Dismissal of employees and huge compensation of famous pharmaceutical enterprises

▍ the pharmaceutical representative sued the pharmaceutical company and got 40 million yuan of compensation It was reported that the former sales representative of Biogen was dismissed because he refused to carry out the super indication promotion The pharmaceutical representative filed a retaliatory lawsuit against the pharmaceutical company, and after winning the lawsuit, he received 6 million USD of compensation, equivalent to 41.9724 million RMB yuan In other words, after the pharmaceutical representative refused to promote the super indications and was dismissed by the pharmaceutical enterprise, the employees sued the pharmaceutical enterprise and won the lawsuit, and obtained huge compensation The so-called super indication promotion refers to the transfer of additional medication information to doctors beyond the indication range indicated in the drug instructions, and guide doctors to use drugs beyond the indication It is reported that the adverse drug reactions are mostly caused by the use of super indications ▍ the promotion of HYPERADAPTATION is not all about benefits, which has been controversial since the appearance of hyperadaptive drug use The logic of its repeated prohibition is not only driven by benefits, but also has ethical dilemma Dialectically, the use of super indications can provide a way to explore more functions of drugs, but on the other hand, it will also lead to the chaos of the promotion of super indications Some well-known medical representatives told cypress blue that the promotion of super indications is a common phenomenon in the industry, but not all of it is driven by economic interests For example, there are many indications abroad, but not at home, so there is the actual demand for the promotion of super indications However, Huang Yong, marketing director of Yongjiang pharmaceutical industry, told Cyprian blue that the promotion of clinical super indications is not very common now, especially for medical insurance varieties, because of the limitation of reimbursement, it is difficult to exceed the limitation of medical insurance and the requirements of indications In addition, it is basically unrealistic to drive doctors to use super indications by relying on economic interests However, the indications of a drug are also expanding with the accumulated use For example, since 2010, Guangdong Pharmaceutical Association has published the list of drugs exceeding the drug instructions every year Through a large number of clinical studies, it has summarized the use of some drugs exceeding the instructions in the field of safe drug use Under this, Huang Yong believes that the hospital will punish the doctors for the over indication drugs, the medical insurance will not be reimbursed, and the hospital will subsidize the money At the same time, the clinicians do not have no drugs available to make mistakes in the case of non-compliance ▍ in fact, the United States, Germany, Italy, the Netherlands, New Zealand and Japan have legislated on the problems related to the rational use of drugs beyond the specification, allowing the rational use of drugs beyond the specification Zuo Hua, executive director of the management and research center of cypress blue hospital, told cypress blue that according to the new guidelines and some evidence-based medical research evidences agreed by new clinical experts, drugs can be used beyond the instructions, which is a normal phenomenon Zuo Hua said, for example, how to manage the clinical rational drug use and super indication drug use in the pharmacy department of the hospital to judge whether the drug use is reasonable? The clinical pharmacists should not only look at the instructions, but also see whether there are any new guidelines, new expert consensus, and combine the new evidence-based medicine research evidence to see whether the drug use is reasonable Therefore, the use of the manual is not only driven by economic interests
Taking the promotion of Plavix in that year as an example, Zuohua said that Plavix was used to prevent atherothrombotic events in patients at that time, and Plavix was used in patients with cardiovascular stents In 2002, credo study suggested one month for patients after stenting Later, there was new evidence of PCI-CURE study, and only three months for patients after stenting, so the clinical promotion of a drug It is based on the research step by step ▍ DRGs promotion, access to the use of over specification Although there are also pharmaceutical enterprises in reality, in order to emphasize the advantages of their drugs and increase the competitiveness of drugs in clinical promotion, they will transmit the functions beyond the specification to doctors, which leads to the exaggeration of the role of treatment methods, and in fact, it also allows doctors to get the wrong information As the case at the beginning of this article, the medical representative said that he was under pressure from the company to ensure that the hematologist issued zinbryta for aplastic anemia, but this is not an FDA approved indication In this case, the driving force of the promotion of pharmaceutical companies is to get more use opportunities However, Zuohua believes that with the promotion of DRGs, the hospital will control the rational use of drugs for each disease in the future, and will not promote the use of super instructions Zuohua said that the hospital will give a reasonable medication plan for each disease, and will not say that it will not be used beyond the indications If the drug is suitable for the treatment of that disease, it can effectively reduce the cost consumption index and time consumption index of the disease, and there should be no barriers to use Through the case of extended use of hyperinstruction, it also reflects the real situation of this phenomenon In fact, the state also attaches great importance to the rationality judgment and operation specification of the drug use beyond the specification, and has formulated many policies to clearly establish the management system of the drug use beyond the specification, so as to promote the rational clinical use of drugs In addition, in recent years, the State Food and drug administration has also actively revised the drug manual to standardize the rational and standardized use of drugs.