Healthy Skepticism Library item: 9959

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Publication type: news

Heuser S.
MS drug makers try a new pitch: empathy
The Boston Globe 2007 May 2
http://www.boston.com/business/healthcare/articles/2007/05/02/ms_drug_makers_try_a_new_pitch_empathy/?page=1

Full text:

Simulator lets doctors experience symptoms

When brain specialist Alejandra Gonzalez arrived at the Hynes Convention Center for a medical conference Monday, she did not expect to end her day standing on a treadmill wearing a pair of electrified neoprene gloves.

Her interest was piqued by an exhibit at the American Academy of Neurology meeting that claimed it could create, in a perfectly healthy person, the disorienting symptoms of multiple sclerosis.

So, flirting with being late for her 6:30 evening train, she pulled on the tight black gloves, climbed into a brushed-steel booth, and within a minute was wobbling on a treadmill, a blurry image in front of her, hot air blowing against her back.

Her fingertips vibrated insistently.

“I never thought that the tingling in the hands would be so bothersome,” said Gonzalez, a doctor at Mount Sinai Hospital in New York who has a number of patients with multiple sclerosis, a disease in which the central nervous system slowly deteriorates.

The machine, commissioned for the meeting by Cambridge drug maker Biogen Idec Inc. and Elan Pharmaceuticals Inc., drew a line of doctors like Gonzalez who were curious to experience how it might feel to have a perplexing disease known for its random, debilitating attacks on the brain and spine. With a video, headphones, and two wobbly treadmill tracks, the machine attempted to mimic the lack of coordination, blurred vision, and other signs of an attack.

“Even though you try hard to imagine how they feel, it’s just not possible,” Gonzalez said of her patients.

Welcome to the newest drug company marketing strategy: empathy. The four-minute simulation puts doctors in the shoes of a typical multiple sclerosis patient, a 30-something woman struggling to keep her life together as her body slips from her control.

Designed by a New York marketing firm called the RJO Group, it joins a handful of other simulators built for drug companies in the last few years. One, also targeted at neurologists, simulates restless leg syndrome. Another chronicles the exhaustion and frustrations of cancer patients with anemia. One machine simulated heart failure by having doctors strap on a pressurized vest that squeezed their chests.

“It’s almost like an Epcot type of experience,” said Robert O’Leary , RJO Group’s founder.

In a world of tight competition and increasing Food and Drug Administration scrutiny of their marketing tactics, drug companies are looking for ways to distinguish themselves. Medical meetings such as the American Academy of Neurology, at the Hynes in Boston this week, are peppered with high-end freebies such as computer memory sticks and cell phone chargers. But a simulator is still unusual.

“They’re always looking for something new,” said John Mack , publisher of Pharma Marketing News and author of a watchdog blog on drug company marketing excess. He was not at the Hynes this week, but is familiar with the heart-failure simulator. “Doctors are very gadget-oriented, and they like this sort of thing,” Mack said. “It’s also very medically oriented.”

The marketing theory behind the simulator is that a more empathetic doctor is more likely to treat patients aggressively, which means prescribing more drugs. O’Leary said one survey showed that the strategy seems to work: Doctors emerged from the anemia simulator measurably more interested in treating patients’ symptoms.

“The whole thing was not to push the drug, it was to push the importance of treating the disease,” said O’Leary.

Mack, the marketing specialist, is skeptical. A cardiologist with a lot of experience treating congestive heart failure “probably knows all there is to know about being empathetic,” he said.

He does, however, believe simulators and other high-tech educational tools can fill important gaps in medical education, even if they are funded by companies that stand to profit from increased drug sales.

“Obviously, pharma companies have a vested interest, but medical schools are just starting to teach doctors about bedside manner and having empathy for the patients,” he said.

Biogen Idec had four multiple sclerosis simulators built: Two depict the lives of a later-stage patient with advanced symptoms, and two depict recently diagnosed patients. A company spokeswoman would not discuss how much the simulators cost. Nor would O’Leary, except to say, “It’s not inexpensive, as you can imagine.”

Once this week’s conference winds down, Biogen Idec plans to take the machines on the road — first to the BIO International Convention across town, which opens Sunday, and then on a national tour of neurology meetings and, possibly, hospitals and medical schools.

The MS simulators took six months to build. To create the desired effects, specialists interviewed doctors and patients, searching for symptoms that are not only typical, but can be reproduced with a video screen and mechanical devices.

For the MS simulator on display at the Hynes, the firm produced a short video that brings to life the symptoms of a typical patient during an MS attack. The person in the booth dons a set of headphones and is promptly surrounded by a woman’s voice and the ambient sounds of her life. At the store, she opens her wallet and the screen suddenly goes blurry, with an MS attack rendering the $20 bills impossible to distinguish from the singles. She tries to pick up a cup, and it falls out of her hand — the drop simulated by a quick tug from a recessed cable.

Art Mellor, a multiple sclerosis patient who runs a research foundation for the disease, went through the simulator an hour after it opened Monday, not long after Gonzalez. He was impressed by the way the coffee cup simulated the sudden loss of coordination — “that’s what it’s like,” he said — and by the thick vibrating gloves. It wasn’t so much the feeling while the battery-powered gloves were turned on, he said, but the eerie after-effect of taking them off — a disturbing residual buzz that has become a permanent part of Mellor’s life.

Mellor said the booth could serve a valuable purpose, since multiple sclerosis patients often don’t have outwardly detectable symptoms and must depend on doctors believing their verbal descriptions. Some patients, he said, get “the equivalent of ‘suck it up,’ or ‘Oh, come on, it’s not that bad.’ “

But there’s one feeling the booth can’t replicate. When the video ends, so do the symptoms for those in the simulator. Multiple sclerosis patients, however, are stuck with a degenerative disease that even the best drugs can inhibit only temporarily.

“It’s that slow build up over time that just eats away at you,” Mellor said.