1. Promotional Material & The Pharmaceutical Representative. Bridget Rankin, Principal Pharmacist – Medicines Information Maidstone & Tunbridge Wells NHS Trust Acknowledgements - London Medicines Information Service (Northwick Park Hospital)

2. Drug Promotion – the Pharmaceutical Representative. Drug Promotion Drug Promotion NHS Standards NHS Standards ABPI Code of Practice ABPI Code of Practice Company Representatives Company Representatives The ‘meeting’ The ‘meeting’ Tricks of the trade Tricks of the trade Evaluating Product Information Evaluating Product Information Quiz Quiz

3. Drug Promotion by Pharmaceutical Companies. Journal advertisements Journal advertisements Mailings Mailings Samples Samples Sponsored meetings Sponsored meetings Gifts Gifts Direct-to-consumer advertising Direct-to-consumer advertising Company representative visits Company representative visits

4. NHS Standards. Commercial Sponsorship – Ethical Standards for the NHS (Nov 2000) Who is the guidance aimed at? Who is the guidance aimed at? Sponsorship, inducements and hospitality Sponsorship, inducements and hospitality Research and development Research and development Potential conflicts of interest Potential conflicts of interest

5. Advertising Regulation. Advertising is regulated by a combination of: Statutory (legal) - Medicines and Healthcare products Regulatory Agency (MHRA) Statutory (legal) - Medicines and Healthcare products Regulatory Agency (MHRA) Self-regulation (codes of practice)- Association of the British Pharmaceutical Industry (ABPI) Self-regulation (codes of practice)- Association of the British Pharmaceutical Industry (ABPI)

6. ABPI Code of Practice. Trade association representing manufacturers of prescription medicines. Trade association representing manufacturers of prescription medicines. Applies to about 75 UK pharmaceutical companies (60 non-member) Applies to about 75 UK pharmaceutical companies (60 non-member) Covers all areas of promotion by the pharmaceutical industry Covers all areas of promotion by the pharmaceutical industry Compliance with code is obligatory for members Compliance with code is obligatory for members Not legally binding Not legally binding Aim “promotion of medicines to health professions and administrative staff is carried out in a responsible, ethical and professional manner.” Aim “promotion of medicines to health professions and administrative staff is carried out in a responsible, ethical and professional manner.”

7. Code for Representatives. ABPI Code of Practice (Clause 15) - covers oral information, as well as written ABPI Code of Practice (Clause 15) - covers oral information, as well as written Must be adequately trained Must be adequately trained Must not give misleading information Must not give misleading information Must not offer inducement to gain interview e.g. fee Must not offer inducement to gain interview e.g. fee Must not cause inconvenience Must not cause inconvenience Provision of hospitality Provision of hospitality

8. Local Policies for Representatives. Local policies may exist relating to: Appointment system for meeting clinicians Appointment system for meeting clinicians Leaving samples of medicines Leaving samples of medicines Sponsorship of educational meetings Sponsorship of educational meetings Frequency of meetings Frequency of meetings

9. Representatives Objectives. Sell company products Sell company products Inform and educate professionals Inform and educate professionals Gather information Gather information

10. ‘The meeting’. What’s in it for me? What’s in it for me? Be selective Be selective By appointment with time limits By appointment with time limits Be in control Be in control Beware of bold statements (check evidence) Beware of bold statements (check evidence) Prepare standard questions Prepare standard questions

11. Points to consider: SSafety TTolerability EEffectiveness PPrice SSimplicity One STEP better?

12. Tricks of the trade. Appeal to authority Appeal to authority Bandwagon effect Bandwagon effect Appeal to pity Appeal to pity Red herring appeal Red herring appeal Appeal to curiosity Appeal to curiosity Testimonial Testimonial

13. Evaluating Product Information. Are the claims backed up by evidence? Are the claims backed up by evidence? Are graphs/diagrams accurate and clear? Are graphs/diagrams accurate and clear? Be cautious of statistics and graphics Be cautious of statistics and graphics Beware of ‘best’ – ‘strongest’ – ‘unique’ Beware of ‘best’ – ‘strongest’ – ‘unique’ Request the original references Request the original references

14. And where should all the ‘glossies’ go? Brochures Brochures Adverts masquerading as editorial articles Adverts masquerading as editorial articles Adverts pretending to be information resources Adverts pretending to be information resources

15. Summary. See representatives if you wish See representatives if you wish View information objectively View information objectively Ask for further information Ask for further information Colleagues use MI as an independent information source Colleagues use MI as an independent information source That independent knowledge source is YOU That independent knowledge source is YOU