Comments

Listed below are the comments from doctors who have pedged to not see visiting pharmaceutical representatives (drug reps) at their practice for one year. Please note that doctors who sign the pledge can do so without making it public and without leaving a comment, so this is not a complete list of all signatories.

Click on the doctor’s name to view their information.

The No Advertising Please Pledge

I believe, with the wide availability of independent medication information, I do not require promotional material from visiting sales representatives from pharmaceutical companies (‘Drug Reps’). The primary role of the Drug Rep is marketing: encouraging doctors to prescribe their company’s medications. This conflicts with my role to provide the best evidence-based treatment and independent advice to my patients. I therefore take this ‘No Advertising Please’ pledge and choose not to see Drug Reps at my practice for one year.

 

Why have you supported the No Advertising Please campaign?

No Free Lunch Germany (MEZIS) is a smilar campaign in Germany

I do not trust drug companies to provide me with unbiased information

I feel that seeing drug reps is in violation with my promise to provide good healthcare for my patients

I would like to reduce the power of Big Pharma and return prescribing to a proper evidence base, independent of financial bias.

Because, if the drug rep is doing his/her job, they MUST be biased. Their mission is to sell drugs. I try to limit my discussions with them to marketing.

any one who thinks drug reps don't change your prescribing is dreaming, they don't visit for the pleasure of your wit and wisdom

The evidence is convincing!

I have always had misgivings about drug company advertising and drug promotion direct to doctors, and prefer to learn about new drugs from such publications as Australian Prescriber. I have just finished reading a book called Bad Pharma by Ben Goldacre, which has given me a renewed determination not to accept anything from a drug company, nor believe anything they tell me about their drugs!
The whole realm of drug trial publishing, promotion and pharmaceutical regulation is in need of a huge overhaul. It's profits before patients, all the way.

The reps represent a good source of information, however, it is unfortunately the medications that I see emerging are mostly medications that are potential treatments for chronic, sometimes lifelong medications. Most of these meds are provided either at the office, or as a mail in request. These meds end up being not covered by most health insurance companies, or require "add-on " coupons that I have to hand out along with the prescribed medication. The end result is this : The patients return for refills on these medications, again, because these meds are for "chronic conditions", such as COPD, Fibromyalgia, Diabetes, Sleep Apnea. The problems now become, that these very same meds that were provided either as in office samples, or time limited coupons, are now demanding my patients ( and my office staff), to jump through hoops, obtaining authorization from their insurance carriers, to cover these meds. As a consequence I find myself, now mandated to change their meds for a generic, or alternate treatment. These meds reek havoc on my uninsured patients, as initially they are taken, and later they are forced to instantly stop taking them, as the out of pocket expense is astronomical. Nobody ( besides ofcourse - big pharma), benefits in the end.

Advertising is pervasive here. It is easier to say 'yes' but we need to re-focus on the patient and the evidence. More work is needed to help doctors here use evidence but I know that changing one's practice is possible.

not seen a drug rep (except as a patient) in over six years. I hope to convince one of my colleagues to NOT continue doing this, or at least put some distance between the practice and commercialism.

BCBS Florida penalizes physician for the use of branded drugs. If generic medications work lets get all patients on the least expensive treatment possible

The evidence is clear that contac from drug reps leads to increased prescribing of the products that rep is selling, along with reduced adherence to guidelines. There is no need for biased information from a drug company, when proper evidence is easily accessible.

I prefer not to see Pharmaceutical Reps because I do not like receiving biased clinical trial information. By virtue of their paid role to promote sales of products, it is highly unlikely for the information to be impartial.

We have to level the playing field. The most effective, safest and resource-efficient management strategies have no smooth-talking advocates to buy you lunch...

I support medicine based on careful review of the evidence

I stopped seeing drug reps in my practice years ago after being involved with breastfeeding advocacy. The principles that applied to breast milk substitute marketing applied to everyday drug marketing.

Doctor's decisions should be as rational as possible, including the prescription of drugs. The foremost criterion when deciding which drug to prescribe a patient must be whether it is effective in treating their condition. Advertising by drug companies introduce subtle biases that compromise what ought to be a purely medical decision.

Science is already bent by ideology. Doctors already have enough to deal with overcoming the "Hidden Curriculum".
Normativity rules and restricts research areas. It is important to promote independent thinking rather than be herded .

Because health is based in evidences, not in friendship or other dificult to explain relationships.

Because we need to make decisions based on evidence not marketing. Conflicts of interest will destroy the trust the public puts in us.

~$1 billion is being spent on marketing of pharmaceuticals in Australia. Much of this activity is directed at doctors (but also increasingly at patient support groups).
As CHOICE stated in 2005: 'Marketing of this sort does not provide doctors with information designed to assist them to improve their advice to patients but attempts to influence them in non-rational ways. The strategy obviously influences the prescribing patterns of doctors in inappropriate ways and for this reason should be banned.'

Medical professionals should not rely on industry for pharmacology education.

I believe that doctors should have best practice and evidence based education delivered by organisations or groups which are independent of the companies who stand to benefit from drug sales.

no estoy de acuerdo con el cohecho y por el rescate de la buena practica y la etica

It's never been a hard choice for me- see a salesperson, or see another patient -- why would you?

I have been involved in medical education and medical research since I began a PhD at University College London in the middle of the MBBS course in the early 1960s. Since the 1970s I have used drug advertisements as a teaching tool for educating students about the importance of assessing evidence. Most Australian doctors still have the naive view that they are uninfluenced by advertising, in spite of the evidence. In this respect Australian doctors area long way behind our colleagues in the UK and US.

Yes, I will support it, I am a NOGRAZIE (in italian means" no thanks") member: www.nograzie.eu

INTRODUCTION from DEADLY MEDICINES AND ORGANISED CRIME - HOW THE PHARMACEUTICAL INDUSTRY HAS CORRUPTED HEALTHCARE

'The main reason we take so many drugs is that drug companies don't sell drugs, they sell lies about drugs. This is what makes drugs so different from anything else in life...Virtually everything we know about drugs is what the companies have chosen to tell us and our doctors...the reason patients trust their medicine is that they extrapolate the trust they have in their doctors into the medicines they prescribe. The patients don't realise that, although their doctors may know a lot about diseases and human physiology and psychology, they know very, very little about drugs that hasn't been carefully concocted and dressed up by the drug industry…If you don't think the system is out of control, then please email me and explain why drugs are the third leading cause of death…If such a hugely lethal epidemic had been caused by a new bacterium or a virus, or even one hundredth of it, we would have done everything we could to get it under control.'

Prescription drugs are the third leading cause of death after heart disease and cancer.

Deadly Medicines and Organised Crime - How big pharma has corrupted healthcare

By Dr Peter Gotzsche
Co-founder of the Cochrane Collaboration - www.cochrane.org – the most important evidence guide in all of medicine
Professor of Clinical Research Design and Analysis at the University of Copenhagen.
Co-authored CONSORT for randomised trials (www.consort-statement.org)

Peter Gotzche is co-founder of Cochrane, has published more than 70 papers in ”the big five” (BMJ, Lancet, JAMA, Ann Intern Med and N Engl J Med) and his scientific works have been cited over 15,000 times.

See interview with Dr Gotzsche here http://www.youtube.com/watch?v=VIIQVll7DYY

As doctors, it is naive to believe that we are immune to impact of drug company advertising. If it didn't work, then the drug companies wouldn't devote resources to it. Medical education stresses the importance of evidence based medicine. Yet when it comes to this area of our practice, the evidence if too often ignored.

I think it is the momento to exige industry chanching his etical practice and also, first, to ourself

Proudly independent professionals like us should actively seek the evidence behind the medications we prescribe and the devices we use. Although TGA regulations "prohibit" claims by drug reps outside of the Approved Product Information, there are many ways around this. Most important of all, though, is the damning evidence of the links between pharma reps' visits and prescribing patterns.

I have personally witnessed what I would call corrupt interactions between my colleagues and the pharmaceutical industry and I don't want to behave in any like them. Lest you think this is ill-informed, my late father rose from being a drug rep when I was born to the Australian Managing Director of a multi-national pharmaceutical company at the time of his death. He informed me on the ethics of the relationship between the industry and the profession from a very early age and was proud to see me graduate in medicine.

Medical students are incidentally exposed to pharmaceutical advertisement at clinical placements, and it has been my experience that universities will accept industry sponsoring of educational sessions, without any explanation to students about the nature or purpose of the involvement of industry in the campaign. In line with the evidence around the effectiveness of advertising to doctors, I believe it is very important for medical students to be educated about this very important and pertinent issue to their future careers.

Because I want to be sincere with my patients

When I started in medicine I committed myself to integrating the best scientific information possible to provide timely and compassionate care to my patients. I believe 21st century medicine is now overwhelmingly influenced by industry and the pursuit of profit and market share. Enough is enough. It is time for medical professionals to insist on unbiased and objective information. It is time for us to stop playing the game.

Most pharmaceutical reps are nice folk but do not seem to understand or accept that their position is inherently biased.

It would potentially conflict my role as Chair RACGP National Standing Committee - Quality Care
I support the choice Doctors are making to get independent prescribing advice. It is a commitment to their patients, their practice and to themselves as professionals.

My valuable time is better spent with patients!

I am convinced that the goal of advertising is to undermine evidence!

Academic detailing influences the prescribing of doctors substantially and it should only be allowed from not for profit education providers The Central Australian Aboriginal Congress has not allowed pharmaceutical company reps on the premises since its inception in 1975. The nexus between Big Pharma and the academic detailing of doctors must be broken along with all of the other financial incentives to prescribe against evidence.

To provide the best treatment to patients, doctors need being autonomous reasoning and evidence based , considering each patient clinical situation for their clinical decisions.
Advertising has a huge negative impact on pattern of prescribers and on patients health in all over the world.

I have long had concerns about influence of drug company representatives and drug company marketing. I am glad to have a reason and an incentive now to make a firm stand against these influences.

The evidence is clear: not engaging with pharmaceutical reps and their data, and not attending industry-sponsored meal/lectures is a meaningful way to avoid bias that could damage the quality of care we provide.

For affordable healthcare

Drug company promotional tactics are ubiquitous

I like to see doctors prescribing according to best evidence, without biased input from drug company representatives.

I have adhered to the principles of this pledge for many years. It's great to see this movement organising those who understand the issues and coherently putting this case to all medical doctors and the people they care for.

We have a responsibility to ensure our practice is evidence based an our information sourced from independant, peer reviewed sources where possible.

I obtain the most objective information I can find elsewhere.

I already pledged the No Free Lunch campaign.

This No Advertising Please campign is the same as NFL campaign.
So,I strongly support the NAP campaign.

I have not seen regular drug reps for more than a decade. The sophistication of pharmaceutical company marketing affects doctor's prescribing habits. In an effort to remain independent, I do not have any brands or marketing material in my consulting room.

I have always avoided drug reps as they promote company profits above patient care.

Pharmaceutical companies and their representatives do not provide balanced information about their products and eschew open and comprehensive evidence-based medicine.

I haven't seen drug reps for at least ten years.

The less drug companies spend on marketing the more will be available for research.
Doctors can get better advice from independent sources, such as journals and non aligned experts.
No contact with drug companies means more potential funds for research and doctors sourcing new information from more appropriate sources.

After 30 years of pens, post-its and pita wraps, a small tear is rolling down my cheek as I sign this pledge. But, as one who has seen the transition from eminence-based medicine to evidence-based medicine, and the impressive results for patients, I am compelled by the evidence. I also pledge to give away my favourite pens, lovingly housed in the top drawer, to non-clinical family and friends, and only use a non-branded pen - goodness, another tear!

Remove conflict of interest

Because Ithink that this campaign is a big sign of democracy!I'm proud to use My Brain without conditioning!Viva l'Australia!

I prefer to learn about new medicines through channels which are free of influence from the manufacturers

I support this campaign because I believe that drug reps give biased information and adversely affect prescribing. I agree that Working as a GP can be isolating and lonely and the reps take advantage of that. We need good peer support, not false friendship.

The evidence for the influence of pharmaceutical marketing on doctors prescribing habits is extensive. There is little doubt that exposure to advertising materials, pharmaceutical representative visits, free samples and other incentives positively influences the prescriber's choice. Such methods often have their impact at the subconscious level (e.g. Principle of reciprocity) which thus allows the alteration in the behaviour of highly educated and otherwise ethical individuals. The only certain way of preventing such influence on our prescribing habits is complete avoidance.

I have not seen reps since 2000 and am well aware of the evidence - I just more Doctors did to same

As a GP registrar, I don't want my education tainted by biased information. Some will say that we are intelligent and educated and therefore can critically analyse the information that drug reps provide. But drug marketing works, just like any other kind of marketing. Marketers are experts at this and we are not immune. That's why pharma companies do it.

Love this campaign. If you need to learn about a drug, choose one of many unbiased sources.

Agree with all reasons, I haven't seen a drug rep for about 7 years

Haven't seen drug reps for years, and don't want to. I support medications (always generic) which do the job I want them to.

I wish to practice in the interest of my patients - using medications only where they give a real benefit.

General practice needs to be informed by quality evidence, interpreted within the local context. Pharmaceutical representatives are fundamentally salespeople, not medical educators. If we are to aspire to evidence-based practice, we must develop a learning culture and environment that fosters critical engagement with the scientific literature. The evidence is clear that interactions with pharmaceutical representatives do not improve the quality of prescribing, and probably has a negative influence.

I support this campaign because I understand the basics of marketing: namely that you don't spend money on marketing unless it is effective in changing behaviour. Considering pharma companies spend millions of dollars each year on marketing to doctors, then it suggests that it's having an impact on their prescribing. If it didn't, pharma companies wouldn't spend the money.

Drug reps undermine our professional standing and independence, particularly in the eyes of our patients. I've found the lunches give me indigestion.

I have already chosen not to see drug representatives for many years and have instead relied on quality educational material/information to keep up to date.

I want my prescribing habits to be based on evidence and therefore wish to minimise the risk of inadvertently being influenced by marketing campaigns from pharamaceutical companies.

I don't desire unsolicited information from pharmaceutical companies. I consider information from pharmaceutical companies as unreliable and that its primary intent is to modify my prescribing behaviour in favour of the pharmaceutical company. I don't choose to consider pharmaceutical company agendas in my management plans for patients.

To be a better doctor.

Drug companies are profit driven, occasionally dangerous and always untrustworthy. The expenditure of tens of thousands of dollars for every doctor in Australia shows that they know that hey will get back much more by influencing our behaviour. It has been proved that contact with drug companies adversely affects doctor behaviour. The only solution is no contact, except under strictly controlled conditions

Because the information from drug reps consistently overstates the benefits and understates the harms of the medications they promote

The evidence suggests that getting my knowledge from commercially unbiased sources improves my prescribing. This must be better for my patients.

Quality evidence based resources are often difficult and expensive to access with costly subscriptions. Access to peers and to skills in research are problematic for rural Practiitioners. Drug company sponsored visits, dinners and publications are frequently the only opportunity to keep up to date. Let's get serious about providing Best Practice information to all healthcare providers...

The evidence has been clear for some time that pharmaceutical advertising influences prescribing. As a junior doctor, I need to keep learning. But my primary duty is to provide the best care for my patients. It is my responsibility to update my knowledge with the best and latest evidence, not the products of a company marketing budget.

The profit motive of pharmaceuticals is often conflictual with best practice patient care.

Because I'm tired of all the advertising with skewed and partial information I receive from a wide range of pharmaceutical companies. I already stopped seeing pharmaceutical reps a long time ago.

I prefer to obtain information about new medications from medical journals and government funded bodies such as the National Prescribing Service. Their publications such as Australian Prescriber and RADAR are informative, balanced and well written.

Interaction with Pharma has imperilled clinical medicine - especially clinical psychiatry. Studies of exposure to information provided directly by pharmaceutical companies have found associations with higher prescribing frequency, higher costs, and lower prescribing quality. All doctors should avoid exposure to information from pharmaceutical companies. Brisbane ACT Centre holds the interests of its patients - not its profits - foremost, and therefore we do NOT allow ANY interaction with pharmaceutical promotion.

I have refused to see drug reps for the last 15 years or more. There is a tremendous sense of liberation because as a young doctor I somehow thought I was obliged to see them.
They are not allowed to leave samples or literature at our practice.

I have not seen drug reps for at least 15 years and that is just the beginning of a long journey to rid my mind of the lies that drug companies tell us all. Walk with me....

I have been a GP for 15 years and an academic staff member in General Practice for the last 10 years. I actively stopped seeing drug reps or being involved in any "educational activities" that supported drug company sponsorship about 8 years ago and never regretted the decision. It was amazing how I at first missed the marketing, contact, information and flattery of drug reps. This feeling was quickly replaced with the satisfaction of seeking independent advice (often via the NPS and Australian Prescriber) that often reassured me about what was best for my patients and the health system. I saw my prescribing patterns change to evidence based recommendations and often use Electronic Therapeutic Guidelines as my "go to" for prescribing when I am uncertain. I have always been a late adopter in new medical treatments and drugs and have been very happy with this decision. I can happily say that I have no regrets with minimal prescribing of COX-II inhibitors or Glitazones (as 2 examples of recent drugs that seemed to be "embraced" by the profession but lacked lustre when looked at more thoroughly in post marketing surveillance). I encourage all doctors and medical students to stop deluding themselves that drug company advertising only have effects on your colleagues and not yourself. You need to be self reflective and aware of the this impact and act on it for the benefits of our patients and our health system.

I have had a policy of not seeing drug reps since I qualified as a GP. I believe that I can access the information that I need from independent sources, and that seeing reps runs the risk of altering my prescribing.
This policy has served me well for 25 years and I plan to continue on reading evidence-based pharmaceutical information, making sure that my patients are offered medication on the basis of science not 'free' lunches.

It is unnecessary and potentially dangerous to rely on pharmaceutical salespersons for information about drug therapy. It is difficult enough to assess information which is heavily influenced by the pharmaceutical industry as it funds about 80% of clinical research. It is also difficult to assess information from key opinion leaders many of whom are benefiting financially from the industry.

I have tried to avoid information from drug reps for some years. Some of their medicines are very useful, but I think it's more reliable and more ethical for me to learn about them from independent sources.

Because it is what I have been doing to years. I have long sought to not see Pharmaceutical Representatives within my practice, and to avoid Pharmaceutical sponsorship of activities within my practice, as I am persuaded the purpose is marketing, which may have an adverse influence on my patent management, and it used to leave me or the representatives (who are nice people doing their job)or my staff in tears.

As a GP registrar, I found drug rep visits a chore and a negative influence on my work day. I was able to pretty easily spot what I felt were clashes with evidence based prescribing, misleading graphs or gaps in the material they presented, leaving me with the choice to either enter a tiring debate during my lunch hour, or glumly go along with their sales pitch. I decided I had better things to do during my lunch hour than see reps, and have been a happier, better informed GP ever since.

while the pharmaceutical industry is a valid and necessary industry, when they promote directly to prescribers, the quality of prescribing diminishes. Our decisions are influenced by their promotion, and I do not want this influence to affect my prescribing habits.

The overwhelming evidence that I will provide better care to my patients if I do not see Pharma reps. I am also very concerned about the missing data from unfavourable trials which are undoubtedly costing patients' lives and health.

To improve the quality of prescribing by medical practitioners

I see no reason why my prescribing choices, and the consequences of these choices that flow on to the health of my community, should be influenced by marketing rather than evidence.

Because I believe that my drug prescribing habits should reflect clinical need, and not pharmaceutical company marketing.

I support this campaign because:
1. I want my patients to be confident that I am prescribing medicines only because it will benefit them.
2. I don't want my prescribing decisions to be determined by the samples I have in the cupboard.
3. There is a big difference between evidence and marketing.
4. I can afford my own pens.
5. I like my home-made lunches.

As a registrar, I trained during the rofecoxib (Vioxx) era and prescribed it to a number of patients. Turns out, the information about its cardiovascular risks was known for at least two years before the drug was withdrawn. I don't trust information from drug companies.

The best choice of treatment for a patient should be based on an independent assessment of the options - sometimes involving medication, sometimes not.
The doctor's crucial decision should ideally take into account a number of important factors - the patient, the illness, the individual circumstances, perhaps the expense.
Notably absent from this list of critical influences is the persuasive skill of the drug rep who happened to visit the surgery that morning.