Saturday, October 24, 2009

Tom and Jerry Pharma Marketing


It is really getting hot ... here in pharma marketing. There were those golden days where pharma companies used to invent a nice drug, appoint medical representatives (MRs) who would go to clinics, the doctors would welcome their presence. In these clinics the MRs would provide a detailing talk with the help of communication aids, give literatures of the clinical data, some samples for the doctor to try out the medication on suitable patients, and this exercise would create prescriptions to ensure sales of the pharma product. As a form of thanksgiving, MRs would provide doctors with small clinically relevant gifts. They were the warm sunny days of pharma marketing.

Slowly however, things got a little more complex with time ... doctors would indirectly require more inducements for prescriptions, and MRs would provide them, to increase sales and earn more incentives.

With time, more companies entered in to the lucrative pharma business and the rat race got more fierce. Doctors would get pampered with cash, gifts, sponsorships to medical conferences and other things and the pharma marketing game became a lot more fiercer. The warm sunny days of pharma marketing gave way to hectic stress filled days of hot oven pharma marketing.

Sales and marketing pressure became the order of the day in pharma companies. Earlier, it was a patronizing atmosphere in pharma companies and at clinics. Managers would patronize their MRs, doctors would patronize MRs and so on. Today, it is a game of pressure tactics, negotiations, inducements and just about everything to generate prescriptions, and sales.

Pfizer: in an unenviable position

The above pharma marketing picture is reflected in La-affaire-Pfizer. Just imagine the predicament of Pfizer. On one hand, there is a huge pressure to maintain the topline and bottomline. On the other hand, the new drug R & D pipeline shows no promise of a blockbuster drug and the pharma market gets commoditized with severe competitive pressures.

Now, if Pfizer does not shore up sales, it will lose its pole position in the global pharma firmament. There is, after all, a lot at stake - shareholder value, share price value, profits, sales, its position as the numero uno pharma company, its reputation, and so on.

In this backdrop, Pfizer did the most logical thing - upped its sales generating tactics. Pfizer focused on strengthening its sales of promising products (like Bextra the withdrawn valdecoxib brand,Geodon (antipsychotic - ziprasidone HCl), Zycox (linezolid) and Lyrica (pregabalin)), and Pfizer even went in to off-label promotion and special services to doctors (kickbacks), which were risky from the legal point of things.

However, Pfizer did it with courage because it still had a mindset of operating in a patronizing atmosphere. BUT LITTLE DID PFIZER REALIZE, THE RULES OF THE GAME HAD CHANGED ...

Whistleblowers took advantage

Whistleblowing is an interesting phenomenon. Whistleblowers are persons who raise concerns about wrongdoings in an organization. Normally, whistleblowers are part of the organization. Whistleblowers voice their concern internally or externally and may take their complaints to legal authorities of the wrongdoings in the organization. If whistleblowers are proved right, the organization pays for it - in terms of criminal fees and also sees its reputation fall. Whistleblowers are not only pharmaceutical personnel, the tobacco industry too has seen a famous whistleblower (Jeffery Wigand). There are governmental and nongovernmental whistleblowers (many of them Indian) too.

This is exactly what happened in La-affaire-Pfizer. Due to wrongdoings of Pfizer in its marketing activities, 6 whistleblowers were paid by Govt. of USA a total of 102 million USD. John Kopchinski got the lion's share of 51.5 milion USD. The other whistleblowers who earned millions include Stefan Kruszewski (29 million USD), Ronald Rainero (9.3 million USD), Glenn DeMott (7.4 million USD), Dana Spencer (2.7 million USD), and Blair Collins (23.54 million USD). Pfizer's marketing activities has been dubbed fraudulent marketing. Pfizer's financial damage due to this event is 2.3 billion USD to resolve the criminal and civil healthcare liability. Of course, it has also damaged Pfizer's reputation too. That is incalculable.


Pharma marketing is entering in to a new era of a cat and mouse game. IT IS THE ERA OF TOM AND JERRY MARKETING. Pfizer's historic fine of 2.3 billion USD is a watershed event in the history of pharma marketing. It is a major wake-up call to pharma marketers. Gone are the patronizing days in pharma marketing. There is nothing funny about TOM AND JERRY MARKETING. It is in fact painful to the pharma marketer.

It would not be an exaggeration to say that we may even start having doctors acting as whistleblowers, and others who want to point out wrong doings and make a fast buck (AFTER ALL WHO IS PERFECT? IT IS EASY TO POINT OUT WRONG DOINGS AND PUNISH, BUT IT IS DIFFICULT TO TAKE RISKS TO ACHIEVE AN OBJECTIVE.).

Risks in pharma marketing

The whistleblowing event mirrors the minefields in pharma marketing. Step on a legal mine, even accidentally, and BOOM it goes on the face of the pharma marketer. It is time to put processes above targets. The race for numbers is fraught with risks. Processes in marketing should be robust and bullet proofed. Nos. can wait, there is no point in being No. 1 in the pharma market if you have to cough up billions of dollars AS FINE and get your reputation tainted. In business, reputation is paramount. Goodwill of a concern, if lost, causes incalculable damage. Today, in trader language, Pfizer is only a sophisticated PCD (propaganda cum distribution) company. In India, we have plenty of PCD companies. They cater to every whim and fancy of doctors to gain prescriptions and sales. So it is time to work out processes in pharma marketing that will bullet proof the organization from the legal mine fields.

Pfizer: the master marketer

Pfizer's corporate USP is their marketing ability. If one goes to the crux of Pfizer's controversial marketing tactics one realizes that they once again proved that they (Pfizer) are masters of marketing. All along in their controversial marketing activities, Pfizer positioned Bextra for acute pain, surgical pain, and other unapproved uses, created sales materials and messages, to promote Bextra for these uses, commissioned market research to test its sales materials, confirmed these unapproved messages and allowed the promotion of Bextra for these purposes to continue. So what this indicates is that all the kickbacks and other activities were done to strengthen MESSAGING. Exactly, this is what brings in business. Messaging. This is what Pfizer the master marketer did. It focused on messaging (kickbacks, gifts etc were used to create the platform for messaging). That is the mastery of Pfizer. Its power in the market is not from its gifts, or kickbacks - IT COMES FROM ITS POWER OF MESSAGING. Master marketers are great at messaging. Pity, the messaging tactics backfired for Pfizer in this case.

Pfizer is not really to blame

Pfizer has acted as a professional marketer. One has to realize that in pharma business, pharma marketers message to informed target customers ie., doctors. It is different from consumer marketing, where messaging is done to ignorant customers. Doctors, on the other hand are educated and informed customers. They have the ability to discern, and they are at a liberty to reject messages. Of course, Pfizer the master marketer should take some rap for overzealous marketing, but not so much.

In the case of kickbacks, once again there is no purpose in merely rapping the provider of kickbacks. In fact, the taker of the kickbacks is at greater fault. If Pfizer is guilty of providing kickbacks to doctors, then why are the concerned doctors not booked for taking the kickbacks? Why is the PHARMA MARKETER PILLORIED? The doctor is equally guilty. The doctor who takes kickbacks is no angel!!

This point needs to be addressed in an emergency mode. Doctors guilty of taking kickbacks should be brought to book. They are the ones who patronize kickbacks from pharma companies. If a Govt. official takes a bribe, the Govt. official is arrested. Not the giver of the bribe. In the same way, the doctor who gets pecuniary and other benefits from pharma companies is more guilty of a crime against his patients than the pharma company.

A case for legal off-label product promotion

This is the age of internet and consumer led conversations. The law against off-label pharma product promotion is stone age, preinternet. It is an outdated thought to disallow off-label pharma product promotion. Suitable changes in the system ought to be made to permit valid off-label pharma product promotion. Regulation is fine. But over-regulation is stifling. If fear stalks marketing activities, creativity will be suffocated. When creative business is not permitted, progress is halted. Society suffers. In this web 2.0 era where a nobody like me can comment freely through this blog on La-affaire-Pfizer, a valid off-label pharma product promotion should be permitted, in the best interests of the modern day information society.

There are many aspects to La-affaire-Pfizer. It is easy to call it Pfizergate. It is nice to watch a formidable Goliath take a beating. But this event of La-affaire-Pfizer has many more ramifications to the PHARMA MARKETER COMMUNITY. ALL PHARMA MARKETERS SHOULD JOIN HANDS COMMUNICATE, COLLABORATE, AND RAISE VALID POINTS THAT WILL IMPROVE THE ENVIRONMENT OF PHARMA MARKETING. It is not good to market pharma products with an eye on one's back. There is no fun in pharma marketing if you are policed and in a cat and mouse game. Tom and Jerry is funny to watch, but in marketing it is no fun. Tom and Jerry marketing is most painful.

If Pfizer is trying to muzzle all conversations about La-affaire-Pfizer, thinking it is negative press, well then, it is doing more harm than good. Pfizer should use this event to stir up open debates on the state of pharma marketing today. Pfizer should get on with life, join hands & unite all pharma marketers to create a more open, trusting and transparent pharma marketing field. La-affaire-Pfizer is an invitation event for pharma marketers to join hands, address common issues, and strengthen themselves. No point, sweeping issues under the carpet.

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