Healthy Skepticism Library item: 9354

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Publication type: news

Sales representatives blow the whistle on rule-breaking call rates
Pharmafocus 2007 Apr 11
http://www.pharmafocus.com/cda/focusH/1,2109,21-0-0-APR_2007-focus_news_detail-0-491178,00.html

Full text:

Pharmaceutical sales representatives are turning to the industry regulator and blowing the whistle on their own companies, when they are asked to over-call on doctors.

Traditionally, many complaints made about companies to regulator the PMCPA have been from doctors or competitor companies, but reps reporting in-house misconduct is a new trend.

A new, tougher ABPI Code of Practice was introduced in January 2006, and this seems to have heightened awareness of the rules – not just among doctors, but also among reps themselves.

In particular, sales reps are increasingly fearful that if they are personally caught breaking the rules, their career will suffer.

There has been a small, but notable, increase in the number of reps complaining about the call rate targets they are given – rising from just one complaint in 2005 to four last year.

The code says reps should not normally call unsolicited on a doctor or other prescriber more than three times per year on average, but this can be supplemented by additional visits, such as group meetings.

One recent case involved a Pfizer rep who complained that he/she had been asked to call on target doctors eight times a year. The complainant said they and fellow reps knew the target was in contravention of the code and had questioned it many times, but that managers had not acted.

Pfizer claimed that there had been confusion over call rate and the broader contact rate, but the PMCPA nevertheless found it to have promoted over-calling and found it in breach of the code.

These cases come during a year in which high-profile breaches have gained considerable publicity in the media; most notably, the suspension of ABPI membership for Abbott and then Merck Sharp & Dohme for serious breaches of the code.

MSD was found to have linked the provision of nurse audits with promotion of its drugs- a very serious breach of the code – but the case also featured allegations of over-calling on doctors. A lack of evidence from the anonymous complainant meant that this complaint was not upheld.

The anonymous former employee also claimed that he/she repeatedly expressed concerns about the arrangements, but was effectively ignored.

MSD says it takes whistleblowers seriously, but the issue is clearly a concern for many reps.

The cases also clearly show that the pressure is still on sales teams to hit tough sales targets, despite an apparent move away from a focus on call rates towards account management.

Heather Simmonds, Director of the PMCPA commented on the trend: “We have seen an increase in complaints from industry employees over the last year, and this could be an indication of greater awareness of the requirements of the code among staff at all levels. Representatives appear to be more willing to call their company to task if they feel they are being asked to breach the code.”

She added: “While I’m sure companies would prefer if these concerns were raised internally (and in some instances they were), the most important thing is that representatives are following the code.

“Again, we encourage anyone with concerns about the activities of a pharmaceutical company to contact the PMCPA.”

Regulatory consultant and former compliance officer for AstraZeneca’s UK marketing company Steven Gray says the new tougher code means reps have to be constantly vigilant.

“They’re the ones that have got to take a decision on the spot about what they can and can’t do,” stressed Gray.

“Some people are worried that if they make a mistake, their company is going to come down on them really heavily and they’ll get fired. I can’t think of a company where that’s true, but that doesn’t stop people worrying.”

Making a high-profile mistake with the code can directly affect your career, Gray added, and he said it was easy to make such a mistake under pressure.

Many companies are going to great lengths to comply with regulations, aiming to be ‘whiter than white’ in relation to the code.

A handful of firms, including Lilly and Amgen, have admitted their own mistakes to the regulator in recent months, once again, eager to show just how seriously they take the regulations.