National Center for Farmworker Health


Pharmaceutical companies spend twenty percent or more of their prescription drug revenues on marketing their products, with a focused emphasis on activities aimed at doctors. Many of these activities such as detailing, advertising in medical journals, and industry sponsored meetings are touted as a service to provide information, education and research to the medical community on the benefits of their specific product.  Much has been said and many questions have been raised in the current media about the merits of this information and how accurate and /or biased this information may be relative to the information that is not sponsored by Pharma.   

To learn about how health care providers in community/migrant health centers approach this subject and where they receive the majority of their drug information, the NCFH conducted a series of focus groups with three C/MHCs and their medical staff.  Focus group results indicate that in varying degrees, prescribers rely on pharmaceutical information provided by the Pharmaceutical Industry to keep abreast of new and emerging drug treatments.  It became evident that a standard mechanism for acquiring information on drug therapies did not exist, but more prominent was the personal preference of physicians and other prescribers for un-biased information as well as the economy of the resource and its access and availability.  Many prescribers articulated a desire to learn more about the various sources of unbiased information used by their colleagues nationally that could be integrated into their own clinical practice. 

To address this issue, NCFH developed a compendium of sources of data which includes a description of the source, a link, and the costs, if any, involved in subscribing or accessing the resource. 

Sources include:

The Medical Letter on Drugs and Therapeutics is an independent, peer-reviewed, nonprofit publication that offers unbiased critical evaluations of drugs, with special emphasis on new drugs, to physicians and other members of the health professions. It evaluates virtually all new drugs and reviews older drugs when important new information becomes available on their usefulness or adverse effects. Published every other week in a four-page newsletter format, it carries no advertising and is supported entirely by subscription fees. A typical issue appraises two or three new drugs in terms of their effectiveness, toxicity, cost and possible alternatives. Occasionally, The Medical Letter publishes an article on a new non-drug treatment or a new diagnostic aid. 

Prescriber's Letter is a subscription service for prescribers to keep them up to date on new developments in drug therapy. The service consists of a monthly letter, plus Detail-Documents available 24 hours a day. The Detail-Documents provide in-depth coverage answering many specific questions related to each topic. Prescriber's Letter is totally independent, and has no connection with any pharmaceutical firm. There is absolutely no advertising, or other financial support. Everything published in Prescriber's Letter or the additional detailed documents is totally objective. 

The Drug Safety Newsletter is a source of information for healthcare professionals about the findings of selected postmarketing drug safety reviews from FDA's Center for Drug Evaluation and Research (CDER). The Newsletter, which is published quarterly, also provides information on important emerging drug safety issues and recently approved new molecular entities 

The World Health Organization - Essential Drugs Monitor contains regular features on national drug policies, current pharmaceutical issues, rational drug use, access, operational research, educational strategies, and much more.  Published twice a year, it is available free of charge.  Aimed at policy-makers, prescribers, health educators, administrators, and health development organizations, the Monitor has an international readership of over 300,000. 

The World Health Organization-Pharmaceuticals Newsletter  disseminates information on the safety and efficacy of pharmaceutical products, based on information received from the network of “drug information officers” and other sources such as specialized bulletins and journals. 

Therapeutics Initiative (The University of British Columbia) is a bi-monthly letter targeting problematic therapeutic issues (brief, simple, practical messages).  The process involves a literature review and development of the message by different working groups of the Therapeutics Initiative (Evidence Based Drug Therapy). 

Evidence-Based Practice is published by the Family Physicians Inquiry Network (FPIN), a non-profit consortium of family physicians dedicated to answering clinicians’ questions with the best possible evidence without the bias of industry support. 

Epocrates, Inc. develops clinical information and decision support tools that enable healthcare professionals to find answers at the point of care.  Healthcare professionals use Epocrates’ innovative mobile and web-based products to help them reduce medical errors, improve patient care and increase productivity.  The clinical content is developed by physicians and pharmacists and is continuously updated to keep users informed and up to date. 

UpToDate is an evidence based, peer reviewed information resource—available via the Web, desktop, and PDA.  The UpToDate community includes a faculty of more than 3,800 leading physicians, peer reviewers, and editors and nearly 320,000 users.  The faculty writes topic reviews that include a synthesis of the literature, the latest evidence, and specific recommendations for patient care.  Users provide feedback to the editorial group. The community’s combined efforts result in the most trusted, unbiased medical information available.  Each UpToDate subscription includes the full collection of UpToDate specialty sections.  New updates are released every 4 months.  Professional subscriptions are available to clinicians who work in private practice, are students, residents or fellows, work in an institution, or who are part of a group practice. 

The Cochrane Collaboration is an international not-for-profit and independent organization, dedicated to making up-to-date, accurate information about the effects of healthcare readily available worldwide.  It produces and disseminates systematic reviews of healthcare interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions.  The major product of the Collaboration is the Cochrane Database of Systematic Reviews which is published quarterly as part of The Cochrane Library, which is available both on CD-ROM and the Internet.  Based on the best available information about healthcare interventions, Cochrane reviews explore the evidence for and against the effectiveness and appropriateness of treatments.  Each issue of the Cochrane Library contains all existing reviews, as well as new and updated reviews.  The review abstracts are available to browse and search free of charge on the website.  These are short synopses of the reviews’ core findings.  The full text of all Cochrane databases are available to subscribers.  All reviews and abstracts are also available in Spanish. 

Lexi-Comp provides clear, concise, and accurate clinical reference solutions to healthcare professionals and institutions including: Drug and Drug Interaction Information; Information on Diagnosis and Disease Management; Formulary Services; Patient Education Resources; Clinical Support Tools.  The unbiased information is collected, validated, and published daily by a team of pharmacists and physicians, ensuring the most current and clinically-relevant support for point-of-care decisions.  Lexi-Comp offers a catalog of products available electronically and in print. 

National Guideline Clearinghouse is a comprehensive database of evidence-based clinical practice guidelines and related documents.  The NGC mission is to provide physicians, nurses, and other health professionals detailed information on clinical practice guidelines and to further their dissemination, implementation and use.   

DynaMed is a clinical reference tool created by physicians for physicians and other health care professionals for use primarily at the ‘point-of-care’.  With clinically-organized summaries for nearly 3,000 topics, DynaMed is an evidence-based reference designed to answer most clinical questions during practice.  DynaMed is updated daily and monitors the content of over 500 medical journals and systematic evidence review databases directly and indirectly by using many journal review services.  Each publication is reviewed cover-to-cover, and each article is evaluated for clinical relevance and scientific validity.    DynaMed is available on-line or via PDA.  The DynaMed Weekly Update is a free newsletter service from DynaMed’s editors.  The newsletter provides valuable information to the medical community via email or on the web.  DynaMed sends a consise brief of articles to subscribers in an email based advertising-fee newsletter.    

Consumer Reports Best Buy Drugs project is to provide consumers and their doctors with information to help guide prescription drug choices – based on effectiveness. The project aims to improve access to needed medicines for tens of millions of Americans.