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Healthy Skepticism Library item: 14224

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: news

Anderson, M
Former Pharmaceutical Reps Tell All
The Social Medicine Portal 2008 Aug 15
http://www.socialmedicine.org/2008/08/15/big-pharma/former-pharmaceutical-reps-tell-all/


Full text:

Among the more interesting genres of medical writing is that of the former pharmaceutical representative who reveals the “secrets” of promoting drugs to doctors. Here are some recent examples:

Shahram Ahari

Shahram Ahari sold Zyprexa for Eli Lilly and is now with the School of Pharmacy, University of California San Francisco. In 2007 he published an article with Adriane Fugh-Berman in PLoS describing in great detail how pharmaceutical reps influence physicians. Their conclusion:

Pharmaceutical companies spend billions of dollars annually to ensure that physicians most susceptible to marketing prescribe the most expensive, most promoted drugs to the most people possible. The foundation of this influence is a sales force of 100,000 drug reps that provides rationed doses of samples, gifts, services, and flattery to a subset of physicians. If detailing were an educational service, it would be provided to all physicians, not just those who affect market share.

Ahari can be seen in a YouTube clip discussing the marketing of Zyprexa. He explains how the reps were instructed to downplay the side effects of the drug (specifically weight gain).

Gene Carbona

Gene Carbona was employed by Merck for 12 years and now works for the Medical Letter, an organization that provides independent evaluation of drugs and therapeutics. [The Medical Letter is one of our personal favorites]. Carbona was interviewed in an excellent article in the Atlantic Monthly about reps by Carl Elliot. He also appears in a film called Big Bucks, Big Pharma (another YouTube clip).

Kathleen Slattery-Moschkau

Kathleen Slattery-Moschkau worked for Johnson & Johnson and Bristol-Myers Squibb. She describes herself as a “former drug pusher (legally).” She has made a film based on her experiences entitled Side Effects and a documentary Money Talks: Profits Before Patient Safety.

Jamie Reidy

Jamie Reidy worked for Pfizer and Eli Lilly and was responsible for promoting Viagra. He has written his book: Hard Sell: The Evolution of a Viagra Salesman and has his own blog on Amazon.

Michael Oldani

Michael Oldani worked for Pfizer until 1998 when he decided to become an anthropologist. He published a very interesting article in Medical Anthropology Quarterly in 2004 entitled Thick Prescriptions: Toward an Interpretation of Pharmaceutical Sales Practices. The abstract is as follows:

Anthropologists of medicine and science are increasingly studying all aspects of pharmaceutical industry practices-from research and development to the marketing of prescription drugs. This article ethnographically explores one particular stage in the life cycle of pharmaceuticals: sales and marketing. Drawing on a range of sources-investigative journalism, medical ethics, and autoethnography-the author examines the day-to-day activities of pharmaceutical salespersons, or drug reps, during the 1990s. He describes in detail the pharmaceutical gift cycle, a three-way exchange network between doctors, salespersons, and patients and how this process of exchange is currently in a state of involution. This gift economy exists to generate prescriptions (scripts) and can mask and/or perpetuate risks and side effects for patients. With implications of pharmaceutical industry practices impacting everything from the personal-psychological to the global political economy, medical anthropologists can play a lead role in the emerging scholarly discourse concerned with critical pharmaceutical studies.

Since the article is not open source, you may want to email him for a reprint. He is currently working at the University of Wisconsin-Whitewater.

Some thoughts

Pharmaceutical representatives are sales people and it looks like they do a good job of selling the story of their past misdeeds. Indeed, the sophistication of these former reps is something for activists to emulate.

While we can be thankful for the information and perspective these reps bring, there does seem to be something wrong when they try to cash in on their confessions. Perhaps they should look upon their confessions as a form of public service and not charge for speaking, writing, or interviews. Or donate their profits to Healthy Skepticism.

 

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As an advertising man, I can assure you that advertising which does not work does not continue to run. If experience did not show beyond doubt that the great majority of doctors are splendidly responsive to current [prescription drug] advertising, new techniques would be devised in short order. And if, indeed, candor, accuracy, scientific completeness, and a permanent ban on cartoons came to be essential for the successful promotion of [prescription] drugs, advertising would have no choice but to comply.
- Pierre R. Garai (advertising executive) 1963