There are numerous areas within a pharmaceutical company that would provide an appropriate “home” for the group that interacts with external healthcare professionals to answer questions and provide information. These include:

Of these possibilities, the two generally favored by the author are Groups 3 and 4, although any of these choices could be optimal in a specific company.

Members of research and development departments often assume that, if a group within marketing responds to an information request from a healthcare professional, the reply may be biased, whereas a member of research and development would provide a scientifically based response. This view cannot be accepted, particularly because well-trained scientists could work within a marketing information group to provide such services (or, conversely, marketers could work with research and development to provide the information). To prevent a marketing orientation in replies to external questions, most companies do not place the product information group under direct marketing control.

Questions received by the information group come directly from physicians and other healthcare professionals via telephone, e-mail, letter, facsimile or are submitted to the group by the company’s sales representatives. The most common areas questioned are listed in Table 99.3. The company may distribute postage-paid cards at scientific exhibits, at conferences, or by mail to elicit questions, but the company must be prepared to address large numbers of such cards (if they are signed by physicians). Telephone calls received at the company are initially screened and then routed by company operators (Fig. 99.1) unless there is a toll-free telephone number that rings directly in the product information group, or at a company hired to provide such information. A toll-free number is usually placed in the front of the Physicians’ Desk Reference (PDR). If company operators are used to route telephone calls, then they should receive adequate training to ensure they fill this role correctly. This includes being able to refer or route medical emergencies to local emergency personnel.

Many questions received from healthcare professionals about a company’s products deal with off-label use of drugs.
Virtually no source outside the company would have as much information on off-label use of a company’s drug as the product information group. Most healthcare professionals would think of contacting a sponsor first if the question was clearly identified as an off-label one. It is important that the company be aware of off-label uses and their outcomes. This may be accomplished by surveying the customer base and compiling published literature on off-label uses. The information group often seeks input from relevant groups within the company to help prepare their standard answers (Fig. 99.2) so that it can provide information to a wide spectrum of external groups (Fig. 99.3). Note that Fig. 99.3 also illustrates a company’s indirect relationship with patients, as companies seldom provide product information to patients directly. However, companies will provide information requested by consumer organizations. Most companies refer patients to their physicians and the company’s website for information about their drug because of the learned intermediary concept that is an important part of a legal defense. Some companies are willing to provide patients with readily available product information that is in the public domain. There has been a trend over the past decade to provide
more information directly to patients, not just via direct-to-consumer advertising but also via company staff trained for this purpose.