Pharmaceutical Sales Reps

I just came across an interesting article in the New York Times entitled Drug Makers Pay for Lunch as They Pitch, describing how pharmaceutical sales reps frequently bring lunch and other meals to doctors' offices in a not-so-subtle effort to pitch their drugs. They resort to providing meals because recent laws have restricted them from offering the fancy gifts that they used to give in the past, such as free vacations, golfing trips, or tickets to sports events.

Anyone that has spent at least a full day in a hospital or doctor's office knows just how true this article rings. You cannot go one day without having a drug rep -- usually an attractive (or wannabe attractive) woman -- prance in with several large containers of food and plenty of drug-related information. Their objective is straightforward: soften you up with goodies and simultaneously slip in information about their drug. They are the missionaries of the medical world ... but instead of "Here, take some Bible with your hot meal" it's more like "As long as you’re eating, let me tell you about this drug.” Their hope, obviously, is that their drug will be the only one you consider if and when you need it at some point in the future.

Careful observation of these reps will often reveal some pathetic behavior. Since drug reps often come in pairs, one will do the talking, schmoozing, and chat-chitting with the doctors; meanwhile their partner is at your disposal, slaving away by preparing fresh food in front of you: Belgian waffles, ice cream sundaes, fresh fruit smoothies, you name it. It is a little sad seeing a grown man or woman in a fancy suit serving milk shakes in Dixie cups. Silly as their behavior is, however, their goal of the bottom line is serious.

Even more amusing is when they refer to a published study that touts their drug's efficacy over a rival drug (conveniently, they are usually pulling out a hard copy of the article and handing it to you.) I don't think they are fooling many people, since most people know these studies were funded by the drug maker, and the results are necessarily skewed. The frightening part is that many people are probably not aware of this financial connection.

The only reason drug reps and their tactics continue to exist is that drug makers have done studies showing the powerful impact of surrounding doctors by simple items that bear the drug names (some people say the only true science that drug companies study is marketing.) They conclude that if even one in every X people (5, 10, 100, etc.) remembers their drug name, it’s a success.

Attending physicians or those with private practices aren't the only targets, but so are the doctors of tomorrow: residents. It is a genius strategy … bombard them with your drug while they are still impressionable and they will likely remember your product once they are practicing on their own. What hungry overworked resident wouldn't pick a fresh hot meal over a repulsive cafeteria meal, even if it means tolerating a short blurb about the latest anti-hypertensive

My personal opinion is that reps should be forbidden from giving any sort of free gifts to doctors ... or if that isn't possible, doctors should not be allowed to accept such items. It was refreshing to hear that Stanford University recently instituted such a rule for its medical centers, by forbidding any of their doctors from accepting even the simplest of free gifts from reps.

Some people claim that drug reps do some good by bringing free samples for doctors to give out to their patients, which is particularly helpful for poorer patients. But the very reason medications have such high prices in the first place is because they include the costs of marketing, including drug rep salaries. So it's kind of like a drug rep bringing a few free paper towels to clean up spilled milk … but only after they had intentionally knocked over the cup of milk themselves.

In the end, as tough as it might be, I hope more medical centers will follow in Stanford’s footsteps. (Until then, you can find me writing with my Zoloft pen on my Rocephin notepad while I drink from my Prevacid cup).