Drug reps and cheerleading?

Pharmaceutical sales if a fiercely competitive business. Does evidence or beauty market this industry? There is nothing inherently wrong with utilizing effective marketing strategies, but does such an approach eventually contribute to Vioxx fiascos. Larry is from Kentucky. Larry, what's going on at UK?

John

Comments

[Britt Smith]

Again, John, very relevant discussion. The drug industry is so driving our medical system with direct consumer marketing (One watchdog group estimates the drug industry is spending more money spent on marketing than R & D!!!), influence pedalling with doctors and corruption of the the RCT process, data analysis, indeed, corruption of the gate-keeper role of the FDA.
Marcia Angell, a former editor from the New England Journal of Medicine has written an excellent expose of the industry: The Truth About the Drug Companies: How They Deceive Us and What to Do About It
by Marcia Angell
www.amazon.com/gp/product/0375508465/002-5028899-6360840?v=glance&n=283155&n=507846&s=books&v=glance
Ray Moynihan and Alan Cassels have written a riveting book about the way the pharmaceutical industry has shaped the definition of 'disease' to broaden the market. Virtually every condition discussed is quoted at '20% of Americans' are at risk or 'suffer' from a disease that is either partially invented or grossly distorted for marketing of a drug, i.e. creating a market niche.
Selling Sickness: How the World's Biggest Pharmaceutical Companies Are Turning Us All into Patients by Ray Moynihan, Alan Cassels

www.amazon.com/gp/product/1560256974/002-5028899-6360840?v=glance&n=283155&n=507846&s=books&v=glance

An interesting aside to this discussion about the corruption of medicine by business & sophistry is the article by RA Aronowitz in Annals of Internal Medicine, 2001: When do symptoms become a disease? PMID: 11346314.
Food (& Drugs) for thought. Britt
PS. Oh, yea, sexy sells.

[Selena Horner]

John, Britt and I have told you that sexy sells. The male reps are just as decent looking. When I ate lunch with the family practice staff, I learned very quickly that any young, good-looking guys (or women)were pharm reps. They usually talked about their med for 5-15 minutes and then it was social hour. There were, of course, some reps that were quite knowledgeable and knew the studies relevant to their med and competitors' meds. There were also times that somehow it was arranged for a specialist physician to attend lunch. Those were usually pretty darn good lunch meetings and a neat experience for me to observe and at times partake in clinical discussions.

Looking good has value in decision-making you wouldn't think it would or should, but I guess we're human and that is a weakness humans have. Value and credibility are based on outward appearance and presentation.

[Larry Benz]

Dr. Childs:

First, I think that you are a little taken aback because a pharma company has never recruited you.

Second, keep in mind that this article was written by the NY Times.

Third, yes we have beautiful women in Kentucky and the drug companies all know this. The Cheerleaders at Univ of Louisille are even more sought after.

Fourth, consumer advertising by drug companies (and now total joint companies!)has demonstrated substantial demand side success-let's use that to drive EBP.

Fifth, there is another side to this story (remember my second comment). Drug reps are under intense compliance scrutiny and cannot do the types of "outings" and "giveaways" of years gone by.

Sixth, in my experience the pharma reps that I have seen by the major drug companies have mucho brains to go along with their looks.

That is all I am going to say.

Larry

[Selena Horner]

Larry, John doesn't need to cross over into the pharm world.... geesh.

John, your physique, smile, face, the way you carry yourself - toss that in with your brains and your diplomacy - you could easily market the profession of physical therapy. Since it might initially be better to market from a view of what we have to offer and the training we have - maybe have a live chat with say, Matt Lauer and snag a bit with Al Roker. Some how have camera time with George Clooney (I'm assuming he had PT after his surgery). Hit Oprah. Maybe do one of those late night shows. I'd probably recommend avoiding television commercials because I think that soon most viewers will completely ignore them... unless air time was purchased during the Super Bowl.

The 2020 vision is a good goal, but there isn't anything within it on how it'll be sold to the public. I watched Bones last night... and the scientist couldn't "sell" her proof until she was coerced into communicating emotion to the jury. What should have been so simple and factual isn't what swayed a jury - but instead mixing some personal information and emotion. I know it was just a show, but I do believe there was some truth to it - it's sad, but facts and figures that are SO logical and representative of evidence don't carry value and are viewed as boring and dismissed as irrelevant. It seems crazy to basically stoop to a lower level to achieve results when the evidence should just speak for itself.

[John Ware]

Larry, I have two-needless to say- attractive sisters who are drug reps for two of the largest companies. They tell me that compliance with the ethical marketing practices is voluntary, and many of the smaller drug companies don't participate. Doesn't this compromise the integrity of the industry if only certain companies subscribe to a code of ethics?
John W.

[Larry Benz]

John: you raise some good points that are actually quite relevant to PT. Compliance is technically not "voluntary" and yes it certainly compromises the integrity of the industry when companies do not pay any attention to compliance laws. I have visited many PT clinics that either maliciously or unknowingly violate all kinds of compliance laws with respect to marketing, coding, medicare guidelines, etc. and unfortunately our entire industry suffers. Drug companies are in the same boat. In my experience the larger companies (drug and rehab) actually put more into compliance, auditing, etc. under the theory that they have the most to "lose" and are more likely to be investigated.

[Kim Maddox]

To be a bunch of scientists, you sure are biased. A couple things come to mind.

1. Let’s just eliminate silly stereotypes: In this world of political correctness, I am sad that the New York Times has fallen prey to stereotypes. It happens to others as well. You wouldn’t believe how many people make comments about dumb football players to me. When they find out that my brothers and father funded their way through college playing football, and that they are bright men who teach American literature and biology and have a pretty amazing philosophy on life and managing people, those same people are a little more careful the next time.

Coincidentally, one of those brothers is married to a former Notre Dame cheerleader. She majored in biophysics, went to Michigan to medical school, and is now an active practitioner and professor of Emergency Medicine. My sister was a college cheerleader, too. She majored in aerospace engineering and physics.

2. Learning Principles: If anyone believes that sales people should just deal in facts and figure and the science, we have totally missed the fact that people’s personalities and learning styles play into their ability to take in information and make decisions. If all people could learn and change behavior simply by being given the appropriate information, then we can conclude that we do not need sales people or teachers for that matter. We could simply produce the information and provide it to the right audience, and the audience would draw all the right conclusions and make all the right decisions.

Whether we like it or not, appearance matters. My Vandy educated teacher friend tells me that research shows that children learn more from their (female) teachers if they wear bright lip stick. Can’t find the reference on that right this second, but here’s one about college professors and their appearance and its affect on students….see page 3 of this link. http://www.ctl.csus.edu/downloads/tsp_april_2005.pdf.

3. Legislating that all drug reps must have science degrees is silly. Shall we legislate that all used car sales people have a mechanics license? How about having all Weight watchers consultants be nutrition majors? Or if you run a retail shop, then you must have a degree in retail.

4. This argument is really about whether sales and marketing should be part of the health care dollar. But let's apply the same argument to the sales of other basic needs of humans…food, housing, clothing, or transportation… It's my choice as a consumer to be swayed by the message or the messenger. The implication here is that doctors and consumers aren't smart enough to separate the facts from the hype. I personally don't want to give responsibility of who and what information can be provided to me or my doctor to legislators, who, by the way, don't have a science degree either. :):)

[John Ware]

Kim,
I think you have a solution to our public education problem: Let's require all teachers (female) to wear designer evening gowns with plunging neck lines-that ought to get those SAT scores up!
I'm being facetious, but the fact is that physicians are basing their decisions to put peri-menopausal, osteopenic women on medication because they like the drug rep-for whatever reason. There's ample research evidence that these women are at minimal risk of fracture (see "The Bone Book" by K. Kahn, M.D., www.bonebook.com), and that they should be told to perform weight bearing and resistance exercise, not given a prescription. This is just one example of what is widespread in pharmaceutical drug sales.
JW