Drug Detailing More Influential than FDA Approval

Rob Wipond

FDA approvals are less influential on prescribing patterns than pharmaceutical sales marketers are, according to a study in Health Affairs. University of California and Harvard researchers examined the prescribing of antidepressants and antipsychotics by pediatricians and child and adolescent psychiatrists at thirty-one academic medical centers in five US states between 2006 and 2009. When the centers restricted visits by pharmaceutical sales representatives, prescriptions for both on-label and off-label uses of drugs that the reps typically were promoting dropped significantly. Conversely, use of non-promoted drugs in both categories increased. “Our results suggest that in these classes of drugs, detailing influences physician prescribing more than FDA approval does,” wrote the researchers.

Restrictions On Pharmaceutical Detailing Reduced Off-Label Prescribing Of Antidepressants And Antipsychotics In Children (Larkin, I et al. Health Affairs, 33, no.6 (2014):1014-1023 doi: 10.1377/hlthaff.2013.0939)

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Rob Wipond
Rob Wipond is a Victoria, British Columbia-based freelance journalist who has been writing on mental health issues for fifteen years. His research has particularly focused on the interfaces between psychiatry, the justice system, and civil rights. His articles have been nominated for three Canadian National Magazine Awards, six Western Magazine Awards, and four Jack Webster Awards for journalism. He can be contacted through his website.


  1. I think it’s all marketing cause I was given Zyprexa for insomnia instead of a much much better choice of an off label drug to sleep Seroquel. This was before the Zyprexa scandal hit the news. The doctors learn from the drug reps and have I would guess have mostly never taken the stuff so besides patent reports so how would they even know what they do ?