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.

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 two decades in particular, and cannot be repaired
by the pharmaceutical industry’s lobbying group.

The atrophy of the image of the pharmaceutical industry is largely due to how they
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 online by request which would bypass the
company’s representatives is done with smaller drug companies, and apparently is
legal, the pharmaceutical industry, overall, prefers to have their own
representatives dispense samples of their promoted medications.

These sales forces of pharmaceutical companies have been examined more now
than in the past by others due to their unbelievable size, for one reason. The
number of representatives of these sales forces of large pharmaceutical
corporations 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 these drug representatives exceeds 20 billion dollars
annually by the pharmaceutical industry.

Sadly, yet with a high degree of confidence, most big pharmaceutical sales
representatives are viewed and evaluated by their employers as it relates to their
ability to gift targeted prescribers- to reward them for prescribing their promoted
products.

This is due to the large number of representatives promoting the same medications
to the same doctors who work for the same pharmaceutical company.
In fact, one could conclude that an individual representative in such a work
environment with multiple partners with their employer is, or could be, potentially
exonerated from any individual responsibility in regards to their vocation.

This is why they may be judged by their employers according to how much of their
employer’s monetary ‘marketing budget spend’ one individual drug representative
dispenses to targeted prescribers in a certain period of time. This will be further
addressed later.

Yet these 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 drug companies know who these prescribers are thanks to the
American Medical Association (AMA).

The AMA sells to the drug companies identifying information on each prescriber to
the drug company. As a result, the drug company can track the prescribing habits
of individual prescribers.

Therefore, the gift dispensing is determined by the prescriber’s loyalty to a

particular pharmaceutical company’s products.

However, and empirically, the drug sampling of doctors may be considered 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, as they
view themselves as outstanding salespeople.

Although such pharmaceutical representatives want to believe such a false premise,

it is samples of medications that determine the prescribing habits of health care
providers, and this has been proven.
Many years ago, drug representatives did in fact use their persuasive, yet ethical,
abilities to influence the prescribing habits of doctors in an honest and credible
manner. They focused on the benefits of their promoted medications for the
doctor’s patients.

However presently, most health care providers now simply do not allow drug
representatives to speak with them, or even see them, because the paradigm had
become darker than it was in the past regarding their benefit to them.

Medical establishments are progressively and completely banning drug

representatives from entering their medical facilities. This is happening for several
reasons, which include the following:

The health care providers lose money. They are normally busy, so their time is
valuable. As a drug representative, you are an incredible waste of their time. Yet
they will accept your samples still.

The credibility you possibly have thought you had and were perceived as such by
doctors as a drug representative is no longer viewed to exist to any noticeable
degree by the prescriber.

Also, the accurate perception of the prescriber is that now pharmaceutical

representatives are more concerned by their financial health instead of the health of
the provider’s 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 drug
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.
Doctors by their very nature seek answers objectively. And doctors do in fact find
out about drugs through other methods besides the representative who promotes
particular drugs.

This is further illustrated by pharmaceutical representatives being selected by

pharmaceutical companies due to their perceived appearance and personalities
judged by certain hiring managers of various pharmaceutical employers. The focus
should be on the candidate’s clinical knowledge and understanding instead.

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, quite apparently.

This is why pharmaceutical representatives have little if any interest or concern

regarding public health, perhaps. This premise is further validated by the
pharmaceutical employers’ minimal concern regarding the 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 to targeted prescribers. The
inducements are not gifts, but are bribes, once again.

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 paying such a
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, and the knowledge of the power of
inducements instead.

In relation to non-monetary inducements given to certain prescribers, they are

valuable and at times without any clear medical benefit for the prescriber.
Examples may be televisions, or DVDs.

Since pharmaceutical representatives understandably believe that since they are

given such directives by their pharmaceutical employers to dispense these
inducements, then they must 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. They
are viewed by their employers as innovative and creative, instead of criminal.

The situation 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.

Targets determined by a drug company are a result of what is referred to as data

mining. This is a primary variable as it relates to who a pharmaceutical maker may
choose to support financially in one way or another.

Prescribing data is in the possession of pharmaceutical companies of the prescribers

nationwide, and this data is analyzed to determine the prescribing habits of health
care providers. This prescribing data is provided to the pharmaceutical companies
by the American Medical Association, as mentioned earlier.

Further disturbing is the fact that this behavior is not prevented or deterred by our
lawmakers. For example, this data mining allows a pharmaceutical company to
conclude who could potentially affect their business.

So the data allows drug companies to dispense gifts to the right prescribers for their
business they are giving the drug company. The gifting establishes reciprocal
relationship with the receivers of these bribes. Quid Pro Quo is now born, and the
pharmaceutical company continues to thrive.

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.

While such unethical activities may appear to be ridiculous and without reason to
some, this does not mean they do not occur. The illegal and unethical behaviors of
certain pharmaceutical companies seem to be rather unbelievable by others on
occasion.

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 are harmful to the
health of others. And if they may do in fact realize what they do for their
pharmaceutical employers is in fact wrong, they continue to please their employers,
as financial benefit for them outweighs the results of their actions.

Fear ensures loyalty.” --- Author unknown

Dan Abshear

Published on: www.pharmagossip.blogspot.com