The Wall Street Journal on Monday examined a state-funded program in Pennsylvania that sends "unsales representatives" to physician offices to encourage the use of generic and other medications that cost less than brand-name treatments. The program is based on the research of Jerry Avorn, a professor of medicine at Harvard University, who has established a system called "academic detailing," which seeks to encourage physicians to make prescription decisions based on scientific evidence rather than promotions from pharmaceutical company sales representatives. In Pennsylvania, the state Department of Aging through a contractor will pay $3 million to a foundation led by Avorn over three years to implement an "unsales" force to counter promotions by pharmaceutical companies and reduce medication costs for the state. Members of the unsales force visit physician offices and discuss alternatives to brand-name medications, such as generic and over-the-counter treatments or behavioral modifications (Hensley, Wall Street Journal, 3/13).
The key thing here will be if this program can help enact systematic changes. It doesn't work very well for the state to keep sending "unsales reps" year after year at a hefty price tag. But if the practice can help change prescribing culture after a few years, it will pay for itself.