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Psychiatrists probed

Specialist GPs are put on the couch to provide their views on the industry's sales activities

The new Doctor Monitor feature series offers insights into different specialist disease areas. Doctors are asked their views on pharmaceutical companies, key brands, representatives, education, and meetings in an online questionnaire.

The first speciality doctor group surveyed for this series was psychiatry. A total of 150 psychiatrists, comprising 90 consultants and 60 specialist registrars, was sampled during January 2009.

Companies you trust

Q1: Which pharmaceutical company do you trust most?
1.
Eli Lilly 22 per cent
2.
Janssen-Cilag
17 per cent
3.
AstraZeneca 14 per cent
4.
BMS 7 per cent
5.
Pfizer
6 per cent

None of these
20 per cent

The companies selling antipsychotics feature prominently in the working lives of psychiatrists. 22 per cent of respondents stated they trusted Eli Lilly the most. Interestingly, 20 per cent of them declined to choose a company they trusted most and opted for "none of these" when given a list of 20 pharmaceutical companies.

Educational materials from pharma companies?

Q2: Which pharmaceutical company provides you with the most helpful educational materials?
1.
Eli Lilly 24 per cent
2.
AstraZeneca
20 per cent
3.
Janssen-Cilag 19 per cent
4.
Wyeth
7 per cent
5.
BMS
6 per cent

None of these
16 per cent

A total of 24 per cent of psychiatrists selected Eli Lilly as providing the most helpful educational materials. AstraZeneca and Janssen-Cilag were placed second and third, respectively, and Wyeth was chosen by ten of the doctors (7 per cent), which placed them in fourth position, even though they do not have an antipsychotic medication in their portfolio at present.

When questioned about the "likelihood to recommend", respondents were not given the option to choose "none of these" as an alternative answer. AstraZeneca, Janssen-Cilag and Eli Lilly featured at the top of this list, unsurprisingly with Seroquel, Risperdal and Zyprexa, respectively, as their brands. This was quantitative research, but as a follow-up it would be interesting to know whether this was due to volume of calls and awareness.

Pharmaceutical company recommendation

Q3: If asked, which pharmaceutical company would you recommend to a colleague?
1.
Eli Lilly
24 per cent
2.
AstraZeneca
20 per cent
3.
Janssen-Cilag 19 per cent
4.
Wyeth
7 per cent
5.
BMS
6 per cent

Wyeth's antidepressant, Efexor, scored highest in terms of satisfaction with clinical experience of a product, and Eli Lilly's Zyprexa scored highest of the antipsychotics. Eisai/Pfizer's Aricept treatment for Alzheimer's disease appeared in the top five for the only time during this research. A total of 15 major psychiatry products were included in this question and psychiatrists were asked to rate each. There was an option for them to enter "not enough clinical experience". The scores were calculated from the doctor responses of "very satisfied" (5) through to "very dissatisfied" (1), with five options in all.

Satisfaction with clinical experience of products

Q4: Please rate your satisfaction with your clinical experience with the product
Product
Mean score based on psychiatrist response
1. Efexor 4.26
2. Zyrexa 4.23
3. Seroquel 4.11
4. Risperdal 4.01
5. Aricept 4.01

AstraZeneca's Seroquel scored highest on overall satisfaction with the representative. Lundbeck's antidepressant, Cipralex, made an appearance in the top five for this measure, with a score of 3.77, calculated according to the (5) to (1) system, as above.

Janssen-Cilag's representatives were believed to have the best clinical understanding, with those for antipsychotics Zyprexa, Seroquel and Abilify following.


Satisfaction with representatives

Q5: Please rate your satisfaction with the product representatives of each of the following products
Product
Mean score based on psychiatrist response
1. Seroquel 3.97
2. Risperdal Consta 3.92
3. Abilify 3.84
4. Zyprexa 3.79
5. Cipralex 3.77

Psychiatrists were asked to rank their top three choices from the list of products, giving the product chosen first a score of three, and the one ranked second a score of two. The scores were then calculated based on the sum of the scores for each product divided by the entire base of respondents. This ensured that the mean scores did not over-value products whose representatives were highly rated by only a small number of doctors.

Representatives with the best clinical understanding

Q6: Which representatives have the best clinical understanding?
Product
Mean score based on psychiatrist response
1. Risperdal 0.74
2. Zyprexa
0.70
3. Seroquel 0.69
4. Abilify
0.55
5. Efexor 0.40

Psychiatrists were asked to make one selection for the question: "Which product sponsored meeting are you most likely to attend?" The top answer was "none of these", illustrating the cynicism that exists within psychiatry. Further studies will discover whether such cynicism is common across other specialisms. Abilify was clear favourite here, with 16 per cent of responses. It is interesting to note that Pfizer's Lyrica appears in the top five products, and that Eli Lilly's Zyprexa isn't mentioned. Are BMS and Abilify organising the best-valued meetings for psychiatrists? It would appear so.

Likelihood to attend company-sponsored meetings

Q7: Which product-sponsored meeting are you most likely to attend?
Product
Mean score based on psychiatrist response
1. None of these
19 per cent
2. Abilify 16 per cent
3. Seroquel 13 per cent
4. Risperdal Consta 9 per cent
5. Lyrica 9 per cent

Other information worth noting
• AstraZeneca's Seroquel representative had been seen the most in the past month by psychiatrists, with 35 per cent recalling a visit. This reflects the increased activity following the launch of the new extended release formulation.
• A total of 30 per cent of all Abilify interactions were in group post-graduate meetings, the highest proportion compared to the other products. Could this offer a clear strategy for BMS and Abilify?
• Of 50 one-to-one calls by the Zyprexa representative, 42 lasted more than ten minutes; an impressive amount of time, and the highest of all the products.

The Author
Doctor Monitor is based on research conducted by medeConnect Healthcare Insight - part of the Doctors.net.uk group. This article is based on answers to a questionnaire conducted online with Doctors.net.uk members. If you would like more information on this survey please contact Carwyn Jones on email pharma@doctors.net.uk or call +44 (0)1235 828 400.
To comment on this article email pm@pmlive.com

10th February 2009

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