The Asbury Park (N.J.) paper ran a brief article today that starts off with quite a bang: a quote from former Merck sales rep Gene Carbona, now publisher of The Medical Letter, who recalls spending a "couple hundred thousand" dollars a year on breakfasts, lunches, happy hours, dinners and perks like football tickets to make the doctors on his route happy and build "relationships" with physicians.
But that is the world of pharma sales, and what is a few hundred thousand, after all, in a world where each rep is expected to generate $1.9 million in sales per year?
"Continuing medical education" is another, much hazier topic where the boundaries are less defined. (See recent controversial Op Ed by Tufts University professor Dr. Daniel Carlat in the New York Times).
I often think about that field, because three former colleagues defected from publishing to the higher paying, more glamorous world of CME. ( "Next month, a conference in Rome, next week a workshop in Bayonne," or "If it's Tuesday, it must be Strattera").
They all had great work ethics and talent, yet two of them became quite miserable and voluntarily left the field fairly quickly---one left within a month, the other within three.
The industry's in a bit of a bind with CME, because most of the important clinical work today is being funded by industry, so it becomes increasingly hard to find experts on specific classes of drugs and modes of action, who don't have some connection to a pharmaceutical company.
Still, I'd wager that some CME programs are far more enlightening than others.
Seeking to provide some definition is PERx: Prescribing Evidence Based Therapies, a new documentary film made by former drug rep-turned-filmmaker, Kathleen Slattery-Moschkau . It's part of an online educational program designed for medical professionals www.perxinfo.org that was launched today.
We'll have to wait until next month to see the film, which is funded by Pfizer/Warner Lambert Neurotonin settlements, $21 million of which were earmarked to provide physicians and consumers with more balanced information about pharmaceutical marketing.
Comparisons were made in the press release between this project and similar projects undertaken by the tobacco industry.
(Time out for a mini-rant - How could the industry have allowed this to happen, andhow sad, when you consider that Big Tobacco makes a product that eventually kills its consumers (some faster than others), where pharma still manages to make so many drugs that cure and help.The source of so many of these problems is the blockbuster model, which has driven companies to take the frenzied approaches to boosting marketing and sales, protecting patents, and developing new drugs that have led to drug safety problems and damaged the industry's public image. However, that same model has also employed millions of people around the world, and cured millions more, since its heyday. More proof, as if we needed it, that anyone searching for clear cut black and white issues in pharma is only going to be disappointed)
Two years ago, we interviewed Ms. Slattery-Moschkau about her classic film, "Side Effects," in which Katherine Heigl portrayed the film maker, or at least, a sales rep who experienced many of the same ethical and other dilemmas that the film maker had. For more, read on.
Slattery-Moschkau is not a rabid industry hater, but, instead knows, first hand, the terrain of drug sales and marketing. The last few films that Kathleen has done have been documentaries. One wonders, will she return to the Side Effects model and film a fictional screenplay treating some aspect of the 'decadent blockbuster model' ?
One option could take the point of view, not of a sales rep but of an FDA reviewer, or a former journalist-turned-CME-expert, who discovers problems, connects the dots and quietly leaks information to law enforcement and the press.
Only time will tell (but for any film taking the second route, I may have some potential authors to recommend)
-AMS
