Tuesday, June 4, 2013

Dr. Orthochick: Drug Reps

Drug company reps are ridiculously good looking.

They're usually in their late 20s--early 30s and they have great teeth. I dunno what happens to them when they get older than 35 or so but I'm guessing they're put out to pasture or something like that. But damn, they are good looking in a really classic way. Nice shiny hair. Classy trench coats. Expensive watches. They look like the type of people who you could have sex with and then they would make you breakfast in bed the next morning and they would still have great hair and fresh breath.

Anyway, I'm guessing the fact that all drug reps are hot is not a coincidence. I guess they've done studies that show that you're more likely to sit quietly and listen to a presentation given by a good looking person over an ugly one. Just like they've shown that using a pen with a drug logo on it will convince you to give that drug when it is not indicated to people who are violently allergic to it.

The drug reps we had today missed the memo. They were both in their early fifties, I would guess. One of them was even overweight. And seriously, their drug was crap. Had they been hot, I might not have thought so, but I'm pretty sure even they thought this drug was useless.

Drug Rep: So you might be interested in this--it's a combination of naproxen and esomeprazole

Me: Wait, so is this Aleve and Nexium in one pill?

Drug Rep: Yeah. I know normally you just prescribe them separately but, uh, if your patients don't like to take two pills, they can take it as one.

Me: What are the other benefits to this combination?

Drug Rep: I guess it cuts down on the amount of pills people are taking. I know we're not the first people to think of combining an NSAID with a PPI, but this is the first drug that combines these two specific pills.

Me: Oh. Is there a financial benefit?

Drug Rep: It's not yet covered by most insurances.

Me: I see.

Drug Rep: But these two drugs have low incidences of side effects. So, I guess the combination of them also doesn't cause too many side effects.

Drug Rep #2: Our company also makes Symbicort. Would you like to hear about that?

I'm not sure I can think of a real advantage to this pill. I guess if you were flipping out at the thought of taking OMG two pills instead of one then maybe, but since the one has the same drugs and same side effects as the two, wouldn't you go for the cheaper option?

I don't even give Nexium most of the time because it's not covered by most insurances--I give Prilosec because it is and pretty much all proton pump inhibitors are created equally. So I really don't see the point to this new combo drug--it's just combining prescription versions of stuff you can get over the counter and charging an arm and a leg for it. Plus, as the drug rep pointed out, we already have combo drugs that do this. And no one's using them either because they're needlessly expensive. And just needless.

I guess these reps weren't hot enough to convince me that this drug was a necessity for all my osteoarthritis patients. They should have been more like that Moxatag rep back when I was in family med. Moxatag is amoxicillin that you take once a day instead of three times a day. It's not covered by insurance, whereas amoxicillin is available for free at Kroger and for $4 at Wal-mart. Moxatag also wasn't offered in a liquid form, which meant kids and people who can't swallow pills couldn't use it. It had all the side effects of amoxicillin. Clinical trials showed no difference in the number of days people needed to be on moxatag vs. the number of days they were on regular amoxicillin three times a day. But that rep was young and blond and wore nice leather boots with her trench coat, she brought us all Panera (and not only that, she gave us menus and we all ordered our own thing) and man, after listening to her presentation, I can honestly see why we need a version of amoxicillin that costs more and does the exact same thing, but thank G-d saves me the time of having to swallow an additional two pills over the course of a day.


  1. You had me with "...using a pen with a drug logo on it will convince you to give that drug when it is not indicated to people who are violently allergic to it." XD

  2. Even as a pharmacist, I could never take an antibiotic three times a day. I ain't got time for that (mostly because I would never remember). So, I think that drug is more useful than a combo NSAID/PPI. I really don't like giving NSAIDS in combo with anything.

    My pharmacy school graduated with all the other colleges of various health professions (MDs, dentists, etc) and we always noticed the dental hygienists who graduated were all tiny little blonde girls. The year I graduated, the hygienists section was a sea of blonde (the year before, there was a single brunette chick . . . she must have felt so alone). I don't ever remember seeing a male, the three years I went. And, hardly any of them overweight and all have that pagenty cheerleadery look. It's like the Stepford Hygienists.

    1. I agree, it's a pain in the neck TID. Especially for kids.

  3. Often suspected...


  4. I like this post in so many ways, ahaha.

  5. Its the same in vet med (as far as who are reps) though honestly, I think that we get the 'retirees' from the human med side. Middle aged but still pretty good looking well dressed people. 'Out to pasture' means into the veterinary side of pharmaceuticals.
    Oh but the amoxicillin thing...one drug company is now promoting 1/2ml doses of vaccines instead of 1ml doses because clients will like us giving their pets a smaller volume. Really? Cause frankly, I'm pretty sure most people don't care. A shot is still a shot.