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Pharmaceutical sales reps are trained in tactics that are on par with some of the most potent brainwashing techniques used throughout the world, according to an in-depth report co-written by former Eli Lilly drug rep Shahram Ahari, and Adriane Fugh-Berman, associate professor of physiology and biophysics at Georgetown University Medical Center in Washington, D.C..

Pharmaceutical companies spend more than $15 billion each year promoting prescription drugs in the United States.

These campaigns are designed to effectively alter prescribing behavior, to sell more of the high-profit drugs (as opposed to the most effective, and least dangerous).

Newstarget July 30, 2007
PLoS Medicine 4(4): e150, April 24, 2007

Take Control of Your Health

by Dr. Mercola

The fact that sales reps for drug companies serve no useful function other than driving up sales for their blockbuster drugs—at your expense—is no surprise. What may shock you, though, is just how insidious their sales tactics really are.

Last weekend, I saw a woman who used to work for me 13 years ago.  She wound up going to a four-year naturopathic college, but prior to going to ND school she worked as a drug rep.  I heard firsthand, detailed stories of the corrupt and deceitful practices they use.  I am hoping I can convince her to write an article that goes into more details.

Rest assured that there is MASSIVE waste and fraud in the drug industry. In the end, you are the one paying the price twice, by emptying out your wallet and endangering your health with drugs you probably don’t need in the first place.

Drug reps are not your run-of-the-mill salespeople. They are meticulously trained to spot the weaknesses of every client. Doctors usually believe they are immune to persuasion tactics, and drug reps know just how important it is to maintain that illusion.

Last year pharmaceutical companies spent over $15 BILLION on physician advertising—a fancy word for bribing individual doctors. And the industry claims it’s worth every penny, which only proves that drug reps most definitely increase drug sales by influencing physicians to change their prescription habits.  That is $10,000 for every doctor in the US.

But exactly how do they do it? What makes otherwise well educated, intelligent doctors turn their backs on their Hippocratic Oath (to do no harm) and do the complete opposite (prescribe completely unnecessary drugs)?

It turns out that doctors are mostly unaware of just how extensive and detailed the drug companies’ profiling of them is. Not only are reps trained to assess their personality, practice style, and medical preferences, they’re also instructed to sniff out personal information, like the names of family members, birthdays, and family interests —as well as the physician’s professional interests and recreational pursuits.

All of this information goes into a database for future reference. When the time comes to devise an “incentive”—say a dinner, sporting event, or membership —it is custom tailored to suit the prey. It’s all about establishing personal rapport. Oftentimes, doctors mistake the reps’ cleverly disguised interest in them as personal friendship. This is exactly how it’s designed to work!

Physicians are clinically dissected into “types” based on their personality, and encounters are specifically tailored for maximum effect. (see text in blue)

“Friendly” physicians get the buddy treatment. Samples and gifts are given, not because it’s part of the job, but because the rep “likes” them. Lunch may be brought in under the guise that the doctor actually provides “pleasant relief from all other docs out there.”

Aloof and skeptical physicians receive journal articles and extensive data that counter the documented apprehensions he or she may have.

“Mercenary” physicians (who generally don’t prescribe as many drugs) receive a clear message that the dinner they just accepted implies their willingness to prescribe a particular drug to a certain number of patients exhibiting certain symptoms. Reneging on the prescriptions-for-dinner bargain gets broadcast over the jungle drums, and suddenly reps don’t come-a-knocking with goodies anymore.

High-prescribers receive better presents, including unrestricted “educational” grants that essentially amount to cold, hard cash.

Competing-drug prescribers are deftly manipulated into understanding how the drug will work better than the competitor’s for a certain patient niche (to circumvent their reluctance to switch).

“Acquiescent” physicians who foolishly imagine that simply agreeing will get rid of the nuisance, realize all too late that there’s no such thing as a free lunch. Gifts here are subtly used to enhance subconscious guilt and social pressure to reciprocate. Sales numbers show it works like a charm.

Hard-to-see physicians are actually not dissed by drug reps, because they’ve found that a good hand-delivered lunch to the office staff, followed by snooping under the guise of a friendly chitchat, can work even better than talking to the doctor to find the right hot buttons.

“Charismatic” physicians, those who are highly credentialed with an aura of integrity, are chosen as “thought leaders” to enhance and further certain drugs. These leaders are invited, and paid, as speakers to influence their peers. Depending on their level of allegiance and tact, they may be elevated through the ranks of speakers to the national circuit and beyond, gaining personal clout and fatter wallets as they go along with the program.

In recent years, physicians have become increasingly aware of—and dismayed by —the additional practice of script tracking. Health information organizations, such as IMS Health, Dendrite, Verispan, and Wolters Kluwer, buy pharmacy prescription records and resell them. Drug companies keep tabs on the return on their bribes with this data, as it tells them the prescription rate of each doctor.

Patient names are not included in these records, but physicians are easily identified through either state license number, DEA number, or a pharmacy-specific identifier, through the American Medical Association’s master database. Physicians are then ranked on a 1-to-10 scale, based on how many prescriptions they write; a “10” is every reps’ dream date.

This information also reveals how many of a doctor’s patients receive specific drugs, how many competing drugs are prescribed compared with the target drug, and how the physician’s prescribing habits change over time. It tells them if a drug is “in favor” or not, and gives them the tools to cook up a winning strategy for future manipulations.

Between 1990 and 2004, spending for prescription drugs increased five times, to a whopping $188.5 billion, and drug reps increased from 38,000 to 100,000 strong. That’s a ratio of one drug rep for every 2.5 physicians targeted for “detailing.” Talk about having a personal “Big Brother.”

The idea that reps provide some kind of valuable, informative service to physicians is total fiction, created and perpetuated by the drug industry, to keep this deadly, but profitable, scheme going.

Dr. Mercola
 www.mercola.com

The international drug company Merck had a hit list of doctors who had to be “neutralized” or discredited because they had criticized the painkiller Vioxx, a now-withdrawn drug that the pharmaceutical giant produced.

Staff at the company emailed each other about the list of doctors. The email, which came out during a class-action suit against the drug company, included the words “neutralize,” “neutralized” or “discredit” alongside some of the doctors’ names.

The company is alleged to have used intimidation tactics against researchers, including dropping hints that the company would stop funding their institutions, and possibly even interfering with academic appointments.

“We may need to seek them out and destroy them where they live,” a Merck employee wrote, according to an email excerpt read to the court.

Dr. Mercola’s Comments:

It is not at all surprising that Merck would have been keeping tabs on doctors speaking out against their blockbuster drug Vioxx. But it is quite disturbing and makes you wonder just how far they would have gone to “neutralize” or “discredit” those physicians had Vioxx not been pulled from the market.

I was one of the very first doctors who openly criticized Vioxx a full year before it came on the market. Those who made it onto Merck’s “hit list” said they experienced instances of intimidation, including suggestions that Merck would stop funding the institution or interfere with academic appointments.

This clearly gets in the way of academic freedom, researchers’ ability to accurately report their findings, and doctors’ ability to speak out against a drug they believe is harmful. But then that is what Merck was after.

Adding to the issue, of course, is that this is probably not an isolated occurrence. Drug companies could be keeping any number of lists of people who are interfering with their ability to sell and make profits, and my guess is that they are at work “neutralizing” those people as we speak. In fact, I would bet on it.

Fortunately I did not have any funding from Merck, but there are strong suspicions that they and other drug giants fund organizations like Quackwatch that openly seek to discredit me and other natural health care professionals.

Drug Companies Routinely Collect Secret Reports on Doctors

Drug companies have been hiring outside firms to purchase data on doctors from pharmacies since the mid-1990s. The reports let drug sales representatives see a doctor’s prescribing habits, among other things, which lets them know:

1. If their sales pitches are working
2. How to change their sales pitch if they’re not

For example, if the report shows a doctor generally prescribes a drug’s competitor, they can prepare a sales pitch specifically to discredit the competing drug. Meanwhile, those doctors who do regularly prescribe their drugs would likely be singled out to receive some “incentives” to keep doing so. But it’s not only doctors who are being quietly influenced.

Congress and YOU are Being Influenced, Too

The pharmaceutical industry spent $1.5 billion lobbying Congress in the last decade, and in so doing has manipulated the government’s involvement with medicine and secondarily reinforced our dependence on them, through government policies.

Their relatively minor investments allow them to manipulate votes on key legislation that are highly favorable to their bottom line and almost always in conflict with your best interests.

At the same time, drug companies have also brought their drug ads directly into your living room — on your television, in your magazines and over the Internet. The United States is one of only two countries that allows drug companies to advertise directly to patients (the other is New Zealand), and they are taking full advantage of it.

One study even found that if you mention seeing an ad for a particular drug to your doctor, you are five times more likely to be given a prescription for that drug!

How Else do Drug Companies Make Sure Their Products are Viewed Favorably?

The common thread here is that drug companies are willing to do just about anything to make you, and your physician, think their drugs are great — quietly devising a hit list of doctors to silence, collecting secret reports on doctors, buying off Congress, advertising to you in your living room … and what else?

Across the board, drugmakers do an excellent job of publicizing the things they want you to know, while keeping very quiet about the rest. For instance it was recently revealed  that drugmaker AstraZeneca “buried” unfavorable studies on its antipsychotic drug Seroquel that showed it may cause diabetes and other health problems.

They’re also well known for funding their own studies so they can have a say in how the results turn out. This isn’t just my opinion; it’s well known that studies funded by industry or conducted by researchers with industry ties tend to favor corporate interests.

Drug companies also shower money and other incentives onto medical schools and their professors, even prestigious schools like Harvard, to get medical students to jump on board with their way of thinking right from the start.

The way the drug companies operate is like a massively powerful, well-run, and well-oiled machine — but it is not invincible.

As more people like you learn the truth about the drug companies, including that their primary motive is money, not your health, the sooner we will begin to see real positive change in the health care arena.

Source: www.mercola.com

The Commonwealth Fund, a non-profit foundation that funds research related to improving the U.S. healthcare system, recently reported that 75,000 to 101,000 deaths could have been prevented in the U.S. in 2002. The conclusion is based on the study Measuring the Health of Nations: Updating an Earlier Analysis conducted by the London School of Hygiene and Tropical Medicine.

The U.S. currently ranks at the bottom of 19 industrialized countries based on data measured between 2002-2003. According to study data, France ranked first in preventable deaths followed by Japan and Australia.

The Commonwealth Fund reports that “Even the more conservative estimate of 75,000 (preventable) deaths is almost twice the Institute of Medicine’s (lower) estimate of the number of deaths attributable to medical errors in the U.S. each year”.

The abysmal ranking of the U.S. points to “weaknesses in the nation’s health system that requires attention”. In reality, the number of preventable deaths in the U.S. each year is many times more than those reported by this study.

In his book Malignant Medicine, Joel M Kauffman, PhD (Organic Chemistry from MIT) writes that in 2000 the U.S. Institute of Medicine and the National Academy of Sciences issued a report authored by Barbara Stanfield, MD, MPH that found “over-medicalization from excessive testing and treatment, not medical error to blame” for poor international rankings and increasingly poor health of Americans.

According to Dr. Kauffman, the report listed the following statistics for annual preventable deaths:

* 7,000 deaths/year from medication errors in hospitals

* 12,000 deaths/year from unnecessary surgery

* 20,000 deaths/year from other errors in hospitals

* 80,000 deaths/year from infections contracted in hospitals

* 106,000 deaths/year from non-error, adverse effects of drugs

That totals 225,000 “premature deaths per year in the U.S.A. from medical care”. These figures are from data analyzed almost 8 years ago.

Since this data was published in the Journal of the American Medical Association, pharmaceutical sales have significantly escalated. Pharmacy Times reports that between 2005 and 2006 “total drug sales increased by 8.3% from 2005, to $274.9 billion and prescriptions dispensed grew to 3.7 billion, an increase of 4.6%”.

These numbers are a stark illustration that the potential for “over-medication” is on the rise in the US. And that if this trend continues unchecked, the US rankings for preventable deaths compared to other industrialized nations will inexcusably remain in last place.

Worst of all, these preventable deaths are the deaths of loved ones and our own.

Sources:

About the Commonwealth Fund:
(http://www.commonwealthfund.org/aboutus/)

E.Nolte and C.M.McKee, Measuring the Health of nations: Updating an Earlier Analysis, Health Affairs, Jan/Feb 2008, 27(1):58-71

Joel M. Kauffman, PhD, Malignant Medicine, p. 278

Stanfield, B., (2000) Is US Health Really the Best in the World? Journal of the American Medical Association, 284(4):483-485

(http://www.pharmacytimes.com/issues/articles/2007-05_4629.asp)

About the author
Teri Lee Gruss, MS Human Nutrition