Pharmaceutical sales ethics

When it comes to pharmaceutical sales ethics, the pendulum has swung between very lax and very strict over the years. For many years, the pharmaceutical companies have been accused of using its sales force to ‘bribe’the doctors to prescribe their drugs. Its been said that with the latest ethics and compliance programs, pharmaceutical sales reps are once again working in a stricter ethical environment. Or are they? There's been plenty of publicity about how sales reps are toeing the ethical line with respect to accessing physicians and promoting pharmaceuticals, but still there are claims that some companies are evading the guidelines with an eye to securing profits.

In recent years, it isn’t uncommon to see doctors being treated to many sorts of royal treatment. The belief among the sales force reps being that without being able to offer prime seats to a baseball game or some other gift or perk, getting a physician's ear can be difficult. Many of the tactics used to lure physicians into prescribing medications are coming under fire. Incentives ranging from pricey vacations, front row ballpark tickets to outright financial rewards are increasingly viewed as unethical.

I have been interning with a pharmaceutical company and the message our company is sending to its reps can be viewed as very ethical. The sales reps are asked to put new emphasis on relationship building. One way in which some sales reps are working to create and strengthen ties with doctors is by positioning themselves as educational resources. The pharmaceutical companies used to invite physicians to attend lectures, which were followed by some special event such as a ball game or golf outing. But now, these dinner meetings feature a modest meal and a lecture by a guest speaker. While many pharmaceutical companies appear to be making adjustments to follow the new ethics, it is still believed that some are skirting the issue with secret strategies such as off-label marketing, the marketing of drugs for purposes other than those approved by the FDA.

The rep is not supposed to go out there and tell a doctor to use a drug for off-label purposes. The doctor is supposed to make the initial inquiry, but it doesn't always happen that way. Drug companies may be cutting back on the actual overt payments and golf trips, but reps are paying doctors to prescribe drugs for off-label purposes just to boost sales and with no proof of the drug's efficacy for that off-label purpose. Big names such as Pfizer, Merck and Astra Zeneca have recently been warned by FDA for off-label usage on their blockbuster drugs.
But with FDA approval process taking longer and getting tougher, companies are trying to find ways for doctors to prescribe more. In this situation, is it really possible to follow the ethical routes or will pharma companies continues to bribe doctors and use avenues of off-label usage to meet its bottom line?