PharmedOut is a project that educates physicians on how drug companies influence prescribing.
Dr. Douglas Melnick, a former drug company insider, explains how these companies get around the bans on promoting drugs for non-FDA-approved uses. Shahram Ahari, a former drug company representative, tells how he sold the drug Zyprexa (olanzapine), an antipsychotic drug now being assailed for its side effects. And several drug reps, their voices distorted to protect their identities, explain the real purpose of free samples.
Drug companies spend $18.5 billion per year promoting their drugs to physicians.
With that kind of marketing budget, it’s easy to understand how drugs have become the first line of defense in many physicians’ offices, rather than the last resorts they should really be. But when you uncover the tactics used by drug representatives it goes way beyond “marketing.”
Psychological warfare would be a better way to describe it.
Drug Reps Use Unbelievable Tactics to Manipulate Doctors
Drug reps are taught tactics for manipulating doctors for industry benefit; it’s a standard part of their training because doctors are essentially their “dealers.”
Shahram Ahari, is a former drug rep who has spoken out before. He spent two years selling Prozac and Zypraxa for Eli Lily and told a Senate Aging Committee that his job involved "rewarding physicians with gifts and attention for their allegiance to your product and company despite what may be ethically appropriate."
Ahari describes sales tactics that were openly taught to new reps during a training class, including:
- How to exceed spending limits for important clients
- How to be generous with free samples to leverage sales
- How to use friendships and personal gifts to foster a "quid pro quo" relationship
- How to exploit sexual tension
If you think that last one is a stretch, think again. Drug companies commonly hire former cheerleaders, ex-models, former athletes and military members to ensure their reps have a certain appealing look and outgoing personality.
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 one PLoS report co-authored by Ahari.
The report states:
“Pharmaceutical companies spend billions of dollars annually to ensure that physicians most susceptible to marketing prescribe the most expensive, most promoted drugs to the most people possible.
The foundation of this influence is a sales force of 100,000 drug reps that provides rationed doses of samples, gifts, services, and flattery to a subset of physicians …
Physicians are susceptible to corporate influence because they are overworked, overwhelmed with information and paperwork, and feel underappreciated. Cheerful and charming, bearing food and gifts, drug reps provide respite and sympathy; they appreciate how hard doctor's lives are, and seem only to want to ease their burdens.
But … every word, every courtesy, every gift, and every piece of information provided is carefully crafted, not to assist doctors or patients, but to increase market share for targeted drugs.”
The Brainwashing Begins in Medical School
Unsuspecting medical students and residents are among the drug companies’ best targets. Drug reps can take advantage of their naivety and inexperience to successfully “train” them to be top prescribers even before they finish medical school.
Drug companies are allowed to develop their own education curriculum for medical students and residents, lavishing them with gifts, indirectly paying them to attend meetings and events where they promote the company’s products.
Even Harvard Medical School, one of the most prestigious in the United States, recently earned an F for its policies regarding accepting money and gifts from drug companies.
The grade came from the American Medical Student Association (AMSA), which ranked 150 medical schools according to their ties to industry. The more money and other incentives a school was receiving from the pharmaceutical industry, the worse grade they got.
Harvard earned the lowest grade possible. According to AMSA:
- Out of Harvard's 8,900 professors and lecturers, 1,600 admit that they or a family member have ties to drug companies that could bias their teaching or research.
- The pharmaceutical industry contributed more than $11.5 million to Harvard in 2008 for “research and continuing education classes.”
Impressionable medical students are being indoctrinated into the drug-based model of disease care as we speak. It goes on all the time, and I can vouch for this personally as I, too, was brainwashed in medical school to favor the drug paradigm.
In the mid '80s, I was actually a paid speaker for the drug companies. They would fly me to various physician education events around the country and pay me a very generous stipend to lecture to these groups. That was more than two decades ago, before I was able to remove myself from their very powerful brainwashing techniques -- and I was finally able to understand the truth of what they were doing.
Your Physician is Likely Influenced by These Persuasive Tactics
If you think your physician will be able to see past these persuasive tactics, think again -- and it’s not about intelligence or even ethics. Your physician may be very intelligent, and he or she may have every intention of NOT listening to a drug rep’s sales pitch.
But maybe she just wants to take advantage of the free samples they’re handing out to offer them to her patients. And there the rep gets a foot in the door, and even if he doesn’t say another word is able to keep a certain drug’s name upfront in this physician’s mind. And maybe he’ll drop off a few pens and pads of paper, also with the drug’s name, in case it starts to wear off.
Even if your doctor isn’t prescribing many targeted drugs, there are ways that drug reps will get that to change.
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:
- If their sales pitches are working
- 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.
As Ahari said:
“It's my job to figure out what a physician's price is. For some it's dinner at the finest restaurants, for others it's enough convincing data to let them prescribe confidently and for others it's my attention and friendship ... but at the most basic level, everything is for sale and everything is an exchange.”
How to Stay Safe in a Medical System Run by Drug Pushers
If you’re prescribed a drug, how do you know that it’s really necessary and safe, as opposed to one made by a company that’s paying off, or essentially brainwashing, your doctor?
You don’t, and that’s why you’ve got to learn to get your own information. Do not take a drug just because your doctor prescribes it. First, learn what the drug is supposed to do, how it may help you, how it could harm you and, most importantly, what alternatives there are.
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, even corrupting studies in medical journals so they show only favorable results.
It isn’t always easy to fight back against this system, but know that the drug companies are not going to protect you.
And it is unlikely that your physician can protect you either -- even a well-meaning one -- when he or she is operating within a system that has become RIGGED for Big Pharma profit.
You are the only one that can protect yourself and your family. You need to Take Control of Your Health. Search my Web site and the Web for answers. Don’t trust what your doctor tells you at face value.
Make sure you double and triple check every recommendation, as your health is too precious a commodity to lose to some carefully manipulated recommendation by the drug company.
So remember to stay alert and informed before taking any new drug, and maintain a naturally healthy lifestyle that will optimize your body’s innate healing abilities and minimize your need for the drug companies’ latest concoctions.
And for those of you in medical school right now, or planning to enter soon, please become familiar with AMSA’s PharmFree campaign. Aside from being a great source of information, their site offers guides and kits to help you make positive changes, including major policy reforms, at your own school.