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Merck detailing – crossing the line?

Back to the detailers v. doctors, if only just for a moment. Dr. Gary Schwitzer of the U. of Minnesota has posted an interesting piece on Rep Henry Waxman’s indictment (figurative, not literal) of Merck’s behavior related to misleading MDs about Vioxx.
Another blog has a highly entertaining review of some highly embarassing marketing training literature ostensibly used by Merck. Suffice it to say that they are using anatomy as well as physiology in their efforts to “reach” docs…
What does this mean to you?
The dollars pharmas have to spend on convincing MDs to order their drugs are much larger than the dollars managed care firms have to “counter-detail”. If managed care firms, insurers, and employers want to stand any chance in this battle, they need to figure out how to do a much better job of educating docs than they have to date.

2 thoughts on “Merck detailing – crossing the line?”

  1. As a physician, I have seen very little effort by any managed care organization to counter-detail. Certainly, I have never seen any managed care organization try to directly counter pharma DTC advertising. Furthermore, I have seen very little support from managed care for evidence-based medicine (although some MCO’s do pay for some dubious CAM treatments.) I realize managed care has to deal with forms of utilization other than pharma, but it seems to me managed care has made very little effort to counter pharma marketing in any meaningful way. Managed care organizations and health insurance companies collectively are hardly poor, and spend plenty on their own marketing, and plenty on their own executives’ salaries and benefits. So my question is: why do they do they direct so little fire in this very target-rich environment?
    (Also, see numerous posts on Merck, pharma marketing etc on Health Care Renewal,

  2. A possible reason for the lack of meaningful efforts to “counter-detail” is the perverse incentives in the PBM business. PBMs make their money on the margin between what the insurer/employer pays them and what they pay the pharmacy. Therefore, if they “prevent” a script, they reduce their own revenue, while incurring costs.
    While PBMs will no doubt loudly state their pure intentions, this perverse incentive is, at the very least, a tough barrer for the well-intentioned.

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Joe Paduda is the principal of Health Strategy Associates



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