Purdue's Point of No Return

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Purdue Pharma's decision to stop detailing OxyContin to doctors was an important step on the road to recovery for the way opioids are marketed in this country, and possibly for industry's reliance on personal promotion.

The move highlights what has for years been the biggest part of healthcare marketing budgets. Results of MM&M's annual Healthcare Marketers survey, which we'll be releasing in full next month, show that, once again, the largest percentage of biopharma and medical device marketers' budgets was devoted to sales reps (17%).

I won't speculate as to why Purdue decided that now is the time to pull the plug on direct sales, when the opioid and heroin overdose epidemics have been raging for years, taking a huge toll on Americans and our healthcare system.

See also: Purdue Pharma stops marketing opioids to doctors

Nor will I ponder (too much) what exactly motivated the decision, which came days before the Senate's homeland security committee released a report showing Purdue and other opioid makers gave millions to third-part advocacy groups, who allegedly oversold the drugs' benefits and encouraged overprescribing. 

Suffice it to say that taking reps off the street is a significant decision. There's a reason the sales channel commands the lion's share of budget year after year. 

Granted, healthcare marketers are embracing an expanded view of their customers, as the notion of "doctor as consumer" gains steam (no, they don't live in their offices or carry on conversations solely with drug reps). You'll see the ongoing transition toward non-personal promotion as you read the full results of our survey, again due by early next month. 

But I'll venture to guess that the conversations at Purdue HQ had less to do with that than with some kind of preemptive self-regulation. Critics and industry insiders alike have said a revamp of opioid marketers' playbook was long-overdue. Legal claims from county and state governments seek money and changes to how the opioid makers operate, including an end to the use of outside groups to push their drugs. Was a government crackdown coming? 

See also: MM&M's Data Week: Demystifying one of pharma's biggest pain points

Or, was it simply a matter of diminishing returns? The use of KOLs for opioid education has caused an uneasy relationship, and some have already chosen to eliminate all association with pharma. A significant percentage of execs from health systems and hospitals had planned to restrict opioid prescribing practices in 2018, anyway, amid an increasing number of "no-access" physicians. 

Indeed, we may never know the precise reason. In terms of the impact, pundits don't expect that cutting off physicians' sales-information channel will really curtail opioid prescribing. However, even if every other opioid manufacturer had already ceased such practices and Purdue's was merely a symbolic gesture, we've just witnessed what I believe is the tipping point in what has been an over-reliance on personal promotion. 

And not just in the pain market. Many in the industry at large have called for the entire sector to accelerate the remaking of the biopharma commercial model in a digital vein, with heavier reliance on medical affairs and only select uses of reps. A year from now, we could look at Purdue—even with all its missteps—not as a pariah, but quite possibly as a presage for how the entire industry markets.

Marc Iskowitz is editor-in-chief of MM&M. 

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