Pharmaceutical marketing strategy: training healthcare providers as speakers

¶ … ethical issues associated with this marketing strategy?

Physicians have an ethical obligation to prescribe the most suitable treatment for a patient, based upon their medical knowledge, not upon persuasive techniques used by salespersons. For many years, the pharmaceutical industry has been dogged with charges that it uses 'freebies' like dinners, stationary, and food to persuade physicians that a name-brand drug is superior to others on the market. "The doctor is not going to prescribe something he or she has never heard of, and it's the drug representative's job to get the products' names in front of the physicians" not to improve patient health (Morreim 2011).

There are serious ethical implications regarding this charge. For example, if physicians are persuaded, even subliminally, to overprescribe, then there may be a rise in antibiotic-resistant bacteria, due to overuse of antibiotics. Children might be prescribed medication to treat ADHD and bipolar disorder as a means of first rather than last resort. Physicians may be more apt to bow to pressure from patients who ask for a specific drug, simply because the patient saw the pharmaceutical advertized on television and the doctor was the target of an in-house advertising campaign.

Overly aggressive physician targeting may thus encourage over-prescription, or may cause physicians to prescribe drugs rather than making consumers aware of generics, which are cheaper than name brand drugs. In this specific instance, training physicians to market the drug is designed to create an image of objectivity and trust, without fully informing the listeners that the physicians are disseminating sponsored materials. Even if there is a disclaimer, a small disclaimer will not necessarily fully convey the extent to which what the audience is seeing is 'advertising' rather than information.

"A recent letter in the Journal of the American Medical Association illustrates how effective drug advertising can be. It describes a patient who came into the hospital with an infected insect bite. The intern who first saw the patient first sensibly wanted to prescribe a nice, inexpensive penicillin…the resident overruled the intern and…decided the patient had to have a brand-new antibiotic at $183 a day...the resident had just been wined and dined by the drug representative whose company made the new antibiotic" (Morreim 2011).

Q2. How would you address these issues as the manager of your division?

To address some of these ethical questions, the information about the disease should focus on basic information, as well as showcase the new drug in a specific manner. Hard data should back up claims about the drug's efficacy. Drug promotions such as stuffed toys, pens, and other paraphernalia should be minimized. There should be clearly-worded disclaimers denoting the relationship between the doctors and the pharmaceutical company that trained them.

Most of the existing evidence suggests that drug advertising can be powerfully persuasive. A study comparing two groups of physicians who had been treated to a vacation at a luxury resort by different pharmaceutical companies found that "the prescriptions for Drug a increased from 81 units before the trip to 272 units afterwards…Drug B. went from 34 units to 87 units, more than doubling. In the case of Drug B, the use those doctors made of the medication went well beyond the nationally agreed-upon standard of care" (Morreim 2011). This discrepancy could not be explained by data about the patients, which was relatively consistent between the two groups.