Shahram Ahari, who spent two
years selling Prozac and Zypraxa for Eli Lily, 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 claims that drug companies often hire former cheerleaders and
ex-models, as well as former athletes and members of the military, even
if they have no background in science.
During their five-week training class, Ahari says he was taught sales
tactics such as:
- 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
Ahari claims that he's even heard stories about sales reps helping to
pay the cost of a doctor's swimming pool, or taking a doctor to a
nightclub where a hostess was paid to keep him company.
For this work, sales reps often earned more than researchers. On top of
a base salary of $50,000 for starting reps, Ahari says, "there were four
quarterly bonuses, an annual bonus, stock options, a car, 401K, great
health benefits, and a $60,000 expense account."
"The nature of this business is gift-giving," Ahari said, and indeed
it seems that in the world of pharmaceuticals, everything has a price.
Your Doctor
Probably Has a Relationship With a Drug Rep
It is the rare physician who refuses to meet with drug sales reps. In
fact, as of April 2007, the percentage was
just 7 percent
of U.S. doctors.
Even I met with drug reps until the year 2000, at which time I just
refused to see any. Before that 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.
So there is a very good chance that the doctor you see right now is
being subjected to similar intense sales tactics like the ones Ahari
describes. According to one study published in
The New England Journal of Medicine:
have some type of relationship with the drug industry
80 percent of doctors commonly accept free food and drug samples
One-third of doctors were reimbursed by the drug industry for
going to professional meetings or continuing education classes
28 percent of doctors have been paid for consulting, giving
lectures, or signing their patients up for clinical trials
Drug reps can be very sneaky. According to a report in
PLoS Medicine
co-authored by Ahari:
“Physicians who refuse to see reps are detailed by proxy; their staff is
dined and flattered in hopes that they will act as emissaries for a
rep's messages.”
Clearly these are no ordinary sales meetings; this is psychological
warfare.
Sales Reps are
Trained to Brainwash Doctors
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 the PLoS report. Said Ahari:
“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.”
Drug reps must target doctors because it is only through a physician
that a consumer can purchase their product. Although in the United
States they have also ramped up their
direct-to-consumer ads
on
television and in magazines, their real “meat and potatoes” comes from
their marketing directly to physicians.
This is why drug companies spend $4 billion each year on
direct-to-consumer ads in the United States, but
$16 billion to
influence physicians.
That
is $10,000 for every single doctor in the United States.
The Drug Sales Rep
Ambush
Most doctors don’t even stand a chance against a seemingly innocent drug
sales rep. They appear friendly, eager to please, and knowledgeable
about their product, and most physicians think there is no harm in
accepting a free sample here, or a free lunch there.
Well, studies have shown that those
free
samples and lunches DO impact doctors' prescribing habits.
So you can imagine what a more lavish gift -- like a free vacation,
“consulting fee” or even companionship -- can do.
What they don’t get to see is the well-oiled machine that is controlling
these reps, and ultimately the physicians as well, like marionettes.
From the instant a drug rep enters your office, the ambush is underway.
Says Ahari:
“A photo on a desk presents an
opportunity to inquire about family members and memorize whatever
tidbits are offered … these are usually typed into a database after
the encounter. Reps scour a doctor's office for objects -- a tennis
racquet, Russian novels, seventies rock music, fashion magazines,
travel mementos, or cultural or religious symbols -- that can be
used to establish a personal connection with the doctor.”
In their PLoS Medicine report,
Ahari and Adriane Fugh-Berman, an associate professor in the department
of physiology and biophysics at Georgetown University Medical Center,
even put together this chart of the specific tactics used to manipulate
physicians.
