The pharmaceutical sales industry was such a lucrative profession that school teachers and retail salespeople were switching their careers to get in on this market.
That was until July 2002, when the pharmaceutical industry’s trade group, PhRMA, published its Code on Interactions with Healthcare Professionals. These are voluntary guidelines that tremendously changed the game for pharmaceutical representatives.
It used to be to get doctors to write prescriptions for the medications they were selling, they would wine and dine the doctors, provide them with great tickets to sporting events, even send them on elaborate trips, as well as bring pens and other gifts when they would call on them in their office.
However, there is a new way to entice the doctors.
These days, in order to get a doctor to write more prescriptions, they are now asking doctors to speak.
Recently, the investigative news organization, ProPublica, published a searchable database of physicians who have taken money from seven drug companies within the past two years. The database features more than 17,000 doctors, many who are paid large sums of money to act as speakers for drug companies. There are only seven drug companies that have publicly reported the payments they give to physicians and those doctors represent only a small fraction of the doctors who actually speak for pharmaceutical companies in the U.S. Most estimates place the number of physician speakers in excess of 100,000.
Typically what happens is a drug company will give a doctor a series of slides, sometimes with some training for the speech, and choose a time and place, such as a popular upscale restaurant, and a group of doctors are wined and dined while he speaks. The goal is for the speaker to explain the drug’s benefits, etc. with the hope that these doctors might write prescriptions for their patients.
Some speaking doctors claim that they are trying to educate other physicians and see it as nothing more than typical and feel they are reporting on new drugs.
However, when the drug companies recruit a doctor to speak, they think of them as a “thought leader.” Some drug representatives choose a specific doctor to speak for one reason; how many prescriptions he can write. Not about how well respected the doctor is, but rather a physician with a large patient population who can write a lot of pharmaceutical drugs.
So, even though doctors may believe that they are being recruited to speak in order to persuade a room full of their colleagues to consider the drug for its benefits, one of the primary targets of speaking, if not the primary target, is the speaker himself. They use psychology when approaching the doctor to speak, saying how the company has identified them as a potential thought leader. The physician has his ego boosted without even realizing he is being manipulated.
The pharmaceutical reps count on the large increase in prescriptions just after a speech.
One whistle blower who no longer works as a pharmaceutical rep said that after paying a high prescribing doctor about $1,500 to speak, the rep would see the speaking doctor write an additional $100,000 to $200,000 in prescriptions of his company’s drug.
The drug companies would track the investments very closely. They would look at how much money was spent on a doctor compared to how much the company made from him in prescriptions. They consider this a good return on investment.
Drug companies buy the doctors’ prescription data from firms like HIS Health that use pharmacy records to track the prescriptions of almost every doctor in the U.S.
A growing number of universities and hospitals no longer allow doctors who work on their staff to speak on behalf of drug companies. And under the new health law, by 2013, every doctor who takes money from a pharmaceutical company will be listed on a government website.
Do you think doctors are being influenced to prescribe a drug more often than they would have if the drug company has paid them for speaking engagements? How would that make you feel if this were one of you doctors?
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