Friday, June 10, 2005

How Doctors Are Spun

SLATE - The [pharmaceutical] industry's semi-secret weapon is prescriber reports, weekly lists of every prescription written by each of the 600,000 doctors in the United States. Relatively few physicians know about prescriber reports, also known as prescriber profiles. But their existence makes it far more difficult to imagine that pharmaceutical marketing has no effect on the doctors it targets...

The weekly prescriber reports can show the names of the doctors in a rep's territory and what each doctor prescribed and how much of it. Reports provide reps with up-to-date feedback on just how effective they've been in persuading their doctors to prescribe the two or three drugs each rep pitches. The reps are schooled for weeks in a variety of sales techniques. They memorize tightly crafted speeches and volumes of data on their products, and some are even trained in personality profiling, to help them guess whether a physician is more likely to respond to reams of scientific research or to schmoozing. Prescriber reports play a key role in helping reps boost sales - they're like weekly focus groups that help reps shape their pitches to individual doctors. If Doctor A increased her prescriptions after being treated to a facial and full-body massage, more expense-paid spa excursions are in order for her. If Doctor B didn't respond to a courtesy five-course meal, then maybe it's time to try football tickets, or up the free drug samples, or plug clinical research that touts the proffered drug's benefits...

One study published in the New England Journal of Medicine in 2001 revealed that patients who used the painkiller Vioxx were five times more likely to suffer a heart attack than users of the generic drug, naproxyn. Yet that year, Merck & Co., Vioxx's manufacturer, managed to make the drug's sales rise faster than the top 10 drugs in the industry, with revenues topping $2.6 billion. How did that happen? Merck documents submitted to Congress after Vioxx was withdrawn from the market last fall show that the company taught sales reps how to deflect doctors' questions about the painkiller's safety.

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