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Optimal Prescribing Practices


A portion of the 2004 settlement paid by the manufacturer of Neurontin, following charges of consumer fraud and off-label marketing of the product, was reserved by the Attorneys General of all 50 states to establish the Attorney General Prescriber and Consumer Education Grant Program. This program made available grant funds to educate physicians and medical students about pharmaceutical marketing practices. The BWH Division of Pharmacoepidemiology & Pharmacoeconomics was awarded one such grant, and used a portion of the funds to support a number of peer-reviewed articles pointing out the dangers of off-label marketing, as well as a series of lectures and interactive cases studies intended for physicians and trainees to teach about the process of drug approval, post-marketing surveillance, and physician-pharmaceutical industry interactions. These curricula are presented below.


Physician Education Module 

Kesselheim AS, Avorn J.  Pharmaceutical Promotion to Physicians and First Amendment Rights. NEJM. 2008 Apr; 358(16):1727-1732.

Kesselheim AS, Misono AS, Lee JL, Stedman MR, Brookhart MA, Choudhry NK, Shrank WH.  The clinical equivalence of generic and brand-name drugs used in cardiovascular disease: a systematic review and meta-analysis. J Amer Med Assn. 2009; 300:2514-2526.

Annotated bibliography on pharmaceutical promotion and prescribing patterns, originally compiled November 2007 by Jeremy Greene, M.D., Ph.D.   (.pdf format)

Physician Curriculum on Optimal Prescribing

Part I.  Evaluating drug risks: what every clinician should know (.pdf format)

Part II.  Factors influencing drug choices by clinicians and patients (.pdf format)

Part III.  Academic detailing to improve the appropriateness and contain the cost of prescribing (.pdf format)

Part IV.  Assessing the cost-effectiveness of medications: an introduction (.pdf format)


Trainee Education Module


Medical Education Day, October 2007 – poster (.pdf format)

Medical Education Day, October 2007 – abstract (.pdf format)

Trainee Curriculum on Issues in Drug Development and Optimal Prescribing

Case 1.  The FDA and the Limitations of the Drug Approval Process: The Case of Cerivastatin. Lee Adam Wheeler HMS’10   (.pdf format)

Case 2.  Post-approval Medication Surveillance: The Case of Antidepressants in Children. Lauren Gold, HMS’08   (.pdf format)

Case 3.  Pharmaceutical Marketing Practices Aimed at Physicians. Matt Zerden, HMS’08   (.pdf format)