In this breaking news update: sales representatives sell things! Thusly, their company stays in business, and the employment of the sales representative continues.
This is a retrospective review of a Canadian hospital’s cardiac catheterization practices, evaluating the association between presence of sales representatives for stent manufacturers and use of each company’s stents during PCI. Each day, during normal business hours, potentially a single sales representative from one of five stent manufacturers could be present in the lounge or in one of three cardiac catheterization laboratories. Certain manufacturers specialized in bare metal stents, drug-eluting stents, or antibody-coated stents.
Unsurprisingly enough, cases performed in the presence of a sales representative resulted in increased use of that particular representative’s stents. Additionally, for cases where DES were deployed, on average, more stents were placed during PCI when a drug representative was present. Increased stenting, increased per-patient average cost.
It is a retrospective review, and there are baseline differences between the indications for catheterization – but, I think the observed association is probably real. The authors also note, after these promotional visits were discontinued, all variation in stent use disappeared.
Further evidence of the suggestibility of physicians to marketing influences – supporting efforts to expunge them from our practice settings.
“The impact of industry representative’s visits on utilization of coronary stents”
www.ncbi.nlm.nih.gov/pubmed/23895808