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首页> 外文期刊>The journal of clinical hypertension. >Can Access Limits on Sales Representatives to Physicians Affect Clinical Prescription Decisions? A Study of Recent Events With Diabetes and Lipid Drugs
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Can Access Limits on Sales Representatives to Physicians Affect Clinical Prescription Decisions? A Study of Recent Events With Diabetes and Lipid Drugs

机译：销售代表对医师的访问限制会影响临床处方决定吗？糖尿病和脂质药物近期事件的研究

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The authors explored to what extent important medical decisions by practitioners can be influenced by pharmaceutical representatives and, in particular, whether restricting such access could delay appropriate changes in clinical practice. Medical practices were divided into four categories based on the degree of sales representative access to clinicians: very low, low, medium, and high from a database compiled by ZS Associates called AccessMonitor (Evanston, IL) used extensively by many pharmaceutical companies. Clinical decisions of 58,647 to 72,114 physicians were statistically analyzed using prescription data from IMS Health (Danbury, CT) in three critical areas: an innovative drug for type 2 diabetes (sitagliptin), an older diabetes drug with a new Food and Drug Administration-required black box warning for cardiovascular safety (rosiglitazone), and a combination lipid therapy that had reported negative outcomes in a clinical trial (simvastatin+ezetimbe). For the uptake of the new diabetes agent, the authors found that physicians with very low access to representatives had the lowest adoption of this new therapy and took 1.4 and 4.6 times longer to adopt than physicians in the low- and medium-access restriction categories, respectively. In responding to the black box warning for rosiglitazone, the authors found that physicians with very low access were4.0 times slower to reduce their use of this treatment than those with low access. Likewise, there was significantly less response in terms of changing prescribing to the negative news with the lipid therapy for physicians in more access-restricted offices. Overall, cardiologists were the most responsive to information changes relative to primary care physicians. These findings emphasize that limiting access to pharmaceutical representatives can have the unintended effect of reducing appropriate responses to negative information about drugs just as much as responses to positive information about innovative drugs.
机译：作者探讨了从业人员的重要医疗决定在多大程度上可以受到药物代表的影响，特别是，限制这种访问是否会延迟临床实践的适当改变。根据销售代表对临床医生的访问程度，将医疗行为分为四类：ZS Associates汇编的数据库AccessMonitor（伊利诺伊州埃文斯顿）广泛使用了非常低，低，中和高的数据库。使用来自IMS Health（丹伯里，CT）的处方数据在以下三个关键领域对58,647至72,114位医生的临床决策进行了统计分析：2型糖尿病的创新药物（西格列汀），较旧的糖尿病药物以及需要美国食品药品管理局（FDA）批准的新药物黑匣子警告心血管安全（罗格列酮），以及在临床试验中报道阴性结果的联合脂质疗法（辛伐他汀+依泽替米贝）。为了吸收新的糖尿病治疗剂，作者发现，与代表接触率非常低的医生采用这种新疗法的比例最低，并且采用这种药物的时间比在低和中等访问限制类别中的医生长1.4倍和4.6倍，分别。在对罗格列酮的黑匣子警告做出回应时，作者发现，进入率极低的医生减少使用这种疗法的速度比进入率低的医师慢4.0倍。同样，在更多访问受限的办公室中，改变脂质疗法处方对负面消息的反应明显更少。总体而言，相对于初级保健医师，心脏病专家对信息更改的反应最为迅速。这些发现强调，限制与药品代表的接触可能会产生意想不到的效果，即减少对有关药品负面信息的适当反应，就像对创新药物阳性信息的反应一样。

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