Pharma Sales Exposed?

Criticism of pharmaceutical sales professionals is nothing new – reps who’ve spent any time carrying the bag have been blamed for taking up too much of physicians’ time, driving up the cost of prescription drugs, ruining the American health care system and, quite possibly, global warming.

Typically this criticism comes from outsiders who don’t understand the informational role pharmaceutical salespeople play in assisting physicians and other health care providers to make the best prescribing decisions. In an unusual break from this practice, however, a former Eli Lilly drug rep named Shahram Ahari recently “came out,” publishing an article in which he described the numerous psychological and sales tactics pharmaceutical salespeople use to persuade physicians to alter their prescribing habits.

In the article for PLoS Medicine, a peer-reviewed open access medical journal, Ahari alleges that pharmaceutical companies engage in ethically questionable activities like profiling physicians by personality type, amassing substantial information about doctors’ prescribing habits, and hiring salespeople based on their capacity to form friendships with the physicians they call on.

In an interview with American Medical News, Ahari, who is now a health researcher with the University of California, San Francisco, explained his view that most physicians don’t even realize they’re being aggressively sold to.

“A lot of physicians feel a sense of invulnerability to the marketing techniques that industry representatives use,” Ahari said. “That’s really a false sense of security and one cultivated by drug reps themselves. They want to lure physicians into thinking they can’t possibly influence their prescribing habits, when in the face of the facts – and the salaries drug reps get paid – it’s clearly the opposite.”

Reading Ahari’s comments, many pharmaceutical salespeople could be forgiven for wondering whether this is much ado about not much at all. After all, physicians are well aware that drug companies compile and parse physicians’ prescribing habits data. And customer personality profiling is a well-known and standard sales practice, across virtually all industries. As to the charge that pharmaceutical companies intentionally hire friendly and engaging salespeople, well, what kind of salespeople are they supposed to hire – surly jerks?

In the same American Medical News article, Pamela Marinko, CEO of Proficient Learning (www.proficientlearning.com), a North Carolina-based pharmaceutical and biotech industry training organization, is quoted refuting much of Ahari’s allegations. She says he “cherry picked” prevailing practices and “served it all up in a negative light.”

Ahari’s allegations are, “the very kind of thing that give drug reps such a bad reputation,” Marinko says. Physicians, she notes, can discern “what’s a pitch and what’s not a pitch. The notion that friendship sells is demeaning and belittles the physician. It’s absurd to suggest that a physician would make a prescribing decision based on whether he liked a drug rep.”

By contrast, Howard A. Brody, MD, the director of the University of Texas Medical Branch’s Institute for Medical Humanities, agrees with Ahari that physicians who spend their workdays facing unruly and demanding patients may look forward to the opportunity to talk with friendly sales reps.

Doctors who speak with sales reps, Brody tells American Medical News, “feel better about the world rather than it being one more drain on you. The relationship of the average physician and drug rep depends on mutual denial that this is about selling. It could be about friendship, education, information – everything but sales. But the drug rep’s job really is to push all the physician’s buttons and pretend they’re not pushing the buttons.”

Experienced pharmaceutical sales reps might respond that education and information are integral elements of the selling process, and help physicians make better prescribing decisions. They might, that is, if they weren’t too busy destroying health care in America. And melting the polar ice caps.