Students learn to see devil in the details

Medical students find the need to question a hard sell from drug companies.

By Jay Greene, amednews correspondent. March 18, 2002.

Medical students at UCLA School of Medicine are learning to be more skeptical about drug company representative presentations.

A report in the December 2001 Academic Medicine recounted how researchers studied a group of 120 third-year students who participated in a class exercise on detailing.

The exercise featured University of California, Los Angeles, pharmacists posing as drug sales representatives and conducting a 20-minute mock detail on a nonsedating antihistamine. The detailing session included somewhat exaggerated claims that overlooked toxicity problems and side effects, and provided no information about costs. The authors said the exercise was meant to replicate actual rep detailing.

After the detail, the students were asked whether the drug rep had presented balanced views and whether it was accurate and sufficiently documented. In addition, students were asked if the reps discussed the economic implications of the drug and whether it had been compared with similar drugs.

The authors said students become less certain about the accuracy and ethics of pharmaceutical detailing after they are taught the full purpose of drug marketing. In student surveys before and after the class, the study concluded that fewer students, 25% after the detail compared with 35% before the detail, felt they were sufficiently skilled to judge pharmaceutical claims. In addition, fewer students, 61% compared with 86%, wanted drug rep details during their residency.

An abstract of the complete study is available online (http://www.academicmedicine.org/cgi/content/abstract/76/12/1271).