Magazine Article | April 1, 2016

If We Don't Police Pharma, It Will Be Done For Us

Source: Life Science Leader

By Rob Wright, Chief Editor, Life Science Leader
Follow Me On Twitter @RfwrightLSL

It was over 23 years ago that I joined our industry in the role of a pharmaceutical sales representative. We called on doctors, not providers, and some of those physicians still referred to us in this noble profession as “detailers,” not drug reps. Our job was to provide these medical practitioners with the “ethical details” for how, when, and where to use the drug we promoted, with messaging supported more by the use of approved clinical reprints and less by sales aids, or what doctors often liked to refer to as “Fifth-Avenue marketing slicks.” Doctors actually took notes during these discussions, and not for the purpose of trying to help law enforcement try to catch a rep for promoting their product off label. But soon pharmaceutical companies embraced reach and frequency sales promotion models with such vigor that the number of reps working in the field more than doubled. Even for those of us who had built significant relationships with doctors, twice as many reps calling on about the same number of physicians resulted in less access.

It was around this time that my district manager suggested a new sales tactic — the dine-and-dash. The concept was simple. Because many physicians had become too busy to let you detail them in the office, why not provide them with a win-win opportunity where you could detail them outside the office? Reps would book a table at a local restaurant and invite physicians to swing by on their way home from work. Doctors would stop and place a “to-go” order to take home to their families. While the meals were being prepared, the rep would detail the physician.

I was not a fan, as it didn’t seem in keeping with our ethical promotional roots. But I did it anyway and watched the concept soon spin out of control (e.g., Christmas-tree-and-dash, pumpkin-and-dash, gas-and-dash, etc.). In 2002, PhRMA tried to police itself with the introduction of “voluntary” guidelines on marketing to physicians. For many reps, to gift or not to gift was no longer a question. But the guidelines were voluntary, and from my perspective, arrived nearly 10 years too late. As a result of our inability to effectively police ourselves, we soon saw it done for us via the Sunshine Act.

I share this trip down memory lane as a teachable moment. Presidential candidates from both political parties have developed a taste for blasting the biopharmaceutical industry for its “high-priced” drugs. And though we can all agree that the Martin Shkrelis of the world are not reflective of our industry, mainstream media are happy to shape public perception to the contrary. History should have taught us that those who cannot remember the past are condemned to repeat it. Just as we were ineffective at policing ourselves during the days of the dine-and-dash, unless steps are taken to better self-police current drug pricing practices, it is likely we will soon have it done for us. Already we have seen the formation of the Health Transformation Alliance, a group of 20 of America’s largest companies (e.g., American Express, Macy’s, Verizon) that have banded together to use their collective resources to hold down the cost of providing worker healthcare benefits. Are government drug price controls just around the corner? We need to do more than preach the value our products provide while reciting how drugs make up only 10 percent of the U.S. healthcare bill. Isn’t it obvious that America isn’t listening? Perhaps it is time for biopharma to take the lead in driving for a “moon shot” approach to reducing U.S. healthcare costs. Otherwise, the industry may continue to be led to the public-pricing perception slaughter.