Pharmaceutical Promotion in Latin America Carlos Berríos AIS LAC 20 May 2009 WHA.
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Transcript of Pharmaceutical Promotion in Latin America Carlos Berríos AIS LAC 20 May 2009 WHA.
Pharmaceutical Promotion Pharmaceutical Promotion in Latin Americain Latin America
Carlos BerríosCarlos BerríosAIS LACAIS LAC
20 May 200920 May 2009WHAWHA
ContentsContents The problemThe problem
Main sources of misinformationMain sources of misinformation Poor regulationPoor regulation Physicians, main marketing agentPhysicians, main marketing agent
Addressing the problemAddressing the problem• RegulationRegulation• EducationalEducational
What we needWhat we need
3
New products to promoteNew products to promote
4
Hospital physicians´ perception of the influence of Hospital physicians´ perception of the influence of Pharmaceutical PromotionPharmaceutical Promotion
(Steinman,2001)
Professionals underestimate the Professionals underestimate the of Pharmaceutical Promotion of Pharmaceutical Promotion
A little38%
A lot 1%
None61%
How much influence do sales representatives have on your prescribing?
A little33%
A lot 51%
None16%
How much influence do sales representatives have on other physicians' prescribing?
Promotional practices downplay safety (I)
Unclear indication - what type of pain?
Does not mention risks other than gastrointestinal problems!
No bibliography references could be retrieved
No information on precautions, contraindications, price…
Nicaragua, 2003
Promotional practices downplay safety (II)
No indication mentioned
No active ingredient mentioned
Medicine approved for hormone replacement therapy but promoted for “weight control” and “ skin improvement”
No information on precautions, contraindications, price…
Costa Rica, 2007
7
Public health consequencesPublic health consequences
Therapy failureTherapy failure Harm due to adverse reactionsHarm due to adverse reactions Antimicrobial resistanceAntimicrobial resistance Increased expenditure in health: Increased expenditure in health:
• Inappropriate use of public fundsInappropriate use of public funds• Out-of-pocket payment by Out-of-pocket payment by
consumersconsumers Reduced trust in health servicesReduced trust in health services
Pharmaceutical Promotion Pharmaceutical Promotion RegulationRegulation
Results of 7 countries - HAI LAC survey: Results of 7 countries - HAI LAC survey: • DTCA not allowedDTCA not allowed• Promotion to Prescribers controlled Promotion to Prescribers controlled • Criteria for advertising establishedCriteria for advertising established• Free samples and promotional events restrictedFree samples and promotional events restricted• Control and sanctions foreseenControl and sanctions foreseen
But, in practice: Poor implementationBut, in practice: Poor implementation In Nicaragua, MoH created a Pharmaceutical In Nicaragua, MoH created a Pharmaceutical
Promotion Department: Pre-approval and Promotion Department: Pre-approval and monitoringmonitoring
Education and trainingEducation and training
PROBLEM:PROBLEM: Early contact between pharmaceutical representatives and Early contact between pharmaceutical representatives and
studentsstudents Conflict of interest of some university lecturers Conflict of interest of some university lecturers Pharmaceutical Promotion not included in Medicine and Pharmaceutical Promotion not included in Medicine and
Pharmacy schools curriculaPharmacy schools curricula
INITIATIVES: INITIATIVES: HAI Nicaragua developed teaching module HAI Nicaragua developed teaching module
• Implemented since 2005Implemented since 2005
• Adapted in 6 universities (4 Argentina, 2 Colombia): DURG – LA initiativeAdapted in 6 universities (4 Argentina, 2 Colombia): DURG – LA initiative
• Teaching in Ecuador and BrazilTeaching in Ecuador and Brazil
The Manual’s ValueThe Manual’s Value
High quality reference document to be used High quality reference document to be used in teachingin teaching
Increase awareness about the need to Increase awareness about the need to include pharmaceutical promotion teaching in include pharmaceutical promotion teaching in university curriculauniversity curricula
Strengthen current teaching experiencesStrengthen current teaching experiences Promote similar teaching in other universities Promote similar teaching in other universities
in Latin Americain Latin America