Evaluating Information from Pharma

Evaluating Information Provided by Pharmaceutical Representatives

While some of the information provided by pharmaceutical representatives may relate to the efficacy of a medication compared with placebo, more often a medication is not the first or only drug receiving FDA approval for that indication. When physicians have more than one medication to choose from, there are several rationales to choose from in selecting a drug for your patient. The acronym STEPS provides a convenient reminder to use when evaluating the benefits and harms of one medication over another in a clinical setting. Click on the acronym below to learn more about STEPS.

Source: Preskorn, S.H. (1994). Antidepressant drug selection: criteria and options. Journal of Clinical Psychiatry, 55(suppl A):6-22, 23-4, 98-100.

Evaluating Information Regarding Off-label Use of Medications

Providers commonly prescribe medications in off label situations; however, it may be difficult to determine the evidence base for such use. Frequently, information regarding ‘off label’ use may be presented at grand rounds or at CME conferences. The evidence base for such use may range from very good, including randomized trials, to modest, including case reports or case series.

While pharmaceutical representatives are not supposed to provide information regarding off label use, industry has, in the past, conducted significant campaigns designed to encourage off-label use of medications. Steinman and colleagues (2006) reviewed industry promotion targets and tactics for off-label uses for gabapentin. This review provides a framework for understanding the potential targets and tactics of pharmaceutical promotion for off-label drug use so that physicians can better evaluate sources of information provided.

Source: Steinman, M.A., Bero, L.A., Chren, M., Landefeld, C.S. (2006). Narrative review: The promotion of gabapetin: An analysis of internal industry documents, Annals of Internal Medicine, 145(4):284-293.