Rx device instructions, IKEA-style

David StanleyI've never actually been to an IKEA store - you know, the company that built its reputation on selling affordable furniture accompanied by incomprehensible diagrams and mangled directions masquerading as assembly instructions - but I almost feel like a regular customer after my experience with the new inhaler.

It came in our regular order, a “new and improved” version of an asthma medication that has been on the market since before I filled out my first application to pharmacy school. I knew questions would probably be coming about it, so I got online and took a look at the manufacturer's instructions for patients.

The first words I saw were “piercing element” followed by “safety catch,” which made me wonder if I wasn't in for more danger than I bargained for. I kept going, though, and noticed a helpful acronym that promised to make the dosing steps easy to remember, the same type of trick I used in college to try to get complex and/or long lists of information to stick to my brain.

There were four pages of patient instructions on the company's website, and at first glance only two things were immediately clear: the part of the diagram labeled “white arrows,” and the fact that I should not keep this inhaler in the freezer. I thought to myself, “How is an elderly patient, let's say with vision problems, supposed to figure this thing out so he can breathe?” 

Then I remembered. The patient would be counting on me. My next thought was something I never thought I would ever say: “I wish there was a sales rep for this thing around here.”

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Remember the detailers?

It wasn't that long ago that educating healthcare professionals about their products could be described as a primary mission of pharmaceutical sales representatives. Somewhere along the way, that seems to have slipped away, at least from my perspective behind the pharmacy counter. 

A few years ago, a sales rep I was friendly with stopped by the store to give me an old-fashioned, full-scale presentation about her product, just for the heck of it. As she spoke, I was struck by how long it had been since I'd had an encounter like this. By the time I left the chain-store world, it seemed as if, in the eyes of a drug company's sales force, pharmacies were only useful as dropping-off points for co-pay coupons destined for the landfill.

I never would have admitted it at the time, but looking back, I now understand the value of a good sales representative - and as I read the instruction to be careful not to touch the piercing element of this new inhaler while pressing the safety catch, I suddenly missed them.

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Saved by the tech

Fortunately, that day there was a solution to my particular problem. One of my technicians had been given a sample of this very device at her physician's office, so I called her over to give me the scoop on working the thing.

As she showed me how to get the device up and running, I wondered whether I could bill the manufacturer for her time.

Perhaps if I had billed them, they would have realized the value of taking some time to educate the educators who will be putting their products into the hands of the patients expecting to use them.

Later on, I read about a new buccal cold sore treatment that a pharmacy had dispensed with the instruction “take one tablet by mouth,” and I wondered whether that manufacturer might have learned a lesson about the value of investing in good product education. Probably not, I decided.

Bucks before value

After all, IKEA made $3.7 billion dollars in its last fiscal year by leaving it up to customers to figure things out. And business people won't hesitate to tell you that the only thing that matters for most modern corporations is the bottom line.

On the bright side, though, if I ever do make it to IKEA, I bet I'll feel right at home. I just might go shopping.