(NaturalNews) An article published in the British Medical Journal, also known as BMJ, has revealed the extent to which pharmaceutical companies go to turn influential senior doctors into undercover salespeople for their drugs.
"Key opinion leaders were salespeople for us, and we would routinely measure the return on our investment, by tracking prescriptions before and after their presentations," said Kimberly Elliot, who worked for 18 years as a sales representative for major drug companies. "If that speaker didn't make the impact the company was looking for, then you wouldn't invite them back."
Elliot worked for companies including Novartis, SmithKline Beecham and Westwood Squibb from the age of 23, until deciding that she was disillusioned with the business in 2007. A major source of her dissatisfaction was the industry's increasingly aggressive marketing practices.
Richard Tines, the medical director for the Association of the British Pharmaceutical Industry, also admitted to BMJ that so-called "key opinion leaders" (KOLs) are a major part of drug companies' marketing strategy.
"Companies will employ consultants to help advise on marketing strategies ... and present and speak at conferences," he said.
But the drug industry's strategy involves significantly more than the payment of consulting fees. There is an entire practice built up around cultivating KOLs and using them to greatest effectiveness.
An article published in the industry magazine Pharmaceutical Marketing promises to reveal the "tricks of the trade" for making KOLs into "product champions." The first step is to "evaluate [the] views and influence potential" of doctors who might make good KOLs. The article stresses that companies should not target just senior doctors who are already influential, but also doctors "who may be further down the influence ladder." In the latter case, the company should then work to "raise their profile, and so develop them into opinion leaders."
After developing relationships with current or potential KOLs, drug companies are advised to supply them with "appropriate communications platforms" to "communicate on your behalf" with patients, doctors and the public in general.
As part of this practice, KOLs may be paid up to $400 per hour for giving presentations at conferences - presentations that have often been prepared ahead of time by the drug companies and take place at company or industry-sponsored "educational" events. A single "scientific speech" may net a doctor over $3,000, and some popular KOLs may make more than $25,000 per year from advisory fees alone.
Elliot emphasized the importance of these practices to maintaining company profits.
"There are a lot of physicians who don't believe what we as drug representatives say," she explained. "If we have a KOL stand in front of them and say the same thing, they believe it."
Elliot regularly paid KOLs $2,500 per lecture. These payments were sometimes concealed by having the drug company pay an academic center, which would then make a separate payment to the doctor.
Another key component of the drug industry's strategy is keeping track of KOLs and evaluating their performance. Failing to do so, the Pharmaceutical Marketing article warns, can lead the company to "[waste] money on the wrong people."
A company called KOL actually specializes in helping drug companies with this function, even offering software custom-made for the purpose. The company's Web site highlights the degree of influence wielded by KOLs: although "thought leaders ... may not write many prescriptions, [they can] influence thousands of prescribers and hence prescriptions through their research, lectures, publications and their participation on advisory boards, committees, editorial boards, professional societies and guideline/consensus document development."
According to Elliot, such doctors forfeit their independence when they agree to take money to promote a corporate message.
"These people are paid a lot of money to say what they say," she said. "I'm not saying the key opinion leaders are bad, but they are salespeople just like the sales representatives are."
Tiner agreed with this appraisal.
"When these people are receiving a fee, they are in one sense in the employment of the company," he said.
At the end of the day, however, Tiner sees nothing wrong with the practice. He rejects the accusation made by many pharmaceutical industry critics that drug companies are bribing doctors to push their products.
"I don't think they are bribes," he said. "It's payment for work done, rather than a bribe."
He did agree that practices such as paying doctors to give presentations at conferences "might help to promote a particular medicine." The way to avoid letting paid KOLs have undue influence, he said, is more transparency. Companies should make it a regular practice to disclose any fees they have paid to speakers or other presenters at conferences or medical meetings.
David Blumenthal of Harvard University, who specializes in studying the connection between doctors and the pharmaceutical industry, agreed that there is nothing illegal or even necessarily crooked about the practice of cultivating company KOLs. But he disagreed with Tiner's assessment that the practice is harmless. While paying KOLs is not necessarily corrupt, he said, it does run contrary to the public interest.
"I think these are legal relationships between consenting adults who have overlapping interests that are not consistent with the interests of the larger society," Blumenthal said, "or necessarily with the patients served by these physicians."
Elliot advises doctors to remain skeptical of presentations that they see at conferences and educational events, especially those related to drugs or medical devices.
"Take them with a grain of salt," she said, "and go back and do your own research."
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