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August 3, 1994

Pharmaceutical Promotion and Physician Requests to Hospital Formularies-Reply

Author Affiliations

Cleveland Veterans Affairs Medical Center Cleveland, Ohio

JAMA. 1994;272(5):355. doi:10.1001/jama.1994.03520050033022

In Reply.  —We thank Dr Rubin for his comments and for the chance to experience what for us is an unfamiliar sensation— being regarded as champions of the "social value and value to patients of the promotional expenditures of pharmaceutical companies." That interpretation of our data is incorrect, however.Rubin argues that drug promotion to physicians benefits patients. Why? Because it works, and patients receive better and cheaper drugs as a result. We reject this logic for three reasons.First, there are no data that drug promotion by manufacturers improves the treatment or outcomes of patients. We found no evidence that physicians who requested drugs with more therapeutic advantage were more likely to have interacted with the manufacturer. Moreover, as Avorn et al1 and others have demonstrated, physicians' beliefs about drugs often match advertising claims that conflict with independent data.Second, no data indicate that drug promotion to physicians

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