One little-known sector of mainstream medicine drives huge sales of drugs

Low-hanging fruit

She shook my hand, smiled and said to call her “Elizabeth.”

And that threw me off. Typically when I go to the doctor, it’s an exercise in intimidation.

But there was one big difference: Elizabeth wasn’t my doctor. She was a nurse practitioner. And this warm, open, friendly manner isn’t lost on one group of people…drug reps.

That’s right. Nurse practitioners can prescribe drugs and, in many cases, it is a drug rep’s dream scenario.

Drug dependency

A recent Harvard survey shows that drug reps have easy access to NPs, and most NPs seem to be quite comfortable with that.

Close to 100 percent of the NPs surveyed said they had regular contact with drug reps, and almost as many — 93 percent — said that gifts, meals, etc., have no sway over their judgment when it comes time to pull out the prescription pad.

Hmmm. That sounds pretty optimistic (not to mention naive). But contrary to their belief that their judgment can’t be swayed, nearly half say they’re more likely to prescribe a drug that’s featured at a special event, such as a dinner presentation.

Other results also reveal a very cozy, drug-friendly relationship:

* About two-thirds believe it’s fine for drug reps to bring meals and even gifts to doctors’ offices and other clinical practice settings

* 90 percent say it’s appropriate to attend a meal that includes a presentation sponsored by a drug-maker

* Nearly 80 percent say that a meal event, sponsored by a drug-maker, is a “good-to-excellent” way to learn about new drugs

No wonder one former drug company rep refers to NPs as “low-hanging fruit.”

What may be most unsettling is NPs’ attitudes toward distributing drug samples.

Two-thirds say they regularly dispense samples to patients. But more than 80 percent say they have no ethical problem in giving samples to anyone. Anyone!

So if an NP has a friend who’s feeling blue — here, try this starter pack of Prozac. Better take some Ritalin too if you have trouble getting focused and motivated.

It all adds up to a frightening commitment to prescription drugs.

The Harvard team notes that there are significantly more NPs than family physicians in the U.S., and each NP writes as many as 25 prescriptions each day, on average.

That’s staggering! Millions of prescriptions every year! And it makes you wonder: Could the major drug companies ever have achieved their current levels of worldwide dominance without giant streams of sales quietly prompted by nurse practitioners?

Very doubtful.

Now if only these advanced nurses would spend just a fraction of their time promoting the use of safe and effective supplements, then we’d be getting somewhere. (Somewhere healthy, that is.)

Sources:
“‘Under the Radar’: Nurse Practitioner Prescribers and Pharmaceutical Industry Promotions” American Journal of Manage Care, December 2010, ajmc.com

“Nurse Practitioners Like Pharma Lunches & Dinners” Ed Silverman, Pharmalot, 2/17/11, pharmalot.com