The Philadelphia Inquirer on Tuesday examined a Pennsylvania program that pays "academic" detailers to "give doctors objective information about the cost and benefits of all kinds of treatments, including diet and exercise." Under the program, called the Independent Drug Information Service, academic detailers search through scientific studies and create reports to inform doctors about the best prescribing methods.
According to the Inquirer, Jerry Avorn, a Harvard University internist and drug expert, developed the program when he "realized pharmaceutical companies were outclassing scientists when it came to telling doctors about new drugs and changing behavior." Several countries, including Australia and parts of Canada, have similar programs, but the U.S. has been "less receptive" because of its "fragmented payer system," the Inquirer reports.
The Pennsylvania Pharmaceutical Assistance Contract for the Elderly, which provides prescription drug assistance for low-income elderly residents, supports the program. The state has allocated about $3 million over three years to fund the detailer program, with the goal of improving care and reducing spending on drugs. Eleven detailers, some of whom work part time, are paid $50 per hour to visit physicians who treat large numbers of PACE beneficiaries.
The first study on the program's effectiveness, involving painkillers, showed that spending on Cox-2 inhibitors decreased by $60 per month per physician after a detailer's visit. Another study of the program has shown greater cost-savings for prescription acid-reflux drugs, according to Avorn.
Avorn said he believes Pennsylvania is the only state with such a program, but Maine, New Hampshire and Vermont are considering implementing one. Pennsylvania is slated to expand the model to include its state retiree-benefit program. Kaiser Permanente in California has had an academic detailing program for 20 years. Sharon Levine, a pediatrician responsible for drug-use management for the HMO in northern California, said, "We think the investment has paid off many times" (Burling, Philadelphia Inquirer, 6/12).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Publication Date: 2007-06-15 07:00
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