Jennifer L' Reck,

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A Tri-State Academic Detailing Collaborative

• Jennifer L. Reck,
• Prescription Policy Choices

2008 Intl Symposium on Pharmaceuticals In the
Home and Environment, S. Portland, Maine,
November 11, 2008
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Prescription Policy Choices

• Nonprofit, nonpartisan 501(c)(3) educational and
  public policy organization focused on
  prescription drug policy
• Evaluate policies and programs that effectively
  reduce prescription drug prices, increase access
  to medications, minimize conflicts of interest
  promote evidence-based prescribing

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What is Academic Detailing?

• Also known as prescriber education and outreach
• Practice of sending independent, trained
  clinicians to prescribers practices in order to
  present objective, comparative, evidence-based
  information on prescription drugs

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Academic Detailing in Context

• Avorn coined the term in the early 80s did
  initial RCTs establishing its efficacy for better
  aligning prescribing practices with the
  scientific evidence
• The US spends more per capita on prescription
  drugs than any other country - 216.7 billion in
  2006 yet many patients still lack access the
  US ranks poorly in health outcomes

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Academic Detailing in Context

• The industry spent 12 billion in 2006 on
  marketing
• Employs approximately 90,000 pharmaceutical sales
  representatives, or approximately 1 for every 5
  doctors
• Conflict of interest concerns

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Academic Detailing Legislationin Northern New
England

• ME passed legislation funding academic detailing
  in 2007
• VT expanded funding for its program in 2007
• NH passed legislation supporting academic
  detailing in May of 2008

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Northern New England Academic Detailing Planning
Initiative

• Prescription Policy Choices convened stakeholders
  in ME, NH and VT for an academic detailing
  planning initiative in the spring of 2008
• Informational summit to identify best practices
  from existing programs
• Working groups to identify potential points for
  collaboration to maximize impact

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Academic Detailing Planning Initiative Funders

• Nathan Cummings Foundation
• Consumers Union
• Endowment for Health
• Maine Health Access Foundation
• The Bingham Program
• Community Catalyst / The Prescription Project

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Academic Detailing Informational Summit

• US
• Pennsylvania (since 2005, administered by
  Harvards Independent Drug Information Service,
  www.RxFacts.org)
• Vermont (since 1999)
• South Carolina (since 2007, Medicaid / mental
  health focused)
• Worldwide Australia, Canada

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Cost-savings

• Though quality-focused, academic detailing has
  demonstrated an ability to cut costs
• Overall cost savings as high as 2 for every 1
  invested in prescriber education programs
  demonstrated in
• RCTs (Soumerai Avorn, NEJM, 1986)
• Real-world practice (Australias program over the
  past 10 years)

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Northern New England Academic Detailing Planning
Initiative

• Potential points for collaboration
• identifying clinical topics for focus
• conducting literature reviews
• developing key messages and physician and patient
  educational materials
• training academic detailers

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Northern New England Academic Detailing Planning
Initiative

• Funding models
• Manufacturer fees (ME, VT)
• pharmaceutical sales representative licensing
  fees (WDC)
• Pharmaceutical industry settlements (Zyprexa)
• Medicaid matching funds

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Northern New England Academic Detailing Planning
Initiative

• Executive summary and full report available at
  www.policychoices.org
• A Template for Establishing and Administering
• Prescriber Support and Education Programs
• A Collaborative, Service-based Approach
• for Achieving Maximum Impact

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Part of a Growing National Movement

• Bills also passed in 2008 in
• New York, Massachusetts Washington, DC
• State legislation expected in 2009
• Colorado, Maryland, Wisconsin Washington
• Federal legislation Independent Drug Education
  Act of 2008 (IDEA)
• Would provide federal grants for educational
  material development and outreach programs

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Upcoming Educational Session on Academic Detailing

• The NHMS, in conjunction with MMA and PPC, is
  presenting a CME program entitled Academic
  Detailing Advancing Evidence-Based Prescribing
  Practices
• Keynotes Dr. Marcia Angell Dr. Jerry Avorn
• November 17, 900 am-1200 pm
• Concord, New Hampshire
• Register with tduffany_at_policychoices.org

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For Further Information on Academic Detailing

• Please feel free to contact me at
• jreck_at_policychoices.org