Healthy Skepticism Library item: 20005

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: Journal Article

Weaving PG
Drug company representatives and sales prioprities
The Lancet 1993 Apr 17; 341:(8851):1031-1032
http://www.mendeley.com/research/drug-company-representatives-sales-priorities/

Abstract:

SIR,-The EC directive on Advertising of Medicinal Products for Human Use (92/28/EEC), which came into force on Jan 1,1993, (see Lancet editorial, 1992; 339: 1452), requires that “medical sales representatives shall be given adequate training … to provide information which is precise and as complete as possible about the medicinal products which they promote”. Moreover, the directive makes it the drug companys responsibility to ensure that this requirement is implemented. Confidential “detail” cards used by sales representatives working for Edinburgh Pharmaceuticals, a part of Allen and Hanburys and thus of Glaxo, suggest that the training received is probably rather different from that which the legislators had in mind. Cards, each of which deals with a specific drug or sales target, all start with a section entitled “Campaign Objectives” printed in bold type. When meeting an otorhinolaryngologist or a hospital pharmacist a prime objective for the representative is to encourage surgeons to endorse (pharmacists to support) “Flixonase for inclusion on the hospital formulary”. At meetings with retail pharmacists an objective is “to persuade pharmacists to identify those patients who either purchase OTC over-the-counter decongestants or who obtain scripts for other nasal sprays and refer them back to their GP for consideration of an alternative therapy”. After the section on campaign objectives many cards have instructions on business objectives. Representatives are told that-the company is involved in a “devices war” and to that end, when visiting a general practitioner, paediatrician, or paediatric nurse, the prime business objective is to “gain commitment to prescribe the Diskhaler, Becodisks and Ventodisks, for either the next asthmatic child or a named asthmatic child”. Finally, the cards have a section headed “Key Messages” which deals with clinical aspects. Key messages to put over when at a general practice meeting are that “Practice nurses have an important role in identifying children suitable for Serevent therapy” and that “Establishing practice prescribing protocols (including Serevent) for children can lead to more effective use of time by GPs and Practice Nurses”. For many years I have suspected that this was a major component of training medical representatives received, but had not imagined that the pitch was so blatant. Is it ethical for a health professional to meet medical representatives knowing that these are their real priorities?