On Friday night, I went to see a big budget movie and found evidence in support of prescription drug reform. Love and Other Drugs, a new movie starring Jake Gyllenhaal and Anne Hathaway, is a bit of a mess: a few great performances, a love story that doesn’t quite work, and moving scenes depicting the impact of Parkinson’s disease. Into this stew, throw in bizarrely sexist portrayals of every woman other than Anne Hathaway’s character, plus an inane subplot involving the lead male’s brother, reminiscent of outtakes from a Zach Galifianakis film.

The movie is not an artistic success—but it mostly held my attention. And that’s because of a biting portrayal of the pharmaceutical industry in the mid 1990s, when armies of sales reps blitzed the offices of family doctors—embodied by the gung-ho charm of Gyllenhaal’s character, a Pfizer rep in Ohio, battling his Eli Lilly competitor: at stake, Zoloft versus Prozac. He attends a pharma boot camp and learns how to sneak in references to “off-label” uses of prescription drugs (uses not approved by the FDA); most importantly, he learns on the job how best to get into doctors’ offices to drop off samples and offer less orthodox inducements to prescribe the company’s drug.

While the competition between the firms is depicted as fierce (Gyllenhaal’s character is beaten up by a Lilly rep), the greater competition comes from less expensive generic drugs. The job of the representatives is clear—increase the number of prescriptions of the most expensive drugs by any means necessary.

The victims of these drug-sale tactics appear in minor but poignant scenes—Anne Hathaway’s character, who suffers from Stage 1 Parkinson’s disease, organizes a busload of American seniors to drive up to Canada where they’ll be able to access needed and more affordable prescriptions available in a country with more public controls on drug pricing.

Here in British Columbia, there are 600 to 700 “drug detailers”—representatives of pharmaceutical companies who promote prescription drugs to doctors and other health professionals. Estimates place about 6,000 such “drug detailers” in doctor’s offices across Canada.

There are 10,000 physicians and 5,448 general practitioners in our province. According to the 2006 BCMA Prescription Drug Survey, “Two out three physicians report visits from drug company sales representatives at least once per month, 42% of GP visited several times per week.”

The job of the “drug detailer” is just like in the movie—to promote a particular company’s product. Life does imitate art. In a recent edition of the Canadian Medical Association Journal, Dr. Aaron Tejani, co-coordinator of drug information for Fraser Health, describes meeting with a pharmaceutical representative who had promoted “off-label” use of the drug Aricept. The drug detailer worked for Pfizer.

In order to combat big pharma’s ratio of rep to doctor transactions, I advocate academic detailing as a counter measure. In a consumer culture where “direct detailing” for merchandise is endemic, academic detailing stands out as an alternative. Here’s how it works: the government hires pharmacists to visit and provide doctors with unbiased information to counterbalance promotional materials delivered by the pharma reps. Much of that information is provided by the Therapeutics Initiative, an independent group at UBC whose role in drug reviews has been sidelined by just-resigned health minister Kevin Falcon. Along with the TI, the NDP government initiated B.C.’s first academic detailing program in the 1990s. Currently, there are nine academic detailing positions in all of the health authorities. I want to see the program substantially expanded, increasing its counterbalancing effect.

According to the Health Council of Canada, “Academic Detailing is an effective strategy for influencing the practices of health professionals....The goal is not to promote a new drug but to educate physicians about the best way to prescribe for their patients.” Further, a report by the New England Journal of Medicine showed that for every dollar spent on academic detailing programs, more than two dollars are saved. Academic detailing improves health outcomes and saves money.

Perhaps, we can plan a sequel to Love and Other Drugs where a feisty academic detailer, trained at UBC, fights Big Pharma by providing evidence-based information to doctors. Not a box office winner? Okay, then let’s make it happen in real life by doubling the number of academic detailers at work in B.C.

Adrian Dix is the NDP health critic and the MLA for Vancouver-Kingsway.