Hollywood, Pharma and the Side Effects of Bad Press

Katherine Heigl (Photo courtesy of IMDB.com)

"Side Effects" stars Katherine Heigl as Karly Hert, a sales rep working to promote a new fictional antidepressant, Vivexx. Hert grows increasingly easy about the company’s marketing tactics, which promote the drug as the next “big thing” while ignoring its side effects. Eventually, she decides to retire in six months; in the interim, she will sell drugs by telling doctors the whole truth. To her surprise, her sales numbers skyrocket, and she finds it even more difficult to leave the company.Slattery-Moschkau says Hert’s experiences mirror her own. She says she wanted to quit the industry many times, but there were too many incentives to stay.“Financially, it’s a damn good job,” she said. “You get offered good pay and a company car… and every time I felt like I wanted to walk away, I got a raise. And I found myself constantly rationalizing away why I’m staying.”A look in the mirrorPresumably, the impending release of "Side Effects" and the two other movies based on the pharmaceutical industry is making many people nervous. Will these films be an even-handed portrayal of sales practices, an honest attempt to hold a mirror up to the industry? Or will they all become one-sided rants?“I hope that some solutions can come out of this,” Slattery-Moschkau said. “In the past, these issues have been raised, and the industry says, ‘well, we’ll do some things differently,’ and it just sort of blows over. But this is as big as I’ve ever seen it.”Slattery-Moschkau says she understands why drug companies market as aggressively as they do. A Lehman Brothers study found the average sales rep, detailed to primary-care doctors, generates about $1.9m in sales annually, according to The Economist. Do the math: a thousand sales reps translate into almost two billion dollars a year for drug companies.So there is certainly an economic incentive for drug companies. And for the sales reps themselves, Slattery-Moschkau notes, a good salary isn’t the only draw.“I think that none of us could do this job unless we felt deep down we were doing some public good,” she said. “And I think the pharmaceutical industry can certainly do some things to serve the public… there are just a lot of problems.”Several times in our interview, Slattery-Moschkau mentioned this uneasy dichotomy in pharmaceutical manufacturing: companies driven by the noble desire to help patients, but also the day-to-day demands of shareholders and profit margins.Controversial practicesAnother area of drug marketing under fire lately is direct-to-consumer advertising, a tactic fairly unique to the American market (New Zealand is the only other developed country that allows the practice). Here, too, she says, drug companies often perform a public service.“The ads do help educate patients on those issues,” she said. “A patient may have had undiagnosed depression for years, and suddenly they see the symptoms being rattled off on TV, and they have an awakening.”The problem, Slattery-Moschkau said, is that direct advertising often is motivated by something other than a desire to educate the consumer. Her film does not address consumer advertising (it would be a “whole new segment”); but, she said, as a filmmaker herself, she thinks pharmaceutical advertisements play too much with consumers’ emotions.“I know the intent of that company is ultimately to drive market share. People emotionally respond to ads that sometimes are not in their best interests.”Wake-up call for doctorsThe other benefit to a movie like "Side Effects," says Slattery-Moschkau, is that it serves as a wake-up call for doctors. Like Jamie Reidy, author of "Evolution of a Viagra Salesman," Slattery-Moschkau had no science training when she became a sales rep; nonetheless, doctors trusted her to provide information about her company’s drugs.“I’m a political science major who probably had no business being in the room with a doctor, even though I was pretty well-trained on my drug and my disease state,” she said. “I was hired basically to repeat my well-rehearsed pitch.”Slattery-Moschkau said, in her experience, she rarely encountered sales reps with a medical background: one nurse and one pharmacist in her ten years working in the industry. The rest, she said, like her, came from business or liberal arts backgrounds, with no real relevant experience. And she wants doctors to be aware of that next time a drug rep is trying to push a product.“Part of the goal of the film is to help raise the level of awareness, even with physicians… doctors need to understand who these people are in front of them, that they’re just giving a pitch to drive more market share for their particular drug,” she said.“Embrace this as an opportunity”It is surely a tough time for the pharmaceutical industry right now, but Slattery-Moschkau views all that as an opportunity, at least for those companies willing to make some changes. For a good place to start, she recommends pharmaceutical executives take a good look at some of the criticisms of their industry (like, for example, her movie).“If they can roll with it [the movie] a little bit, it might allow them to see the industry in a way that lets them make some changes, and make things better… better for consumers, patients, doctors, and for themselves,” she said.To see a trailer for "Side Effects," click here.