U.S. Senate Special Committee on Aging Chairman Herb Kohl (D-WI), Senate Majority Whip Dick Durbin (D-IL), and Senate Committee on Health, Education, Labor, and Pensions (HELP) Committee Chairman Ted Kennedy (D-MA), and Senator Bob Casey (D-PA) were joined by House Committee on Oversight and Government Reform Chairman Henry Waxman (D-CA) and House Energy and Commerce Subcommittee on Health Chairman Frank Pallone (D-NJ) in introducing a bill in both chambers to provide doctors with unbiased information on prescription drugs. This federal "academic detailing" program would provide physicians and other prescribers with an objective source of information on all prescription drugs, based on independent, scientific research. Currently, pharmaceutical sales representatives are one of the only ways doctors learn about new drugs on the market, and evidence has shown that interaction with them can impact doctors' prescribing patterns. In April, the Journal of the American Medical Association (JAMA) published an editorial underscoring the need for physician access to unbiased research about the drugs available on the market.

"This bill will provide an important alternative to the way doctors currently get their information about drugs-from the drug companies themselves. This practice seems to be fraught with conflicts of interest," said Kohl. "By providing physicians with thorough, independent research on all the drugs available to them, we believe we can improve the quality of health care and reduce the cost of prescription drugs in America."

"Many doctors learn about new drugs from drug company salespersons who may not be objective," Durbin said. "Studies confirm that when unbiased health professionals, armed with educational materials, provide guidance to doctors, they are more likely to purchase the best drug for the patient instead of the best deal for the pharmaceutical company."

"This legislation a cost-effective, common sense and practical solution to a serious problem - it is exactly the kind of support the federal government should be providing the states," said Casey. "I'm proud to note that Pennsylvania has one of the best and most innovative academic detailing programs in the country, with documented and measurable cost savings."

"For far too long, most of the information physicians receive to make prescribing decisions has come from the drug companies marketing reps, not independent experts, This important legislation will go a long way toward giving doctors another, less biased perspective," said Waxman.

"Providing doctors with objective information about prescription drugs allows them to prescribe the most effective treatment to their patients," Pallone said. "Through this legislation, medical professionals will have the option of hearing independent and scientific opinions on a wider range of drugs, devices and medical interventions, which also has a proven record of lowering health care costs."

The proposed legislation would provide grants to produce educational materials for doctors on the safety, efficacy, and cost of prescription drugs, including generic and over-the-counter drugs. A second set of up to ten grants would be made available in order to dispatch trained medical staff (such as pharmacists, nurses, and other health care professionals) into physicians' offices to distribute and discuss the independent information. To ensure their neutrality, grant recipients may not receive financial support from any drug manufacturers that they are reviewing. When doctors are better informed about the full range of drugs available on the market, they are more likely to prescribe the most effective treatment, as opposed to the latest brand-name blockbuster drug. The result is also lower health care costs, as generic drugs are more likely to be prescribed. A study in the New England Journal of Medicine projected that for every dollar spent on academic detailing, two dollars can be saved in drug costs.

At an Aging Committee hearing on academic detailing in March, senators heard testimony from a former sales representative for the pharmaceutical company Eli Lilly, who shared with the committee his experiences as a drug detailer and discussed the techniques sales representatives employ when marketing drugs to doctors. Other witnesses, including Dr. Jerry Avorn from Harvard's School of Medicine, outlined the concept of academic detailing, shared success stories from state and international programs already underway, and discussed both the documented cost savings of academic detailing programs and how patients stand to benefit when doctors have access to unbiased information.

The academic detailing legislation is part of a larger effort to change the way the pharmaceutical industry interacts with doctors. In September 2007, Kohl and Finance Committee Ranking Member Charles Grassley (R-IA) introduced the Physician Payment Sunshine Act (S.2029) to require manufacturers of pharmaceutical drugs, medical devices, and biologics to disclose the amount of money they give to doctors through payments, gifts, honoraria, travel and other means. The drug industry has challenged the Grassley-Kohl bill, claiming that the legislation will potentially restrict their ability to inform doctors about new drugs. The academic detailing bill by Chairman Kohl and Senator Durbin addresses this charge.

In addition, Kohl and Durbin have recently been in correspondence with the American Medical Association (AMA) over concerns that pharmaceutical companies develop profiles of individual physicians' prescribing information as part of their marketing efforts.

Statements Of Support

"We need a program like this to counter the pharmaceutical industry's marketing free-for-all," said Robert Restuccia, executive director of the Prescription Project. "Academic detailing programs already exist in other countries and in several states, and they've been shown to improve care and generate savings."

"As long time proponents of comparative effectiveness research, the Blue Cross and Blue Shield Association supports this legislation and its goal of making sure doctors have access to objective information about the safety and effectiveness of pharmaceutical drugs," said Scott P. Serota, president and CEO of the Blue Cross and Blue Shield Association. "Providing doctors with information based on independent, clinical research will help patients get the best treatment, and improve safety and affordability of healthcare for everyone."

Full List Of Supporters

The Prescription Project / Community Catalyst
HealthPartners Health Plan, MN
HealthPartners Medical Group, MN
Gray Panthers
American Medical Student Association (AMSA)
Consumers Union
Health Care for All (Massachusetts)
Medicare Rights Center
Mississippi Human Services Coalition
Minnesota Senior Federation
National Physicians Alliance
No Free Lunch
Tennessee Health Care Campaign
National Legislative Association on Prescription Drug Prices (NLARX)
American Association of Colleges of Pharmacy
UMass Memorial Medical Center
US PIRG
The Harvard Interfaculty Initiative on Medications and Society
The Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital / Harvard Medical School
The Leapfrog Group
BlueCross BlueShield Association
The Marshfield Clinic
Prescription Policy Choices

Special Committee on Aging
Senator Herb Kohl, Chair
http://www.aging.senate.gov