Bioethics Blogs

As Doctors Lose Clout, Drug Firms Redirect the Sales Call

[The Wall Street Journal] SAN DIEGO—Kendall French used to pitch drugs to doctors who could prescribe them.

But many of those doctors now work for hospitals that don’t give them final say over what is on the menu of medicines they can pick. So when the GlaxoSmithKline PLC saleswoman began plugging two new lung-disease drugs to a big San Diego hospital system this spring, it was to an administrator who doesn’t see patients but helps write the menu, also called a “formulary,” of approved medications.

Ms. French urged the administrator in the system, Sharp HealthCare, to consider the two drugs’ effectiveness. It was the kind of pitch she once used to persuade doctors to write prescriptions.

The administrator, Electa Stern, said she would run the effectiveness data by doctors who are helping decide what to put on a systemwide formulary. “And then we will be taking a look at cost.” There are about 2,600 doctors in the Sharp system.

Ms. French’s sales calls are part of a shift that is rewriting the drug-marketing playbook. As hospital systems get bigger, they are putting distance between their doctors and drug sellers, making it harder for pharmaceutical companies to get quick acceptance of newly approved medicines and putting pressure on profits.

Today, 42% of doctors practice as salaried employees of hospital systems, up from 24% in 2004, according to Cegedim Relationship Management, a marketing consultant.

As a result, the pharmaceutical industry is shifting its sales efforts from doctors to the institutions they work for. In 2005, drug companies employed about 102,000 U.S.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.