Use of new drugs – relationship with industry
There are many external influences on prescribing decisions, local formularies, local specialist use of medications, publications, advertising and drug representatives. You may wish to reflect on the extent to which external forces influence your prescribing. This template will help you to consider some of the key issues in this area. You may wish to include your reflections as an appraisal entry and download the template below as supporting documentation.
Example
Influences on prescribing
1. How soon after launch would you consider prescribing a new drug?
Which statement is most accurate?
- I am likely to be one of the first to prescribe it
- I would normally prescribe after seeing the company representative
- I will wait until my colleagues in the practice have tried it in a few patients
- I will prescribe after I have seen local consultant colleagues use it in a few patients
- I will wait until it is commonly used or on local formulary
2. What is your policy about seeing drug reps?
I see reps after morning surgery on Thursdays by appointment only. I tend to see 2 or 3 each week
3. What influence, if any, do drug reps have on your prescribing?
I like to hear about the different formulations of medications and latest evidence that they produce in connection with their drug. I recognise this probably does influence my choice of drug within a class but I am aware of costs in this equation. I try to appraise the evidence presented but it is not always possible.
4. Do you accept hospitality from the Pharma industry? – if so to what degree?
I do occasionally go out for a meal with local reps and I also attend educational meetings sponsored by the industry. I have been on educational weekend meeting but not for a few years.
5. Examine your answers above and reflect on any issues arising
This exercise has made me think quite hard about what actually influences my prescribing, I had to think very hard whether or not seeing reps regularly had undue influence on my prescribing. I suspect that there is definitely some influence although I do not actively prescribe drugs in return for hospitality. I suspect the influence is over which drug I prescribe within a category. My generic prescribing is high but with many drugs not yet off patent that makes little difference overall to drug costs. I note I am quite an early adopter and I was aware of this, I do like to try new improved therapies to see if I can benefit my patients.
Overall I do not think I have issues of probity but I will in future be more aware of influences on my prescribing habits.