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12/08/2014

Marketing Extremes That Even Give Big Pharma Supporters Pause

On
November 28, 2014,
The New York Times
broke another story about Big Pharma marketing extremes. Reported by Katie
Thomas and titled “Using Doctors With Troubled Pasts to Market a Painkiller
,
the article reveals that one drug manufacturer is taking usual and customary
sales strategies beyond the reasonable.

It
is
independently reported that pharmaceutical manufacturers spent as much as $27
billion in 2012 to promote their products.  (Curiously during the same year, Big Pharma itself reported spending about $48
billion on the research and
development of new drugs.  However, some believe the research and development costs are overstated because
government grant support and marketing and other expenses are included in the
totals.)

Pharmaceutical
companies have long marketed prescription drugs to prescribers. This appears to
be common sense because only authorized practitioners can prescribe legend or
prescription drugs. Manufacturer marketing takes several typical forms: sending
pharmaceutical representatives to offices with information about new products;
providing free samples for distribution to patients as starter drugs; giving
away relatively inexpensive items such as pens and other office favors labeled
with product names and logos; and offering free continuing medical education (CME)
programs at conferences and dinner meetings.

For
CME programs, Big Pharma usually engages speakers who are prescriber peers
recognized for their expertise and respected because of their best practices or
unique contributions. These authorities are sometimes called “key opinion
leaders” (KOLs) or “thought leaders.” Medical school faculty members are well
known KOLs and thought leaders that Big Pharma enlists both to conduct basic
and clinical research and speak at CME conferences and meetings. One would
think that the KOLs or thought leaders might not be physicians who have been
charged or sanctioned by their respective medical boards. However, with Insys
Therapeutics – which manufacturers and markets SUBSYS® (fentanyl sublingual spray),
a powerful painkiller – that does not appear to be the case. Insys is reported
to have had continuing speaker relationships with physicians in Michigan, Rhode
Island, and Texas after these doctors had been charged by their medical boards
for unprofessional practices related to prescribing narcotics. According to
The New York Times article: “An analysis of the new federal open payments database shows that five of the 20 physicians who received the most money from Insys
recently faced legal or disciplinary action, including three who were said to
have inappropriately prescribed painkillers.”

Moreover,
the same article highlighted other shadowy marketing behaviors: “Several former
sales representatives said in interviews that they were encouraged by the
company to call on pain doctors who treated patients with a wide range of
ailments, and to reward high-prescribing physicians with perks like paid
speaking engagements. And in at least two cases, the company hired the adult
children of top doctors to serve as their parents’ sales representatives.”

Regrettably,
these aggressive marketing practices with clear conflicts of interests at least
appear to have led to inappropriate prescribing broadly. At least that is one
inference and it is one with widespread implications to influence others. And
unfortunately, this was occurring at a time when authorities were cracking down
on the overuse or diversion of narcotics and pain relievers.
These reported unseemly marketing practices only add more fuel to the flames licking
away at what remains of integrity for quality patient care within the
pharmaceutical manufacturing industry.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI’s online graduate programs, please visit our website. 

This entry was posted in Conflict of Interest, Health Care, Pharmaceuticals and tagged , . Posted by Hayley Dittus-Doria. Bookmark the permalink.

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