The dilemma of the pens
As of the first of the year the Pharmaceutical Research and Manufacturers of America (PhRMA code) forbade the distribution of such goodies as pens or mugs with product logos. It's been estimated that industry spends as much as a billion dollars a year on such trinkets.
But what's supposed to happen to all such pens doctors already own? Could they not influence the writing of prescriptions? If they don't, what is the logic of banning them from now on?
So what are pharmaceutical companies supposed to do?
Sending out the sales force to collect them seems wasteful and impractical. But suppose Pfizer sets a good example by collecting all its pens. After all, this is the company that responded to criticism of commercial contamination of CME by refusing to work with for-profit education companies. Would Lipitor sales go down? Or might they go up?
In that case, industry critics would presumably charge that the company had engaged in a cute maneuver to create an opening for a product pitch.
Maybe the companies could ask doctors to send them back. That's not likely to work because presumably they like their pens. Walk into any doctor's office, and you'll see collections of them if not on the doctor's desk, then on the receptionist's, quite likely in a logo-fied mug.
That leaves only one alternative—do nothing. Let the doctors keep the pens they already have. But in that case commercial corruption of prescribing will continue.
Explaining the new code provisions, Billy Tauzin, PhRMA's CEO, said: “This updated code fortifies our companies' commitment to ensure their products are marketed in a manner that benefits patients and enhances the practice of medicine. Simply put, it marks a renewed pledge to ‘practice what we preach.'”
Tauzin added that he hopes all companies that interact with healthcare professionals will adopt these standards, and judging by the response of some 40 companies, that hope has been fulfilled.
So far, most major companies have told PhRMA that they are complying with the new code, including Merck, Pfizer, GlaxoSmithKline, Roche, Johnson & Johnson and AstraZeneca.
But what if the rationale for the new code is based on a fallacy, and the organization has responded unnecessarily to anti-industry hysteria?
Just suppose that doctors are not that susceptible to persuasion, hidden or overt—that instead, they are intelligent men and women whose training has taught them to examine the evidence and make up their own minds. Could that be proved? How about a survey? The sponsor should be someone without a dog in this race. Call the doctors at home and ask them to name the companies whose pens and mugs are on their desks.
If PhRMA were to conduct it, critics would immediately discount the results. I nominate Project HOPE, publishers of Health Affairs—that would also provide a venue for disseminating the results.
Two groups would not be happy if the outcome proved my contention that doctors can't be seduced by trinkets: industry critics and the less imaginative marketers who have come to rely on pens and mugs.
But most marketers have proved to be adaptable. After all, they're learning to live with the new PhRMA code.
Warren Ross is editor at large of MM&M