Former drug rep talks tactics in primetime
Shahram Ahari, a former Eli Lilly sales rep, is in Boston this week talking to medical students at Tufts, Harvard, and Mass General Hospital about how reps make the sale to physicians — and how the future docs can resist the pitch. He speaks here to Jim Braude of NECN about the rules of engagement for pharma’s sales force.
Ahari, now at the University of California-San Francisco School of Pharmacy, has testified recently before Congress on the Physician Payments Sunshine Act and federal academic detailing initiative.
April 28th, 2008 at 2:09 pm
Imagine if others besides this gentleman came foward with thier similiar stories? Your blog would certainly stay busy. His story is not an isolated take on the tactics of big pharma.
May 8th, 2008 at 11:32 pm
You Have Now Been Sampled
While company image and falling profits have been progressively increasing in the pharmaceutical industry due mainly to both patent loss and increases in the use of generics, the pharmaceutical companies certainly have retained most of their promoters, which I believe is without any valid reason, and these are the drug reps.
While named in different ways, we’ll call them drug reps, which number close to 100,000 in the U.S. presently, so I’ve heard. The cost of these employees is around 5 billion dollars for the industry, I believe. Income for each rep grosses close to 100,000 grand a year, along with great benefits and a company car.
Their main function these days of pharma reps I believe is offering doctors various types of inducements, such as sampling doctors with the drugs they promote, as this is the most influential element for their choice of treatment, which I believe costs the industry about 20 billion annually. While historically drug reps used their persuasive abilities to influence the prescribing habits of doctors, most health care providers now simply refuse to speak with them, or have banned drug reps now from their practices for a number of reasons:
1. The doctors lose money. Doctors are normally busy, so their time is valuable. As a drug rep, you are a waste of their time. Yet they will accept your samples still. The credibility you possibly have as a rep is not considered anymore do to others without this trait.
2. Most reps in the U.S. are hired for their looks and personality, so most are ignorant in regards to anything clinically relevant, and doctors know this. Most have degrees that do not correlate with their profession as a drug rep. An Act is being considered presently called the SafeRx Act to have the government certify drug reps for such reasons.
3. Most reps, it is believed, are void of any ethical considerations, and this allows them to embellish the benefits of their promoted products usually due to deliberate ignorance, yet at other times with deliberate intent. Worse yet, due to pressure to keep their high-paying jobs, they always are tempted to bribe doctors and have the money to do so and are coerced to spend these budgets by their employer who gave them the bribing material, money or other expensive things, specifically for those who will have impact for their territory, financially speaking. This, of course, is a federal offense, as it is quid pro quo and violates the federal anti-kickback statute. Employers of such reps are not opposed to this necessarily, although they will deny this fact, yet they dispense to the reps these large budgets reps have and are required to spend, and this mainly applies with the big pharma companies. In fact, there is an association between the money a rep spends and the progression that occurs with their career with their employer. Disclosure laws are being considered presently to mandate the release of all funds dispensed from pharmaceutical companies, as it is presently very secretive.
4. It’s called data mining. The American Medical Association sells data to pharmaceutical companies, which allows them to track the scripts a doctor writes, free of the patient names, yet names the products prescribed. This allows reps to tailor their tactical approach with any given doctor. Worse yet, it allows reps to reward those who support the rep’s products that they promote, which again is a form of quid pro quo. Laws are being considered presently to prevent this practice of allowing reps to have this data. Doctors are opposed to the data the reps have as well about them for privacy and deceptive reasons, so they say.
5. Overall, reps can be best described as far as their function goes with their profession is to whenever possible manipulate doctors with remuneration or other forms of inducements, as they continue to sample such doctors along with others. Also, frequent lunches bought for doctors’ offices and their staff as a method of access. Because of the income and benefits they receive that they would likely not be able to obtain with any other job, they are compelled to do such unethical tactics that they normally would not do in another setting. My opinion, yet based on experience.
6. Samples keep the prescriber from selecting their preferred choice of med due to cost savings from sample. Yet at the same time, Doctors are now being paid by prescription providers for switching to generic drugs.
As an ex big pharma rep, I believe most reps are good and intelligent people who are coerced to do things that are corruptive to others in order to maintain their employment. Regulation is necessary to prevent their employers from allowing the autonomy and encouragement that allows the reps to do the wrong thing for the medical community. Clearly, greed has replaced ethics with this element of the health care system which is this industry, but reversing this focus is not impossible if the right action is taken to benefit public health with confidence. Get rid of the reps, and you get rid of the tactics.
“What you don’t do can be a destructive force.” — Elanor Roosevelt
Dan Abshear