DEPP framework for Medical Advisors

I have been spending the last few months training two medical advisers. In the process I realized that there are limited tools for helping medical advisers approach the therapies/devices or situations we face daily. So in the process I came up with a basic framework for assessing/authorizing or advising. I believe its just as relevant to marketing advisory as managed care related reviews.


(D)iagnosis:This should be starting point when looking at any issue. 

• Is the diagnosis certain ?
• Is the diagnosis easily made and what is the gold standard ?
• Does the target provider have the skills to make this diagnosis ? if not why not?
• When this diagnosis is made what factors are generally taken into consideration ?

Tools: Society Guidelines, ICD 10 codes, Review papers, Good understanding of pathophysiology.

(E)vidence:What does the cold hard facts say?

• Is it clinically appropriate ?
• Does the research link the treatment and the diagnosis well ?
• Is this a labelled indication? If not why not ?
• What is the strength and depth of the evidence ? Is there a ongoing trial that might change the whole accepted view?
• Evidence vs Hope?

Tools: Evidence Based medicine reviews, Cochrane, NICE, Society guidelines, Uptodate

(P)rice: How cost effective is it?

• Cost effectiveness reviews  ?
• Is the marker of cost effectiveness relevant ?
• Price vs alternatives ? Item price vs true cost ?
• Affordability on individual/group and population level ?
• QUALY?
• Do we have any data to asses?

Tools: NICE, PBS, Managed Care Policies, Pharmacoepidemiology

(P)olitics: What are the rules and opinions that affect this area?

• Laws and guidelines  ?
• Codes of conduct issues?
• Current political/social climate ?
• Fallout ?
• Client/ Key account issues ?

Tools: Codes of conduct, Google news, Local Laws, Precedent