they also make you a little fatter…). Free catered lunches for the entire clinic staff delivered daily, invitations to hear speakers at expensive restaurants all sound great, but are they influencing your practice positively or negatively? The Wall Street Journal Health Blog discusses the abundance of interactions between nurse practitioners and the pharmaceutical industry. According to the article, 96% of nurse practitioners surveyed said they had regular contact with pharmaceutical-industry reps. 49% of nurse practitioners said they had attended a pharmaceutical-sponsored lunch event in the past six months and 64% said they had attended a dinner event. Of these nurse practitioners, 48% said they were more likely to prescribe one of the featured drugs after attending these events.
Pharma reps do not sell generic medications. The reason drug companies can employ pharma reps is that the drugs they are marketing are expensive. This cost gets passed on to patients. Are these drugs really necessary for patients? Usually, no. In my current position as a nurse practitioner, I work with a low income population and over 90% of the drugs I prescribe are generic. Have I missed all of these “new” drugs pharma reps were previously marketing to me? Not much. I have treated hundreds of medical conditions using only generic and over the counter medications. Most drugs pharma reps market have a generic equivalent or likely a generic drug will treat the medical problem being addressed. By unnecessarily prescribing branded drugs, nurse practitioners and physicians increase the cost of medical care for their patients personally and our country’s healthcare system as a whole.
What do you need to do as a nurse practitioner to address this issue? Do you continue to accept free lunches and attend drug rep dinners? Do you prescribe expensive medications based on your relationship with pharma reps? Do you feel that this type of marketing by pharma does not influence you personally? My opinion? If you see pharma reps you are influenced, bottom line. It is your choice to attend lunches and dinners and see pharma reps in your clinic but you must be honest with your patients. Don’t prescribe expensive medications when cheaper ones will be sufficient. It is bad for your patients and it is bad for our country.