Big Pharm and Gas

[geogil]

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I've been wondering, for a specialty that relies heavily on drugs, what role have pharm companies played in gas? Do they send reps around to woo you guys, or do they leave you alone since you're not prescribing their drug for years at a time? If they do send out reps, how do you guys handle it? Can they track your prescribing habits the same way they can look at some IM doc's scripts?

 

[dfk]

most of the reps i see come through
are usually pushing stuff we use in
the OR, such as volatile agents,
NMBAs, and precedex, to name a few.
the drug rep always comes
bearing gifts and food.....
this gets me thinking of a really
bad jeffrey osborne "you should be mine. and ya woo woo woo.."

 

[coprolalia]

I don't know if they can individually track prescriber data, but they know the volume of drugs being used by the inpatient pharmacy.

We regularly get the Organon rep comin'-a-knockin' and have had a host of others from the Emend people to the Cardene folks. They try to impact your habits, but I don't think it's that effective. No one prescribes Emend because by the time we see the patient, it's usually too late. And, Cardene... well, Cardene is not the first drug of choice for our aneurysm cases and it has, in my opinion, limited practical applicability in other areas (such as cardiac cases, where the pressure is usually too low not too high).

But, it's still nice to get a new pen or lanyard once in a while. 😀

-copro

 

[cchoukal]

We used to have a pretty active Sevo guy and a REALLY active ondansetron group. Of course, now that ondansetron is off patent, we never see them and, in fact, our hospital put really strict limitations on reps coming in at all, so we almost never see them. They still have dinners around town from time to time, though.

 

[geogil]

Do they really expect you to use sevo over some other agent? would you guys say that anesthesiologists are less susceptible to pharm pressure? more?

 

[coprolalia]

Do they really expect you to use sevo over some other agent? would you guys say that anesthesiologists are less susceptible to pharm pressure? more?

Well, we had the desflurane guys (about a year ago) really pushing Des for the fatties. A lot of people regurgitated this mantra, and started using des during all the big-people surgeries. So, the "critical thinking" barrier definitely broke down there.

It's hogwash. You can do any case with any agent, if you know what you're doing. All using Des does is increase your hospital's cost of the anesthetic.

-copro

 

[huktonfonix]

Well, we had the desflurane guys (about a year ago) really pushing Des for the fatties. A lot of people regurgitated this mantra, and started using des during all the big-people surgeries. So, the "critical thinking" barrier definitely broke down there.

It's hogwash. You can do any case with any agent, if you know what you're doing. All using Des does is increase your hospital's cost of the anesthetic.

-copro

Agree with the above, except Im not sure if Des increases the cost over a sevo anesthetic (perhaps over iso). Usually I use much lower flows on des than I do on sevo and end up using much less overall agent. granted I havent done a cost analysis on this, but just something to keep in mind.

 

[goodoc]

In my hospital desflurane is approx one half the cost of sevo, add low flow you can save some bucks, more if you get desflurane to pay for the vaporizer.

 

[jwk]

We used to have a pretty active Sevo guy and a REALLY active ondansetron group. Of course, now that ondansetron is off patent, we never see them and, in fact, our hospital put really strict limitations on reps coming in at all, so we almost never see them. They still have dinners around town from time to time, though.

Years ago we actually met our Pentothal rep - she came around for the very first time shortly after Diprivan was released. Fortunately for her she had other drugs to peddle.

I seem to have noticed a significant uptick in the number of out-of-hospital dinners and presentations lately - we definitely don't see the DRUG reps in-house near as much as we used to, although the EQUIPMENT reps are still here all the time.

 

[geogil]

forgive my naiveté, but what equipment do they peddle to anesthesiologists, or are you talking ortho screw salesmen? Are they trying to get you to use their special blade? some great new ETT?

 

[huktonfonix]

wow. just goes to show you that many people think all we do is intubate. To answer the question, some of it is intubating equipment (video laryngoscopes). Other items include anesthesia machines, vaporizers, other airway rescue equipment, supraglottic devices, nerve stimulators, ultrasound machines, regional equipment, etc...