PLoS Medicine: How Drug Reps Make Friends and Influence Doctors

The article title is a word play on Dale Carnegie's bestseller How to Win Friends and Influence People and is co-authored by a former Eli Lilly drug rep who was featured on YouTube describing the tactics used to convince doctors to prescribe Zyprexa:

Following the Script: How Drug Reps Make Friends and Influence Doctors. Fugh-Berman A, Ahari S (2007). PLoS Med 4(4): e150.

"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.

During training, I was told, when you're out to dinner with a doctor, “The physician is eating with a friend. You are eating with a client.”

Table 1 in the article lists Tactics for Manipulating Physicians.

In conclusion, the authors claim that "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."

You just have to love the license of the journal:

"Everything we publish is freely available online throughout the world, for you to read, download, copy, distribute, and use (with attribution) any way you wish. No permission required. Read a detailed definition of open access."

The former pharmaceutical representative Shahram Ahari describes the tactics he was supposedly advised to use in order to convince doctors to prescribe Zyprexa (olanzapine).

Following the Script: How Drug Reps Make Friends and Influence Doctors. Fugh-Berman A, Ahari S (2007). PLoS Med 4(4): e150.
How I Did It: The "Confession" of a Zyprexa Drug Representative on YouTube
Link via The Patient's Doctor.
Image source: Wikipedia

Related reading:
Lilly Considers $1 Billion Fine to Settle Case. NYTimes, 01/2008.
How to be a drug rep. Half
Drug company official praises "smoke-and-mirrors job" by Seroquel project physician in emails. NYTimes, 02/2009.

Updated: 02/27/2009

1 comment:

  1. A big hurdle with the Zyprexa issue is Lilly's credibility over their continuous PR on how they are going to pay out $1.2 billion in damages.As long as they keep up this rhetoric and don't actually pay the issue won't go away.

    Daniel Haszard took zyprexa 1996-2000 gave me diabetes