No Free Lunch – Confessions of a Poacher turned Gamekeeper…

This from the No Free Lunch confessions page

When I was young and naïve and straight out of college I thought that the Pharmaceutical industry was admirable almost altruistic (sad I know but true and we are going back almost 20 years). So I went to work in a Pharmaceutical company in Regulatory Affairs (this is the department in most companies that amongst other things is responsible for collating all of the relevant research information for submission to the Medicines and Healthcare products Regulatory Authority to be able market their products). The companies I worked for over the 6 years I worked in the industry were relatively small so my role got me involved in a number of things including how products were formulated, how they were manufactured, how clinical trials were designed and carried out, labelling and artwork (all controlled by regulations) and inevitably marketing. As my experience grew I also got involved in developing marketing strategies and training reps.

What did I learn?

(Before I candidly confess I must just say first, I left the industry over 12 years ago so what I’m about to say may not be relevant – although a piece of research I did recently suggests that what I learnt hasn’t changed much and Second, that none of the companies I worked for exist any longer so it would be difficult to prove what I’m about to say and may not be applicable to any current company – on the other hand as most companies don’t necessarily publish everything they do its very hard to say that it doesn’t!!!!)

I learnt that the key to the Pharmaceutical Industry’s success is control over information

“Control one” – in doing clinical trials you need to choose your investigator carefully, you need an opinion leader and then you need to tie them up in a contract so tight that they cant publish (or say) anything about the results of the trial good or bad without your agreement first.

“Control two” – you don’t ask a research question you don’t want to know the answer to (usually the one you don’t ask is “is your product as good as or better than the current gold standard?”)

“Control three” – when teaching reps about new clinical trials you draw out quotes to highlight the good parts and show them how to skip over the criticisms/flaws of the trial (like its relevance to the wider population)

“Control four” – you don’t publish anything in full that doesn’t show benefit or you only publish abstracts which aren’t peer reviewed (yes I know its obvious now but 12 years ago it wasn’t).

I also learnt that strategic marketing can make all the difference – a good plan of action is essential – by pin pointing strategically the opinion leaders in secondary care (usually Consultants) you can have an impact on the prescribing of up to 150 GP’s (or more if it is a teaching hospital) and if you offer a product at a ridiculously low cost to Hospitals but charge a premium in primary care you can make a huge difference to your profits.

The key point for companies is increase the market share – your competitors gain but so will you … ”penetration of new drugs is greater than gap perceived.” MacGavock et al BMJ Aug 93 and also …“success depends more on creative marketing than innovative research” Ill-advised rep from a pharma company

I also learnt having been involved in a couple of drug withdrawals that – today’s wonder drug is tomorrow’s problem.

Last but not least I learnt cynicism – no matter how much “idealism” there maybe in individuals in the pharma industry and no matter how companies tell you their researchers are altruistic and on a mission to “save lives” – “companies” are there to make a profit and individuals research/projects will only be taken up if it is likely to be profitable. (Note the lack of investment in research for topical or rare diseases prevalent in third world nations and the desire of companies to medicalise certain conditions that they can treat symptomatically but not cure – after all there is no comparison in the profit gained in curing conditions compared to the profit in long-term treatment of symptoms.)

The rest of the No Free Lunch site is well worth a look at.

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