Thursday, August 13, 2009

Digital Drug Detailing by Jim Hamilton


While watching the evening news recently, I was astounded by the number of pharmaceutical ads that were being aired during the commercial breaks. They were relentless: ads for male impotence, hair loss, frequent urination, heart disease, high cholesterol, peripheral artery disease, depression, sleep and digestive disorders, asthma, herpes, various cancers and diabetes. Post-menopausal women were targeted for osteoporosis, fibromyalgia, restless leg syndrome, seasonal allergies and malaise, Alzheimer’s, bowel irritability and involuntary flatulence.

This in-your-face marketing consistently extols the product benefits, minimizes adverse effects, and neglects to mention the medication cost. For example, one highly advertised blood thinner is not much better than aspirin in its platelet activity, yet is about 100 times more expensive. The rule of thumb for consumers should be, if Big Pharma is marketing the hell out of a drug, it’s probably very expensive and you don’t need it.

I thought all this direct-to-consumer (DTC) marketing had finally reached its zenith in today’s media: radio, TV, movie trailers and print, but then I read an article in the February 5, 2009, Pharmaceutical Executive Newsletter “The Future of Media and Social Influence Marketing.” This article discussed the grand scheme of Big Pharma as it enters the digital world with its need to expand its influence into Facebook pages, MySpace, corporate blogs, YouTube health channels, and any digital source that will allow it to advertise. The author called this “social influence marketing” and the major issues proponents are most concerned with are not regulatory ones that may be mandated by the FDA or FCC, but figuring out how to minimize adverse event reporting and cultivate off-label drug discussions. Physicians, and even patients, can now interact directly with manufacturers online via the blogosphere to exchange information about new medicines and the latest clinical data on these drugs.


Now drug information will be discussed on digital social networks by anyone and everyone. Pharmaceutical companies have already downsized their sales forces and replaced them with part-time contract representatives (sample droppers). These temporary reps discuss very little drug information with physicians and are essentially UPS/Fed-Ex operators clothed in better suits. So in addition to seeing fewer pharmaceutical representatives – which is probably OK – doctors can now look forward to increased electronic apothecary misinformation.
Younger patients currently text one another [WAT RU TKN 4 UR HRPS?] to share the latest anecdotal drug info they receive on YouTube, or for example, some celebrity blog that may have dismissed the importance of childhood vaccines because they cause autism. This quote from online marketer Mike Luby (TargetRx) could be straight out of Dilbert: “Companies that flourish going forward are going to be able to integrate feedback on the full breadth of the marketing mix to determine the forces that are moving their markets and deploy their sales and marketing resources to the areas of greatest opportunity. This holistic, multi-channel approach is true closed-loop marketing, and I believe companies that establish leadership positions here are going to reap huge benefits.”


This scenario reminds me of that old adage about IBM computers in the ‘60s, “Garbage in, garbage out.” Dispensing drug information by amateurs across the electronic highway is new-age methodology similar to advice given out fifty years ago by your know-it-all Aunt Minnie. She wasn’t a doctor, but by God she knew how to diagnose and treat Strep throat. I don’t think I’ll call (not text) my doctor before I take another drug – I’ll just check with Aunt Minnie in the rest home first.