This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: The medical community should be aware of a pharmaceutical marketing practice that creates pressure on hospital pharmacies to distort incentives and recommendations regarding antimicrobial use from those arising exclusively from efficacy, toxicity, and single drug cost-effectiveness considerations. There are important counterforces to these pressures—medical education, practice standards, the hospital's pharmacy and therapeutics committee, clinician integrity—but loss of prescriber confidence in pharmacy recommendations can have damaging consequences. Among these is undermining programs to decrease overall antimicrobial use designed to delay the spread of antimicrobial resistance.

Some pharmaceutical manufacturers offer hospitals and hospital purchasing consortiums a range of prices for key antibacterials contingent on the aggregate dollar volume of purchases within specific "market baskets" of antibacterials. A market basket is a set of drugs (antimicrobials in this case) selected by a manufacturer and set out in the purchasing contract. For instance, one fluoroquinolone manufacturer proposed the following 1999 contracting . . . [Full Text of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?