Tuesday, September 30, 2008

How To Gift Others Nicely Dressed

Published on: www.pharmagossip.blogspot.com

While the pharmaceutical industry’s image and reputation has and appears to continue to suffer, added damage has expressed itself with costly patent expirations with certain large corporations within this industry in particular. This may have resulted in desperate behavior by such companies to achieve maxium profitablilty.

As the president of the lobbing group for the industry which is called PhRMA would likely concur to a degree if asked, the image of this industry has experienced noticeable trauma over the past decade in particular, and such injury to the pharmaceutical industry cannot be repaired by this lobbying group. The atrophy of the image of the pharmaceutical industry is largely due to the manner in which they now market and sell their medications. Let’s take branded drug samples as an example:

Even though the ability for health care provider to request samples of a pharmaceutical company’s medications directly from such a company, and completely bypass the company’s representatives, the pharmaceutical companies choose not to, although samples being delivered to health care providers in such a way is possible and perfectly legal.

Yet pharmaceutical companies continue to prefer to have their own representatives dispense samples of their promoted medications. This also allows such pharmaceutical companies to have their representatives to dispense inducements to certain targeted prescribers. Such inducements, specifically directed for select health care providers, is of much larger monetary value than samples of medications alone.

These sales forces of pharmaceutical companies have been investigated more now than in the past due to in large part to the unbelievable size in the number of representatives with big pharmaceutical companies in particular.

The number of representatives of these sales forces of large pharmaceutical corporations has tripled within a decade- starting in the mid 1990s. Also, the estimated total income for an individual pharmaceutical representative may exceed 200,000 a year- if benefits and perks are factored in to this cost. Overall, the amount spent on their representatives exceeds 20 billion dollars annually by the pharmaceutical industry.

Sadly, and with a high degree of confidence, most big pharmaceutical sales representatives are viewed and evaluated by their employers tacitly by their ability to gift targeted prescribers as determined by their employer. This is due to the large number of representatives promoting the same medications to the same doctors who work for the same pharmaceutical company. As such, no individual representative can be evaluated by their employer by the benefit they may provide them in any othe objective way.

In fact, one could conclude that an individual representative in such a work environment with multiple partners with their employer is potentially exonerated from any individual responsibility in regards to their vocation. This is why they may be judged by their employees according to how much of their employer’s monetary ‘marketing budget spend’ each of their representative dispenses to targeted prescribers in a certain period of time. This will be further addressed later.

Yet the inducements are never described by what they actually are, which are bribes. Who receives these bribes is largely determined by the volume of scripts the prescriber writes as it relates to the pharmaceutical company’s promoted products. The gift dispensing is also determined by the prescriber’s loyalty to a particular pharmaceutical company’s products as well.

The data that determines the prescribing habits that are analyzed by pharmaceutical companies is certainly available, and this will be further addressed shortly.

However, and empirically, the drug sampling of branded promoted products themselves to health care providers likely is the ultimate if not primary gift that influences the prescribing habit of a health care provider. Some pharmaceutical representatives are falsely led to believe that their territory’s performance is due in large part to their powerful ability to influence others, and truly believ that they are outstanding salespeople. Although such pharmaceutical representatives want to believe such a false premise, it is again the samples of medications promoted that determine the prescribing habits of health care providers, and this has been proven.

Many years ago, drug reps used their persuasive, yet ethical, abilities to influence the prescribing habits of doctors in an honest and credible manner. They focused on the benefits for the doctor’s patients with particular drugs that the detailer may promote to such a doctor, and how these drugs may and can restore the health of their patients.

However presently, due to the absence of the paradigm of the past, most health care providers now simply do not allow drug reps to speak with them, or even see them, because the new point of view regarding pharmaceutical sales and marketing has become darker than it was in the past. Medical establishments are progressively and completely banning pharmaceutical representatives from entering their medical facilities. This is happening for several reasons, which include the following:

The doctors lose money. Doctors are normally busy, so their time is valuable. As a pharmaceutical representative, you are an incredible waste of their time. Yet they will accept your samples still. The credibility you possibly thought you had as a pharmaceutical representative, along with your misperceived belief that the data you have on your promoted products was authentic, has now been shattered because health care providers seek more objectivity than you can possibly provide them due to your employers.

Also, the accurate perception of the prescriber is that now pharmaceutical representatives and their employers overall are more concerned by their financial health instead of the health of their patients. The health care providers do not find the pharmaceutical representatives with the knowledge they need to benefit their understanding of the drugs that the representatives promote. Any information shared by the pharmaceutical representative to them, either oral or written, is likely embellished if not fabricated.

This view is due to the frequent statistical gymnastics the employers of pharmaceutical representatives engage in way too often with their promoted products, and the representatives are likely unaware of the data they have is as inaccurate as it is because of such deception.

Doctors by their very nature seek answers objectively. And doctors do in fact find out about drugs through other methods besides the pharmaceutical representative who promotes particular drugs.

This is further illustrated by potential representatives being selected by pharmaceutical companies largely due to their perceived appearance and personalities as judged by certain hiring managers of various pharmaceutical employers. Another trait desired by the pharmaceutical company is the potential candidate’s likelihood of being completely obedient to their directives, as well as their affinity for monetary gain.

Qualities related to anything of a scientific, medical, or clinical nature is of little if any concern to most pharmaceutical companies, and this is quite apparent.

This is why pharmaceutical representatives have little if any interest or concern regarding public health, perhaps. They do not recognize the importance of the health of others, perhaps. This premise is further validated by the pharmaceutical employers’ absence of consideration regarding the relevant medical knowledge of their sales representatives, as mentioned earlier.

What the pharmaceutical company is concerned with, however, is the ability of their representatives to effectively offer inducements provided by them to targeted prescribers. The inducements are not gifts, but are bribes.

Examples may be creating a check from the pharmaceutical representative’s employer to be issued to one of the targeted prescribers determined by the pharmaceutical company. This check, when given to such a prescriber, is often for doing little, if anything at all for the pharmaceutical company that is paying the targeted prescriber.

Knowing this, it seems to validate the pharmaceutical industry’s overt apathy regarding this industry’s absence of focus regarding the essential medical knowledge of their sales representatives as well.

In relation to non-monetary inducements given to certain prescribers, they are often of great monetary value absent of any benefit for the patients of health care providers often. Such gifts include electonic devices, such as TVs or DVDs, perhaps.

And the autonomy that exists with some pharmaceutical companies results in authoritarian directives to their sales representatives to implement the activities with such inducements that are given again to targeted prescribers determined by the pharmaceutical company. Since pharmaceutical representatives understandably believe that since they are given such directives by their pharmaceutical employers, then the directives just have to be legal and ethical.

This is further reinforced by the applause and rewards the pharmaceutical representative receives often for this behavior of giving bribes to prescribers more than other pharmaceutical representatives from the same pharmaceutical company often. They are viewed by their employers as innovative and creative, instead of criminal.

This appears to eliminate the need or desire for the pharmaceutical representative to examine the consequences potentially of some activities and tactics encouraged by their pharmaceutical employers. It is clear that most pharmaceutical representatives do not question what they are told to do.

How a pharmaceutical company identifies their targets is because of what is referred to as data mining. It is prescribing information on each individual health care provider. Among other things, this data allows a pharmaceutical company decide who to possibly support financially in one way or another. Prescribing data is in the possession of pharmaceutical companies, and the data is that of most prescribers nationwide. The data is analyzed to determine the prescribing habits of health care providers- and to evaluate trends in their prescribing habits. This prescribing data is provided to the pharmaceutical companies by the American Medical Association.

Further disturbing is the fact that this behavior is not prevented by our lawmakers. This data mining allows a pharmaceutical company to conclude who could potentially affect their business and therefore dispense gifts to the right prescribers for their business. The gifting establishes reciprocal relationships with the receivers of these bribes. Quid Pro Quo is now born, and the pharmaceutical company continues to thrive as a result.

Conversely, if a prescriber is determined by a pharmaceutical company to be harmful or of minimal financial benefit to their business, they will essentially be ignored and ostracized by the pharmaceutical company related to any assets the pharmaceutical company could offer them for the benefit of their patients.

While such unethical activities may appear to be ridiculous and without reason to many, this does not mean this does not occur. The illegal and unethical behaviors of certain pharmaceutical companies seem to be rather unbelievable by others, so it seems.

It seems that external regulation is necessary to prevent the drug companies from allowing this corruptive autonomy to continue to exist. It is rather obvious that internal controls of companies that perform such wrongdoing are void of self-regulation with deliberate intent.

If regulation happens, then health it may be possible to resurrect the ethical element necessary as a participant in the health care system. The importance of public health should be the apex of their existence as a company that participates in this system.

Overall, pharmaceutical representatives are decent and intelligent people who do not realize the results of the actions they perform upon direction that often are potentially harmful to the health of others. And if they may do in fact realize what they do for their pharmaceutical employers is wrong in many ways,they continue to please their employers, as the financial benefit for them outweighs the results of their actions.

Fear ensures loyalty.” --- Author unknown

Dan Abshear

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