Is the American Medical Association's (AMA) Prescribing Data Restriction Program (PDRP) the answer to physicians' privacy
concerns, or will it just hamper the relationship between rep and doc? Observant LLC recently gauged reactions to the PDRP
and doctors' expectancies of how this initiative affects physicians' practices and their relationships with pharmaceutical
representatives. The findings suggest that the initiative may have paradoxical negative implications for physicians.
The PDRP was introduced in July 2006 to address physicians' level of discomfort with the amount of personal prescribing information
available to pharmaceutical representatives. The broad objectives of the PDRP aim to keep prescribing data out of the hands
of sales reps who have direct contact with physicians. This voluntary program restricts physician-level prescribing data from
being shared with representatives and their direct managers. However, it does allow prescribing data to be shared at the corporate
level for marketing and segmentation purposes.
In-depth discussions with 44 physicians suggest that enthusiasm for the PDRP is muted, as only slightly more than half indicated
any likelihood of enrolling in the program. Those who do intend to enroll largely plan to adopt a wait-and-see attitude with
respect to the potential impact on their practice. The research indicates that the PDRP may ultimately fall short on several
metrics of concern.
The High Cost of Information
Despite the fact that many doctors prefer not to share their prescribing data with pharmaceutical companies, there is a sense
of resignation that this data provision is a necessary evil of practicing medicine in a capitalist paradigm. However, physicians
are particularly sensitive to personal information being recorded and shared among pharma sales reps.
Personal information can include conversations between the physician and the representative regarding vacation plans, recent
car purchases, or children's birthdays. Information disclosed in these kinds of one-to-one interactions is generally viewed
as private. Doctors are often surprised and offended by the notion that this information might be stored and shared among
In the study, physicians were shown three scenarios outlining possible cumulative levels of prescribing and interaction data
that pharmaceutical representatives may have available to them. These scenarios reflected industry approaches and were not
based on any one client company's practice. The first scenario, depicting the most conservative level of information—including
total-level monthly prescribing data, or month-to-month change in the prescribing of a rep's product—drew discomfort from
the physicians. Some doctors said that even at this level, "reps have too much information available to them."
This discomfort was exacerbated when respondents were shown scenarios illustrating even more personal and specific information
that could be gathered and shared amongst reps. The second scenario indicated that reps had access to total-level data for
competitor products and their change month-to-month over the past year, as well as functional notes on the rep's laptop of
the rep's interactions with the physician and his staff, accessible to other sales reps.
The third scenario, which elicited the greatest level of discomfort, listed dose-level monthly prescribing data for that rep's
product and competitor products, detailed graphs and charts illustrating month-to-month change for all products, and personal
notes on the quality of the rep/physician interaction, along with the doctor's personal details. Physicians were instructed
to assume these notes—as well as prescribing data and functional/personal notes from other reps who have visited the physician—were
reviewed by the rep before entering the office.
No Free Lunch
Although the sharing of personal information is not the purview of the PDRP, some physicians believe that these types of tactics
will become more prevalent if the AMA were to restrict prescribing data to reps. For many, this is of equal or greater concern
than rep access to their prescribing data per se.
Many physicians also presume that restricting their data will undermine the value of the relationship they have with their
reps. The ability to deliver commodities, such as samples, lunches for staff, and new product information, may be hampered
if reps are not equipped with prescribing data to guide their efforts.