Marketing Pharmaceuticals

Abstract

PHARMACEUTICAL COMPANIES HAVE STRONG ECOnomic interests in influencing physician prescribing behaviors. They advertise directly to consumers and to physicians. Beyond general marketing, manufacturers promote their drugs to physicians through “detailing”—sales representatives (“detailers”) visiting medical offices to persuade physicians to prescribe their products. By law, pharmacies receive specific information with every prescription, including the physician’s name, the drug, and the dosage. Pharmacies sell these records to prescription drug intermediaries (data miners), who use advanced computing to analyze prescriber-identified information (which physicians prescribe what drugs, in what dosages, and with what prescribing patterns). Data miners, in turn, lease sophisticated reports to pharmaceutical companies to refine detailers’ marketing tactics, armed with knowledge about physician prescribing practices—for example, who are high or low prescribers and early or late adopters of new drugs. Detailing raises vital health policy questions, including its effects on clinical decision making (safety, quality, and cost) and the patient-physician relationship (privacy and professionalism). Yet private companies claim a First Amendment right to buy and use prescribing data for product marketing. The tensions between privacy and commercial speech have deep implications for public health regulation.