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March 27, 2008 | By Dan Abshear
If you have been in a doctor’s office, you’ve probably seen them. They are the ones that are unusually well dressed — considering their environment. They also are typically young, healthy, and attractive. And worst of all is that they typically pay absolutely no attention to you, the patient, as you are not their objective. Certainly, they will avoid any conversation with you as the reasons for your visits are in opposition. They are the drug representatives… the detailers… the pharmaceutical promoters and marketers that could care less, really, about your concerns while you are both sharing the same space at the same time. Yet these reps will possibly take up the valuable time of the very doctor you are suppose to see for a health issue or concern, possibly of a serious nature. So there is actually one thing in common between the rep and the patient in the office: you both want to see the doctor, but for entirely different reasons. Pharmaceutical marketing tactics have become more transparent to many others over the years, and their methods have been exposed more so than they have in the past. And the public doesn’t like what they hear and read, that is largely valid and authentic. This is why the pharmaceutical industry’s image has been traumatized so much during this time over the past decade or so in particular, and the trauma is deserved, considering what the industry does and has done over the years with deliberate intent and reckless disregard in some cases, by seeming to ignore patient benefits for immediate profits. Yet there are those who are trying to change things for the better. Because pharmaceutical marketing to both doctors and patients is a troubling public heath issue, as they are a threat to the health of the community, certain advocacy groups such as National Physician’s Alliance and Community Catalyst, among others, are addressing concerns raised by the marketing tactics of the pharma industry, and their passion and ability to organize and work as a team appears obvious. I think very highly of their continued efforts to improve the well-being of others. In a way, such advocacy groups are in fact treating a disease, if one defines a disease as being harmful or abnormal. Also, such groups are attempting to prevent disease by deterring the etiology of the disease itself. In this case, pharma marketers, yet there are unfortunately quite a few others.
In this article, I address four factors focused on by some advocacy groups and conducted by pharma companies that are trying to be fixed or eliminated by others, and where notable progress has been made: 1. Data mining Data mining is preventing pharma reps from having prescribing data on the doctors they see on a regular basis. This data, while provided to the reps by the employers, originates with the American Medical Association. This association sells data necessary to identify prescribers and their habits, which is purchased from the AMA by the pharma companies. This arrangement is very lucrative for this association. The data the reps have from this arrangement allows them to analyze the historical prescribing habits of the doctors they are trying to influence to prescribe the drugs they aggressively promote in order to specifically create the most effective message to a particular doctor based in large part on this prescribing data. It has been stated and known that vicious debates have occurred between pharma reps and doctors because of this. There are those that insist this data is necessary for pharma companies to improve treatment regimens and protocols for the patents the doctor sees, and state the data is useful for educational purposes. This clearly is a fallacy. Advocacy groups and others are trying assertively to have bills passed through the legislature in order to prevent pharma companies from having this data, as it is not fair for the doctors for pharma companies to have such records of thier practicing habits with the prescriptions they write, although the names of thier patients are fortunately not included. In fact, pharma’s reps have no right to possess such data, regardless of the content. Furthermore, pharma reps having this data and what they say to a doctor based on this data removes potentially the objectivity of the doctor and may interfere with the best treatment of the patient, prevents any authentic and credible relationship with the doctor, and it could interfere with the judgment of such a doctor. 2. Disclosure Also the mainstream media to some degree has microscopically received and reported some level of acknowledgment of the money given out by the pharma industry to anyone who can potentially benefit the profitability of the pharmaceutical industry, such as their lobbying force, yet most of their collaborations, remunerations, inducements, and other forms of gifting to the medical establishment remains overall a mystery to the public and the government to a degree until they get caught by the government for wrongdoing because of these attempts at reciprocity with prescribers in attempt to form symbiotic relationships with them. Intimidation and extortion are possibilities as well. Yet insiders if the pharma industry, who choose not to be deliberately ignorant and dig deep for the truth are an exception with their drive to make others aware. Whistleblowers have been a big help with revealing and uncovering a large part of such activities, which is a rather courageous and brave thing for them to do, considering what they risk, yet regardless, for the benefit of public health, the public consistently should have a right to know where this money goes from the pharma industry to those who are responsible for restoring their health. So again, legislation and bills are being contemplated that would mandate pharma companies to disclose what they dispense financially and for what reasons. The pharmaceutical industry is the most lucrative industry that exists, so they have the money, yet no one knows where exactly it goes. It is mysterious. And likely, if it ends up that the pharma industry reports their financial output, it will likely be an exercise in creative accounting. We have a right to know. Of course, the pharma industry is opposed to such obligations with the disclosure issue, yet if it is for patient benefits, this money the pharma industry spends, as the pharma industry has repeatedly stated, the opposition should not exist.
A rather secretive industry… Revelation is quite a threat to the pharma industry, so it seems. Is it cronyism? A unique cult? One can only speculate. 3. Direct-to-consumer (DTC) marketing Two countries allow this: the US and New Zealand. Here’s the problem: About a third of those who view such ads seek out their doctor and ask for the med, regardless if they need it or not. Likely they will get it. And the ads are unmonitored. If a discrepancy is discovered, it’s after an ad has been broadcasted, usually for a lengthy period of time. It is then that the FDA intervenes. Embellishments with DTC ads are obvious. Exaggerations with the disease states are apparent as well. Elimination of such ads are being considered, and should be eliminated, as it diminishes the role of the doctor, for one reason. The pharma industry believes such ads encourage others to seek treatment. Yet they are unable to determine who needs treatment, and clear definitions of the diseases that they are attempting to promote. Doctors, however are. That’s what all that schooling and training is all about with your health care provider. 4. SafeRx Act Finally there is the SafeRx Act, being considered by lawmakers now, which aims to have reps certified by the government in order to be employed as pharma reps. Ethics are included in the training. Hopefully, the complexity of diagnosis and treatment will be integrated into the certification process as well. Unfortunately, most reps have little if any medical training. In the US, more value is placed on pharma rep selection based in large part on looks and personality. This, needless to say, can be damaging in this particular industry. Yet the act is still pending on a national level. The pharma industry states that it is a waste of time, and their stance on this issue disappoints me, yet I remain unsurprised. Bias may exist in this article, as I am an ex big-pharma-rep myself and consider myself a pharma critic at this point, yet the contents of this article are factual and not exaggerated. Yet I still honestly recognize the benefits this industry and all that it has provided to others from a historical perspective of lifesaving drugs as well as other medications that delay the progression of chronic diseases. Their effort is acknowledged. And I applaud their efforts to improve patient health, and wish for a return of such ethics. Maybe in time the pharma industry will become more pragmatic if the public is more empowered with knowledge. Doctors should not have any interference when it comes to the treatment of their patients. Again, there are others besides pharma that are guilty of this. I suppose the issue is best summed up by Hippocrates, who said, Whenever a doctor cannot do good, he must be kept from doing harm.
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