Psychiatrist Bans Sales Reps After Seroquel Reps Visit

Danny Carlat, whom many of you know through his website and his "Dr. Drug Rep" article of last year, is a clinical professor of psychiatry at Tufts University and is in private practice. Anyhow, Carlat recently had a visit from some AstraZeneca reps, pushing Seroquel for bipolar depression and using some of the most asinine sales patter ever.

"Yes, until today, I was seeing reps a few times a month for 5 minute visits in order to keep up on trends in drug company marketing techniques. But today, an Astra Zeneca rep and his district manager came in to push Seroquel for bipolar depression. They came armed with the two studies that won Seroquel its FDA approval. The studies have their limitations, but somehow these reps didn't bring these up."

Those studies would be BOLDER I and BOLDER II, which CL Psych and I have had much fun carving up previously. A letter of mine challenging some of the statistics in BOLDER II will be published in the Journal of Clinical Psychopharmacology in June.

Back to Carlat:

"[W]hat I got was a ridiculous hard sell: 'Dr. Carlat, given this data, would you choose Seroquel over the other atypical antipsychotics for bipolar depression?' I asked them if Astra Zeneca had done any head-to-head studies comparing Seroquel with the others. The rep adopted a pseudo-confused look, and said, 'I'm not even sure that kind of study would be ethical--would the FDA even allow you to compare an approved drug with an unapproved drug?' I pointed out that the FDA, in fact, requires that drugs be compared with placebo, the ultimate in 'unapproved' drugs, and that they deem this ethical enough."

His encounter with the reps goes from there. Were these guys so dumb that they didn't know who they were dealing with in advance? Are reps still being taught and using that absurd Zerox sales training dialogue? I was smarter than that when I was a pharma rep 20 years ago.

As a result of the visit, Carlat has banned pharma reps from his office. Good for him. I wish other doctors would follow suit. I also wish doctors would be a hell of a lot more skeptical about how they hand out Seroquel. In my opinion, it is not a good drug for anything other than short-term use--and even in short-term use it's pretty nasty stuff. Your mileage may vary, however. I'll leave it at that.