Healthy Skepticism Library item: 1723

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: news

Hensley S.
More Than Ads, Drug Makers Rely on Sales Representatives
The Wall Street Journal 2002 Mar 14

Notes:

URL for this article: http://online.wsj.com/article/0,,SB1016053761226069200.djm,00.html

Hyperlinks in this Article: (1) http://online.wsj.com/article/0,,SB1016053991820089240,00.html (2) http://online.wsj.com/article/0,,SB101596852355964520,00.html (3) http://online.wsj.com/article/0,,SB1015968588107926720,00.html (4)

Full text:

There’s been no sign of pollen in Duluth, Minn., since early October, and hay-fever season won’t start until winter’s snow recedes sometime late next month.

But sales reps from Schering-Plough Corp. started buttonholing doctors in frosty January to tell them that Clarinex, the company’s new allergy medicine, is even better than Claritin, its current bestseller.

The Schering-Plough reps have “really been hustling,” says Timothy Kleinschmidt, an internist at St. Mary’s-Duluth Clinic. Out of politeness or curiosity, sometimes he stops to listen when drug salesmen loitering outside the dining room reserved for doctors “yell things” to flag him down.

In a recent two-week stretch, Schering-Plough salesmen intercepted him three times to talk for a minute or less about Clarinex. The reps told him Clarinex is “a lower-dose, lower side-effect version of Claritin,” and stopped leaving vouchers for free samples of Claritin, substituting Clarinex coupons instead. Dr. Kleinschmidt usually waits six months before prescribing new medicines, just in case unanticipated problems emerge. Yet he bent his own rule of thumb to give a coupon for a seven-day trial of Clarinex to a low-income patient who’d come to him after an allergic reaction to Benadryl, an over-the-counter antihistamine.

Long before the FDA allowed drug companies to advertise prescription medicines directly to consumers, the industry relied on armies of sales reps to influence doctors. Even now, drug companies spend more than 2½ times as much on their sales forces — about $7.2 billion in 2001, according to NDCHealth — as they do on consumer ads. The practice of sending salesmen to doctors’ offices is known as “detailing”; drug salesmen earned the name “detail men” from their ability to memorize and regurgitate scripted pitches.

With the imminent expiration of Claritin’s patent by year end, Schering-Plough’s scramble may be a matter of survival as an independent company. Schering-Plough built Claritin, an allergy remedy that doesn’t cause drowsiness, into a $3 billion-a-year franchise through persistent advertising and promotion. Now the drug maker must persuade doctors to prescribe its newer, patent-protected Clarinex to allergy patients so the company won’t lose its Claritin users to generics or an over-the-counter version of drug. Clarinex, a chemical cousin of Claritin, carries patent protection through 2004.

Schering-Plough started mentioning Clarinex in some meetings with doctors in late November even before the drug had been approved, says ImpactRx, a closely held firm in Mount Laurel, N.J., that tracks how drug companies promote products to doctors who write the most prescriptions. When the big push for Clarinex began in January, Schering-Plough salesmen virtually stopped talking about Claritin. Now more than 60% of the time that a Schering-Plough rep meets with a primary care doctor it is to discuss Clarinex. “Schering-Plough has thrown everything at the Clarinex launch but the kitchen sink,” says Tim Margraf, president and chief executive of ImpactRx.

In a written statement responding to questions about its sales force, Schering-Plough, Kenilworth, N.J., said that it is “a firm believer in the value of a well-trained and educated sales force” and that its reps are held to rigorous guidelines that ensure they contribute to the “awareness of the need to treat allergies.” The company said it hasn’t performed a head-to-head study of the medicines. There is no proof that Clarinex is superior to Claritin.

Drug companies realize that particularly for the launch of a new drug there is no substitute for salesmanship. Sales forces at drug companies have nearly doubled to 80,000 reps over the past five years, according to Scott-Levin, a pharmaceutical research concern in Newtown, Pa.

The time drug makers have to convert a doctor to a new drug is fleeting. Nine in 10 doctors decide whether to incorporate a new drug into their practice within six months or less after it’s launched, according to ImpactRx. Though many doctors assert that drug reps don’t sway prescribing decisions, the research firm finds that 55% of high-prescribing primary-care doctors acknowledge that drug reps are their primary source of information about newly approved medicines. Only 26% say they turn first to medical journals.

So far, the sales effort for Clarinex appears to be paying off. Clarinex picked up about 20% of new prescriptions for antihistamines during February, according to ImpactRx. Last week, Schering-Plough also kicked off a massive consumer ad campaign trumpeting such messages as “Billions of Allergens, One Tiny Blue Pill” in spots on TV, print and the Internet; that campaign aims to build on the efforts of the sales force.

The hard part will come after Claritin becomes available without a prescription perhaps as soon as December. Will patients stick with prescription Clarinex instead? It will depend largely on what their doctors tell them.