BLOGSCAN - "Be the Power," Never Mind the Data

Available in 3 parts on the Clinical Psychology and Psychiatry Blog (here, here, and here), and in one part on PharmaLot, is a video apparently used for training Merck pharmaceutical sales representatives to sell Vioxx (rofecoxib) to doubtful physicians. The strategy seemed to be to use flash and bluster to avoid dealing with concerns that Vioxx was no more effective a pain reliever than generic non-steroidal anti-inflammatory medications (NSAIDs) like ibuprofen and that Vioxx caused adverse effects, including myocardial infarction. Although waving around graphically fancy sales brochures was advised, dealing with the shaky data for clinical research (some of which later turned out to be gimmicked in favor of Vioxx) was not. Tell me again that story that pharma sales reps serve an educational function.

Are You Ready for Some Football?

When I first heard about this one, I thought it was a joke, but...
The New York Times reported today that pharmaceutical companies seem to be going out of their way to hire former or current college or professional (US) football cheerleaders as pharmaceutical representatives.
It provided two examples. Ms. Cassie Napier, former cheerleader for the University of Kentucky, "now plies doctors' office selling the antacid [actually, the proton pump inhibitor] Prevacid [lansoprazole] for TAP Pharmaceutical Products." Ms. Onya [last name not printed by the Times] is currently is a cheer leader for the Washington Redskins, and "weekdays find her urging gynecologists to prescribe a treatment for vaginal yeast infections."
"Known for their athleticism, postage-stamp size skirts, and persuasive enthuisiams, cheerleaders have many qualities the drug industry looks for in a sales force." "T. Lynn Williamson, Ms. Napier's cheering adviser at Kentucky, says he regularly gets calls from recruiters looking for talent, mainly from pharmaceutical companies." "They don't ask what the major is," he said. "Exaggerated motions, exaggerated smiles, exaggerated enthuisaism - they learn those things, and they can get people to do what they want." There is now at least one employment firm, Spirited Sales Leaders, that specializes in recruiting cheer-leaders. The article reported that quite a few former University of Kentucky and some current Washington Redskin cheer-leaders are now pharma reps.
Lamberto Andreotti, MS, Executive Vice President, and President, Worldwide Pharmaceuticals for Bristol-Myers-Squibb rationalized the interest in cheer-leaders as pharma reps thus, "Obviously, people hired for the work have to be extroverts, a good conversationalist, a pleasant person to talk to; but this has nothing to do with looks, it's the personality. However, industry critic Dr. Thomas Carli of the University of Michigan charged that "seduction appeared to be a deliberate industry strategy."
You just can't make this stuff up.
Obviously, there is nothing wrong with hiring current or former cheer-leaders as pharmaceutical representatives per se. What is dismaying is the pharmaceutical companies' emphasis on hiring people, regardless of their academic background or knowledge of pharmacology or medicine, mainly because they are attractive, have "exaggerated" mannerisms, and perhaps even imply "seduction."
This emphasis on short-term, superficial marketing rather than serious science, integrity, and focus on the welfare of patients seems already to have gotten big segments of the pharmaceutical industry in trouble.
One explanation for the continuing unraveling of once highly-respected Merck (for example, see this article in the Washington Post on the latest budget cuts and layoffs there) is its shift in emphasis from science, integrity, and patient welfare to marketing glitz.
You would think the leadership of the pharmaceutical industry would put down their pom-poms and pay attention.
[See widely ranging blog-sphere coverage of this at Dr. Sanity, Health Business Blog, Medical Rants, and PharmaGossip.]

Tales of Sales Reps

Two recent news stories about how pharmaceutical companies' sales representatives market to physicians provided some interesting information....
The Philadelphia Inquirer noted that Wyeth has joined GlaxoSmithKline, AstraZeneca, and Pfizer in laying off sales representatives. A pharmaceutical sales consultant remarked, "this may be related to the issue of public trust. What we'ver realized is that we've probably gone too far." On measure of the distance traveled is the figure the Inquirer cited for the number of sales representatives working in the US prior to the lay-offs, over 100, 000, or approximately one for every seven physicians (see this post for numbers of physicians in the US versus numbers of managers). More striking was the statement that "a succesful sales representative can earn $150,000 to $200,000 a year, including a car and other perks. That's more than many primary care physicians make (see this post on physicians' compensation.)
Meanwhile, a reporter for the Los Angeles Times interviewed Jamie Reidy, the author of Hard Sell, described as a "slacker's tale," about Reidy's life as a sales representative for Pfizer. Reidy said, "I was the kid who didn't become a doctor because I almost failed high school chemistry. I was trained for six weeks and considered qualified to tell doctors which drugs to prescribe. Scary, isn't it?"
At the end, this becomes another story about the perils of blowing the whistle about the management of large health care organizations. Reidy had left Pfizer, and was working in the oncology division of Eli Lilly, advancing to a trainer of other sales representatives, until his book came out. Then Lilly fired him.