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. 2007 Apr;4(4):e134.
doi: 10.1371/journal.pmed.0040134.

Characteristics and impact of drug detailing for gabapentin

Michael A Steinman  1 , G Michael Harper, Mary-Margaret Chren, C Seth Landefeld, Lisa A Bero
Affiliations

Characteristics and impact of drug detailing for gabapentin

Michael A Steinman et al. PLoS Med. 2007 Apr.

Abstract

Background: Sales visits by pharmaceutical representatives ("drug detailing") are common, but little is known about the content of these visits or about the impact of visit characteristics on prescribing behavior. In this study, we evaluated the content and impact of detail visits for gabapentin by analyzing market research forms completed by physicians after receiving a detail visit for this drug.

Methods and findings: Market research forms that describe detail visits for gabapentin became available through litigation that alleged that gabapentin was promoted for "off-label" uses. Forms were available for 97 physicians reporting on 116 detail visits between 1995 and 1999. Three-quarters of recorded visits (91/116) occurred in 1996. Two-thirds of visits (72/107) were 5 minutes or less in duration, 65% (73/113) were rated of high informational value, and 39% (42/107) were accompanied by the delivery or promise of samples. During the period of this study, gabapentin was approved by the US Food and Drug Administration only for the adjunctive treatment of partial seizures, but in 38% of visits (44/115) the "main message" of the visit involved at least one off-label use. After receiving the detail visit, 46% (50/108) of physicians reported the intention to increase their prescribing or recommending of gabapentin in the future. In multivariable analysis, intent to increase future use or recommendation of gabapentin was associated with receiving the detail in a small group (versus one-on-one) setting and with low or absent baseline use of the drug, but not with other factors such as visit duration, discussion of "on-label" versus "off-label" content, and the perceived informational value of the presentation.

Conclusions: Detail visits for gabapentin were of high perceived informational value and often involved messages about unapproved uses. Despite their short duration, detail visits were frequently followed by physician intentions to increase their future recommending or prescribing of the drug.

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Conflict of interest statement

Competing Interests. MAS, MMC, and CSL served as unpaid expert witnesses for the plaintiff in the litigation from which source data for this report was obtained (United States of America ex rel. David Franklin v. Pfizer, Inc. and Parke-Davis, Division of Warner-Lambert Company). GMH and LAB were not involved in this litigation. MAS is a member of the board of No Free Lunch. He does not receive any compensation for this position and No Free Lunch had no role in the preparation or submission of this manuscript. Seed funding for an online searchable archive of documents from the gabapentin litigation (http://dida.library.ucsf.edu) was provided by a gift from Thomas Greene, lawyer for the whistleblower plaintiff in this litigation, to the University of California Board of Regents. Two of the authors (MAS, CSL) participated in the creation and development of the archive, including solicitation of start-up funding from Mr. Greene. The cost of obtaining and photocopying some of the documents used in this research was paid by the archive, which incorporated these documents into the collection. The authors have no financial conflict of interest with any product discussed in this manuscript.

Figures

Figure 1
Figure 1. Detailing Reporting Form
Excerpt from a detailing reporting form providing information on a detail visit for gabapentin. Some markings (e.g., “032417 Neuro” and “12233” next to “Product: Neurontin”) were annotations entered by Verispan employees to assist with coding and data entry of completed forms.
See this image and copyright information in PMC

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