Monday, July 21, 2008

More on Loopholes in the PhRMA Code

See below for the very helpful comment appended by Jim Edwards to my recent post:

Of the various links that Jim provided to his own writing, the most comprehensive one seems to be:

This very helpful overview makes the following observations:
  • There is an internal power struggle going on within Pharma between the sales people in the trenches, and the more centralized marketing managers. The new stress for instance on web-based marketing amounts to a victory for the latter. The new code of conduct is a further (partial) victory for that wing of marketing, since it disarms the reps of some of their historically most potent tools--the "reminder items" such as pens, coffee mugs, etc.
  • Edwards quotes an unnamed "drug marketer"-- "[Consultants' and speakers' fees] is the area where reps have a slush fund for prescribers...none of that is off the table. These were the areas that were much more abusable than pens and mugs."
  • Put the above two observations together and you get: take power away from the reps in the field, and strip them of some of their sales tools, and you can bet the rent that they will be heavily tempted to use to the hilt what they have left, code or no code; and what they have left is precisely what has already been most heavily abused as rewards for high prescribers--that is, consulting and speakers' fees.
  • The new code, of course, offers verbal cover for the industry, in promising that it won't hire any consultants unless they actually do the work they are contracted to do at a fair rate of exchange; and they won't hire speakers unless the speaker actually possess some sort of expertise. In the past, these claims have been swept aside and the payola distributed purely on the basis of rewards for the high prescribers in the region. The new code offers very few enforcement teeth to give us any confidence that it will be any different--especially since so much of the question of "expertise," fair market value" etc. is in the eye of the beholder. (Just as is a "modest" meal, probably the most-often-repeated word in the entire code.)

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