Jan 2 2014, 8:39am CST | by Forbes
The sales and marketing of new medicines provide a lightning rod for discussions about all that is wrong with the biopharmaceutical industry. Certainly, there have been over-aggressive practices used by the industry in terms of free dinners and paid conferences, but these practices are becoming less utilized. However, sales reps need to interact with doctors to prescribe their drugs. After all, this is their life blood.
GSK has recently announced that it is changing the way that sales reps will be compensated. Instead of tying compensation to the number of prescriptions written by doctors with whom they interact, the reps will be paid based on their technical knowledge, the quality of service they provide to clients, and the company’s business performance. The GSK changes have inspired a lot of comments, many applauding GSK for this and speculating on whether other companies will follow suit.
However, there are some comments that totally exasperate me. The most egregious to me was the post on Forbes.com by psychiatrist, Dr. Dale Archer, entitled “The Dark Side Of Big Pharma”. Archer feels that the entire practice of compensating sales reps based on prescriptions written is: “a practice rife with conflict of interest, leading to over-prescription of medications that may not even be the most appropriate for patients…” He goes on to say that: “When you incentivize a sales person with a hefty bonus check based on the number of prescriptions emanating from their territory, they’ll find a way to get doctors to write their drug.”
Archer describes why this is a problem. “This is key, because, no matter how principled we believe we are as doctors, we are only human, and the dark side of Big Pharma casts a long shadow. There can be no doubt when a charming drug rep visits your practice and introduces you to the latest product, it’s going to be at the top of your mind the next time you pull out your Rx pad.”
Is this really the case? Do sales reps so entrance a psychiatrist that he/she can’t wait to start writing prescriptions? If this is the case, why do physicians even agree to see sales reps in the first place? Actually, Archer answers that himself: “And to be fair, pharmaceutical reps do serve a need by bringing new information to doctors that may be too busy to keep up.” So, he admits that sales reps do bring value. When Archer was practicing psychiatry full time, he was undoubtedly seeing various sales reps who were touting the benefits of various antidepressants, such as Paxil (GSK), Prozac (Lilly) and Zoloft (Pfizer). He was also getting information from sales reps on antipsychotic medications like Geodon (Pfizer) and Abilify (BMS). I find it hard to believe that he changed his prescribing practice each time a sales rep left his office and that a new antidepressant or antipsychotic was now “at the top of his mind”. My guess is that he tried a variety of medicines, found what worked best for his patients and stayed with that particular drug as is the habit of most doctors. But the information from each sales rep helped to shape his views. Why is this bad?
Certainly, sales reps will highlight the benefits of the drug that they are selling. They will also talk about why their drug is better than competitive agents. As a result, when a doctor hears about a number of drugs, he/she can get a feel of the strengths and weaknesses of each drug and then treat patients accordingly. That’s not a bad system. However, at the end, it all comes down to the doctor’s judgment. Articles like Archer’s make it seem that doctors are mindless and prescribe new medicines whimsically. I think that this does all doctors a disservice. If a doctor prescribes a drug based on how “charming” a sales rep is, we have a major problem.
While some might find it unfortunate, the reality is that, for medicines to reach patients, they must be sold through sales and marketing. Without this, new drugs will never recoup the enormous investment needed to support the biopharmaceutical industry. A doctor can get information from a variety of sources – medical journals, scientific meetings AND sales reps. But the latter are a key component of getting new drugs to patients and, unless a better system can be devised, this practice will continue.
Source: Forbes Business
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