Pill Girl Report

MERCK, PFIZER, ELI LILLY, and over 30 of their cohorts rang in the New Year with a pledge to stop plying physicians with the five-star meals, expense-paid trips, and scores of logo-emblazoned freebies that critics have long argued have a subliminal — if not a tit-for-tat — influence on prescribing practices.

But don’t take Pharma’s willingness to forego this age-old practice as an admission that it has any such effect. The pledge is simply a way to emphasize the educational nature of the relationship between industry and doctors, says Diane Bieri, executive vice president of Pharmaceutical Research and Manufacturers of America (PhRMA), the lobbying group responsible for revising the “Code on Interactions with Healthcare Professionals.”

“We have never said and would never say that a pharmaceutical pen or notebook has influenced any prescription,” Bieri told the New York Times. The Code itself allows only that drug companies are “concerned that our interactions with healthcare professionals not be perceived [my italics] as inappropriate by patients or the public.” They realize that “providing items for healthcare professionals that do not advance disease or treatment education … may foster misperceptions [m.i.] that company interactions with healthcare professionals are not based on informing them about medical and scientific issues.” That’s why the revised Code limits gifts to those that advance disease or treatment education.

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In other words, if you thought the way Senator, the promotional pen company, did when it shelled out thousands of dollars for this ad in Pharmaceutical Executive (courtesy of Pharma Marketing Blog), you were mistaken.

But before you go losing sleep over hapless Pharma being pressured into giving up a perfectly innocuous practice, consider at least the following five ways Big Pharma’s Big Resolution will hardly be debilitating for those who’ve signed on.

They’ll save a bunch of money. Drugmakers have been spending about $1 billion a year on promotional products, Promotional Products Association International told the Times. Now, I can’t imagine why they’ve done so if it’s so ineffective in boosting sales — or how they’ve justified it to shareholders … But, regardless, think of all the money they’ll now have to spend on other things. Research? Development? Wait —

Think of all the marketing alternatives beckoning for that billion. Drug companies have become less reliant on gift-bearing sales reps to hook physicians, anyway. These days, not only are they slapping ads all over TV and print media, they’re venturing online where they can interject their products into the lives and minds of doctors and consumers via social-networking sites, blogs, podcasts, etc. Merck and McNeil Pediatrics have drawn thousands to their groups and applications on Facebook. Johnson & Johnson has launched its own YouTube channel. And, with over 90% of doctors Googling for medical information, countless drug makers are springing for paid searches.

Click to enlarge. Go to Brandweek.com for full post.

It’s a preemptive strike. Billy Tauzin, head of PhRMA and former Republican congressman, has made no secret of this being the motive behind the Code’s revision: “We had better self-police and stop doing the things that cause so much criticism,” he told the Washington Post, “or we’re going to get legislated and regulated by government.” He and his constituents hope lawmakers will overlook all the limitations and loopholes — summarized in a Brandweek.com article and captured in a (satirical) Q & A on Carlat Psychiatry Blog.

Presumably, not only would drug companies rather make their own rules than risk more more aggressive legislation, they’d prefer to decide their own fate for failure to adhere to them.

The consequences of noncompliance are negligible. The Code simply asks CEOs of companies pledging their allegiance to certify that they have a compliance process in place and encourages them to have their sales reps’ practices audited every three years or so by an external source retained by the company. What if they don’t? PhRMA, “will identify on its Web site if a company has sought and obtained verification of its compliance policies and procedures from an external source” — and presumably if it hasn’t? Is there no oversight person or panel, no punitive process or penalty? Sure, if the information is made easily accessible and ends up in the wrong — or right — hands and is effectively publicized, there might be repercussions: bad publicity or even a boycott. But then again there might not.

Aren’t resolutions made to be broken, anyway? (Depending on the study you consider,) between 50% and 90% of New Year’s resolutions are broken in a matter of weeks … Come to think of it, a doctor friend told me in early January that a drug rep had just offered to pick up NHL tickets for him and some colleagues. My friend asked if the rep was worried about repercussions, to which he responded, “What people don’t know won’t hurt them.” And he has a point. Who’s going to report it — other than PillGirl, and I’m just telling you …

Now that I think about it, maybe all this poking at the PhRMA Code is an indirect expression of my own underlying fear of nurdles … which I’ll try to build up the courage to write about in my next post.

Tags: big pharma