Docs and Big Pharma

Prepare yourself for a seemingly boring piece of news: GlaxoSmithKline has announced that it’s changing the way that it incentivises its sales staff. And the way that it pays doctors.

The announcement is receiving an unusual amount of coverage for something that appears to be a minor shift in an internal compensation policy. So at the risk of being a bit patronising to some of my readers, this post is going to explain why it’s important.

An Introduction

I have a friend that does not believe in Western Medicine. Instead, he/she goes to have his/her chakras cleansed with a tea therapist that floats a pendulum over a chart of flowers and then makes hot beverage with whatever blossoms are at hand. Payment takes place on a credit card, and the consultation fee is pretty close to a standard GP visit. You also get extra blooms for a little pick-me-up later in the week.

Of course, these visits are repeat business for the tea therapist.

There are two ways to look at this:

  1. Either it’s working, and the client returns because it’s working; or
  2. It’s not working, and the client is a fool.

Since I’m a believer in Western Medicine, I clearly vote with the latter. My descriptive phrases of choice in reference to homeopathy and such are “hokum” and “unadulterated placebo effect”. Not that I’m biased or anything.

That said: if you were looking for some good reasons to distrust Western Medicine, you wouldn’t have to look too far.

Where Capitalism and Desperation Meet 

Let’s say that you’re unwell: suffering from fevers and boils and halitosis. So you visit your GP, who writes you a prescription and charges you a consultation fee. And then you go to a pharmacy and hand your money to a pharmaceutical company in exchange for antifungals or whatever.

big pharma 1

Doctors in this case are meant to be nothing more than middlemen, offering you an independent and objective opinion as to the best treatment for your specific condition.

In fact – they’re not meant to be independent. They’re meant to be on your side. You, after all, are the one paying them for their advice.

However, if I were the pharmaceutical company in question, I would reason the following:

  1. I can’t stand the competition.
  2. My product is better than theirs. And even if it isn’t, I don’t care. I want my drugs to be the ones that people take.
  3. I could market the drug to the people that will be taking it – but that’s no good, because they can’t self-prescribe.
  4. I need to go after the prescribers.
  5. It’s not that I want them to prescribe my products unnecessarily (well, not per se), I just want my drug to be front of mind each time they come to write out that script.
  6. So let me date them. I obviously need to educate them about my products, so I’ll organise some conferences. In Hawaii. And Venice. In 5 star hotels. And I’ll pay for it.
  7. And maybe I can pay leading specialists in specific fields to give speeches about my product at these events. I’ll, um, compensate them for their time spent reading the research and preparing a presentation.
  8. Then, I’ll get sales representatives to visit the doctors regularly. Take them for lunches and such. And I’ll reward those sales reps according to how many drugs get sold.

Things begin to look like this:

big pharma 2It’s the type of system that’s focused on the sale of more prescription medication, regardless of whether it’s required.

And then you get:

Prescription Drug Abuse

GSK’s Announcement

GSK announced the following:

  • sales representatives will no longer be rewarded for volume, but instead will be rewarded based on their technical knowledge and quality of service provided;
  • “healthcare professionals” will no longer be paid to speak on GSK’s behalf; and
  • conference attendance will no longer be funded directly by GSK, but rather through “unsolicited independent education grant routes”.

Which is actually a drastic overhaul of the status quo.

Of course, it’s going to be bad news for GSK shareholders.

But still, maybe it’ll also be bad news for flower/tea therapists. Because once you remove the glaring problem of incentives, Western Medicine might be able to offer a less obviously biased opinion on the medication front.

Although that would be a rational decision. And perhaps that’s expecting too much from flower therapy patients.