Glaxo's Prescription for Big Pharma Falls Far Short of Curing Industry Ills

Company President's Actions Don't Appear to Match Up With Her Words

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Rance Crain
Rance Crain
My wife, Merrilee, and I went to see "Love and Other Drugs," the movie about a womanizing Pfizer drug salesman and his girlfriend who suffers from the early stages of Parkinson's disease.

The guy, played by Jake Gyllenhaal, uses his way with the ladies to get into doctors' offices and replace Prozac antidepressant samples with his company's Zoloft. The sales reps are taught to sell the off-label capabilities of their drugs as a way to boost sales.

And when Viagra is introduced, he promises to give doctors all the samples they want if they prescribe other Pfizer drugs. If he hits his prescription numbers he's told he'll be promoted to the "promised land" of Chicago.

Deep down, though, Mr. Gyllenhaal's character has a good heart. While masquerading as an intern, he meets Maggie Murdock (Anne Hathaway) and eventually falls for her, learns everything he can about Parkinson's disease, commits himself to taking care of her, quits Pfizer and enrolls in medical school.

The movie is based on the book "Hard Sell: The Evolution of a Viagra Salesman" by James Reid, and as he explains in an interview, "everybody is trained to think and claim to be doing the right thing. That they're looking out for the doctors' and patients' best interest. But every drug rep has been trained that their drug is the best. So, when everybody's coming to the doctor saying their drug is the best, well, how could that be? Somebody's drug isn't the best."

Deirdre Connelly, president of GlaxoSmithKline's North American pharmaceutical unit, must have seen "Love and Other Drugs" and maybe even read the book. She acknowledged in an industry speech that "in some ways our industry has lost its way." But after reading her speech, I'm not so sure that she's doing much to get the industry and her company on the road to recovery.

Just like the movie depicted, she said the industry "relied on a competitive selling model based on sending in ever-greater numbers of sales representatives to call on a single doctor. The focus was on reach and frequency -- reach as many doctors as possible and provide them with our messages as often as possible." From now on, she said, Glaxo drug reps will not get bonuses based on sales targets but on criteria like overall performance of their business unit and assessment of their scientific and business knowledge. But who will make that assessment -- their doctor and hospital buddies?

Ms. Connelly pledged Glaxo won't blanket the airwaves with Levitra ads, but Glaxo hasn't run a TV commercial for its third-place erectile-dysfunction drug for a couple of years. And as pharmaceutical blog Pharmalot commented, "Of course, Levitra continues to trail Pfizer's Viagra, so saving money on an also-ran is a relatively easy move."

Ms. Connelly asserted that her sales reps are trained to emphasize the label restrictions of their drugs. But she also maintained that if doctors want to prescribe drugs for off-label symptoms, that's up to them. It's the doctor's job to determine "the appropriate drug for the appropriate patient in his medical opinion."

I also think Ms. Connelly is raising yet another strawman when she claimed some doctors participating in speaker programs for Glaxo are unhappy that they can't use their own slides, noting that the company wants to be sure that all info on its medicines -- both benefits and risks -- is presented in a "fair and balanced way." I can't imagine why this restriction should upset doctors getting paid to spread the word about the wonder of Glaxo drugs. After all, they're giving a canned pitch approved by Glaxo; why not use their slides, too? Then all they'd have to do is show up.

The reaction to Ms. Connelly's talk on Glaxo's bulletin board where the drug reps hang out: "So far the anonymous pollsters aren't loving it," reports NPR's health blog. And this from Pharmalot: "Like it or not Glaxo execs remain on the hot seat. The drugmaker has simply stepped in poop too many times in recent years. ... What went wrong? What didn't?"

Merrilee and I give "Love and Other Drugs" three stars. It was a saucy and frothy yet heart-warming tale. I was not, however, as captivated by Ms. Connelly's efforts to cure the ills of Big Pharma.

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