Transcript Prescriber Education Programs: An Evidence

A Tri-State Academic
Detailing Collaborative
Jennifer L. Reck,
Prescription Policy
Choices
2008 Int’l Symposium on Pharmaceuticals
In the Home and Environment,
S. Portland, Maine, November 11, 2008
Prescription Policy Choices
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Nonprofit, nonpartisan 501(c)(3) educational
and public policy organization focused on
prescription drug policy
Evaluate policies and programs that
effectively reduce prescription drug prices,
increase access to medications, minimize
conflicts of interest & promote evidencebased prescribing
What is Academic Detailing?
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Also known as prescriber education and
outreach
Practice of sending independent, trained
clinicians to prescribers’ practices in order to
present objective, comparative, evidencebased information on prescription drugs
Academic Detailing in Context
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Avorn coined the term in the early 80s & did
initial RCTs establishing its efficacy for better
aligning prescribing practices with the
scientific evidence
The US spends more per capita on
prescription drugs than any other country $216.7 billion in 2006 – yet many patients
still lack access & the US ranks poorly in
health outcomes
Academic Detailing in Context
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The industry spent $12 billion in 2006 on
marketing
Employs approximately 90,000
pharmaceutical sales representatives, or
approximately 1 for every 5 doctors
Conflict of interest concerns
Academic Detailing Legislation
in Northern New England
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ME passed legislation funding academic
detailing in 2007
VT expanded funding for its program in 2007
NH passed legislation supporting academic
detailing in May of 2008
Northern New England Academic
Detailing Planning Initiative
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Prescription Policy Choices convened
stakeholders in ME, NH and VT for an
academic detailing planning initiative in the
spring of 2008
Informational summit to identify best
practices from existing programs
Working groups to identify potential points for
collaboration to maximize impact
Academic Detailing Planning
Initiative Funders
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Nathan Cummings Foundation
Consumers Union
Endowment for Health
Maine Health Access Foundation
The Bingham Program
Community Catalyst / The Prescription
Project
Academic Detailing
Informational Summit
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US:
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Pennsylvania (since 2005, administered by
Harvard’s Independent Drug Information Service,
www.RxFacts.org)
Vermont (since 1999)
South Carolina (since 2007, Medicaid / mental
health focused)
Worldwide: Australia, Canada
Cost-savings
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Though quality-focused, academic detailing
has demonstrated an ability to cut costs
Overall cost savings as high as $2 for every
$1 invested in prescriber education programs
demonstrated in:
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RCTs (Soumerai & Avorn, NEJM, 1986)
Real-world practice (Australia’s program over the
past 10 years)
Northern New England Academic
Detailing Planning Initiative
Potential points for collaboration:
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identifying clinical topics for focus
conducting literature reviews
developing key messages and physician and
patient educational materials
training academic detailers
Northern New England Academic
Detailing Planning Initiative
Funding models:
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Manufacturer fees (ME, VT)
pharmaceutical sales representative licensing
fees (WDC)
Pharmaceutical industry settlements (Zyprexa)
Medicaid matching funds
Northern New England Academic
Detailing Planning Initiative
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Executive summary and full report available
at:
www.policychoices.org
A Template for Establishing and Administering
Prescriber Support and Education Programs:
A Collaborative, Service-based Approach
for Achieving Maximum Impact
Part of a Growing National
Movement
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Bills also passed in 2008 in:
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State legislation expected in 2009:
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New York, Massachusetts &Washington, DC
Colorado, Maryland, Wisconsin & Washington
Federal legislation: Independent Drug
Education Act of 2008 (IDEA)
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Would provide federal grants for educational
material development and outreach programs
Upcoming Educational Session on
Academic Detailing
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The NHMS, in conjunction with MMA and
PPC, is presenting a CME program entitled
“Academic Detailing: Advancing EvidenceBased Prescribing Practices”
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Keynotes: Dr. Marcia Angell & Dr. Jerry Avorn
November 17, 9:00 am-12:00 pm
Concord, New Hampshire
Register with [email protected]
For Further Information on
Academic Detailing
Please feel free to contact me at:
[email protected]