Invisible Prescribers: What You Do and Don't Know About NPs and PAs - Pharmaceutical Executive

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Invisible Prescribers: What You Do and Don't Know About NPs and PAs
How many prescriptions are written each year by nurse practitioners and physician assistants? It could be 200 million. Not that anyone is counting.


Pharmaceutical Executive


If physician assistants see an average of 50 patients per week, the 60,000 physician assistants in the United States would have 150 million patient visits if they all worked 50 weeks a year.

In fact, the number of patients seen in a year could easily be higher, since almost one in three physician assistants sees more than 75 patients a week. Together, physician assistants and nurse practitioners take at least 400-million patient visits a year. Using conservative assumptions, 60,000 physician assistants writing 25 prescriptions a week for 50 weeks would write 75 million prescriptions per year. Added to the estimated 125 million prescriptions written by nurse practitioners, these largely overlooked clinicians may write 200 million prescriptions a year.

Off the Radar

Three in four nurse practitioners report meeting between one and four times a week with pharmaceutical sales representatives. One in three nurse practitioners reports spending more than five minutes with reps each time they call. Seven of eight say they spend more than two minutes with pharmaceutical reps per visit. By comparison, industry analysts estimate that primary care physicians are called on 80 to 100 times per week by pharma sales reps.

Frequently, the doctor does not see the sales representative, but when she does, she spends, on average, between 30 seconds and two minutes in a sales discussion. As the number of "no-see" physicians continues to rise, the number of successful details will continue to decline, diminishing the actual time available for reps to spend in discussion with physicians.

More than four in five physician assistants meet with pharma reps between one and four times per week. More like physicians, many physician assistants take very short meetings with pharmaceutical representatives. Only one physician assistant in four reported spending 5 minutes or more with sales reps.

More than four in five physician assistants meet with pharma reps between one and four times per week. More like physicians, many physician assistants take very short meetings with pharmaceutical representatives. Only one physician assistant in four reported spending 5 minutes or more with sales reps.

About 85 percent of nurse practitioners and physician assistants believe pharmaceutical companies recognize them. Which means that roughly 24,000 prescribers feel they are off big Pharma's radar screen.

Pharma needs to put resources and energy into connecting with these clinicians, and restoring productive relationships.

Continuing Medical Education

Nurse practitioners and physician assistants use a variety of educational programs for continuing education, including case studies, small-group discussions, journal articles, Internet courses, and conference lectures.

The Medical Education Broadcast Network survey respondents were asked to indicate their degree of preference for five different learning methodologies (see table).

More than two of three nurse practitioners preferred—at least somewhat—conference lectures, the Internet, and enduring materials, such as journal articles, over small-group discussions or case studies. Two of the three asked said they are willing to pay for their continuing medical education; 37 percent indicate that they will rely on online courses for their future professional education.

Asked to indicate their degree of preference for five different learning methodologies, more physician assistants-—nearly two in five—favored conference lectures, the Internet, and enduring materials more than small-group discussions or case studies.

Fifty-five percent of physician assistants also said that they would be willing to pay for their continuing education; nearly half said that they will most likely rely on online courses for their future professional education.

Meeting the Market Halfway

Nurse practitioners and physician assistants are not only big prescribers, they report high compliance levels among their patients. Two out of three clinicians say at least half of their patients comply with medication treatment plans. In too many cases, prescriptions written by physicians and other providers are never filled.

Because nurse practitioners and physician assistants spend time educating patients about medication, their prescriptions are more likely to be filled than many written by other providers. When patients do not comply, both types of clinician report, the main reasons are financial problems and simple denial.

In addition to spending time with patients, nurse practitioners and physician assistants are willing to devote time to visits from pharmaceutical representatives. This offers a tremendous opportunity for pharmaceutical manufacturers.

If 160,000 high-prescribing doctors were more willing than most to see sales reps, they would be at the top of every call list. The pharma industry needs to rethink its call-time allocations and raise the per-call value of detailing nurse practitioners and physician assistants.

Sharyn Lee
(
) is CEO of Medical Education Broadcast Network.


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Source: Pharmaceutical Executive,
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