feels that way…

Posted on Monday 19 May 2014

Howard Brody has an interesting post based on his junk mail:
Hooked
by Howard Brody
May 14, 2014

Back in 2011 I heard from Cutting Edge Information on the subject of key opinion leaders [KOLs]:
I figured that once I outed them on this blog, they would know better than to send me any more e-mails, but apparently they are still at it; the cold-call e-mail that’s reprinted below arrived this week. The content would seem to suggest that Pharma firms are having greater difficulties finding “Key opinion leader” physicians [aka shills] due to the increased transparency requirements of the pending Sunshine Act. If this is the case, then of course it is what I have been advocating for years. I read both the e-mail and the attached detailed brochure but could not find a figure as to the actual cost of this 179-page report, so you’ll have to contact Cutting Edge Information directly if you want to buy a copy. [I have a feeling there might be some sticker shock]…

He goes on to reproduce their email, brochure, and a link.
The Cutting Edge Information website is actually worth looking over. It’s filled with stuff like this:
    Addressing Physician Needs through Customer-Centric Commercial Strategies: Many medical device and pharma sales forces are adopting more customer-centric approaches. These commercial models move away from purely product-driven conversations to focus on — and meet — physicians’ and patients’ needs while educating them on key products. Customer-centric sales representatives must work to bring value to their target physicians and patient populations. Many teams focus on finding best-fit product solutions for specific practices. Teams also seek out opportunities to package these products with value-adding materials such as education- and support-based websites or applications…
After chuckling at all the lyrical business-ese and marketing language, there’s a more ominous dirge playing in the background. This company sells reports and presentations for pharmaceutical sales staff and marketeers focusing on ways to game the system – like ways to get around the impact of the Sunshine Act, ways to extend direct-to-consumer advertising, ways to better utilize existing KOL pools, ways to enhance LCM  vis-à-vis ROI [Life Cycle Management, Return On Investment], etc. etc.

A few years back, I wrote a post [rip van winkle… ] in which I analogized myself to Rip Van Winkle, Washington Irving’s fictional character who slept for forty years and awoke to a world he didn’t understand. I claimed that my cloistered practice had been a similar hibernation, and that the psychiatry of today was unrecognizable to me. At the time, even I thought I was being melodramatic with that analogy, but now I think I was right after all. But it’s not just psychiatry, it’s Medicine in general. I’ve finally gotten old enough to be visiting doctors myself, and the taint I’ve written about in psychiatry is everywhere.

This Cutting Edge Information company basically functions by taking every aspect of running a pharmaceutical company and surveys the whole industry, collecting the various companies’ ways of approaching the problems, then puts together documents and presentations to sell. It’s marketing research on marketing, and they thrive on attempts to curb the out of control industry marketing techniques. Each new regulatory hurdle is just another market for their materials about how to get around it. Think I’m kidding, just dance around in their site for a while – at least for as long as you can tolerate their strange jargon.

And at the risk of beating a dead horse, Cutting Edge Information has nothing to do with whether the drug in question is any good, or if it’s safe – just how to sell more of it. And since they’ve discovered that their bottom line is total pills sold, they’re getting into the medication compliance business.  In psychiatry, we’re also well aware of how LCM [Life Cycle Management] as in indication sprawl, patent extension, dissuading generics, patenting XR versions or nearby chemical clones, have all have become routine practices.

Science Fiction thrives on taking some aspect of modern life and extrapolating it to absurdity as a cause for the apocalypse.  Historical fiction does the same thing by projecting our modern absurdities into the past. But here in the present, we’re sentenced to ponder and decry them without knowing where they’ll lead. It seems to me that the intrusion of raw capitalism into the field of medicine has reached a tipping point, one of those places that drive radical evolution or revolution. But I almost always feel that way about the things I don’t like. More likely, things have to get worse before they get better, and this isn’t the worst – though it sure feels that way…
  1.  
    Steve Lucas
    May 20, 2014 | 11:52 AM
     

    The first day of my first sales class the instructor opened with this statement: Nothing happens until something is sold. While this has many connotations pharma has taken this to mean sell at any cost.

    Professional reputation, financial hardship, and even death are not to deter ever increasing sales.

    This is what drives pharma, nothing else, sales.

    Steve Lucas

  2.  
    Bernard Carroll
    May 20, 2014 | 12:25 PM
     

    Read Systems of Survival by Jane Jacobs.

  3.  
    Arby
    May 20, 2014 | 7:03 PM
     

    Dr. Carroll,

    I was unable to find this book in the SUNY system, yet I’ll keep looking. For what I was able to pick up on Wikipedia, I can say that I’ve seen evidence that both sets of moral precepts are mixed together in a tangled mess in the business world.

    Yet, I am curious to know how individual morality fits into all of this. Most precepts on the Commerce side are taught as virtues while only a few on the Guardian side are. And, also, how one precept overrides another (i.e., there’s a terminal optimism in business that shuts down valid concerns. So, does this then become deceit?)

    If these are covered in the book, no problem. When I can locate a free copy, I’m sure I’ll read it.

  4.  
    May 20, 2014 | 10:14 PM
     

    I found a used copy for $0.48 + postage on Amazon…

  5.  
    Arby
    May 21, 2014 | 5:08 AM
     

    Dr. Nardo, I appreciate you sharing this. Personally, I’m really rather on a quest right now. With five private colleges nearby and a countywide library system, odds are good that I can read it on loan. However, if all else fails, Amazon FTW!

  6.  
    May 22, 2014 | 1:41 PM
     

    Aren’t KOLs simply being put on the payroll now?

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