Drug Marketing: Different Impacts on Different Physicians

Pharmaceutical company representatives (PCRs) are as ubiquitous in otolaryngologists’ offices as seasonal allergies and ear infections. Their job during their marketing visits, commonly referred to as “detailing,” is to get physicians to write more prescriptions for their products. But there is more to friendly PCR visits than meets the eye, as Sridhar Narayanan, PhD, an assistant professor of marketing at Stanford University’s Graduate School of Business, has shown. Several studies of the marketing of second-generation antihistamines to both physicians and consumers have demonstrated that pharmaceutical companies, assisted by health care information organizations (HIOs), use marketing tools fashioned from massaging databases of individual physician prescribing data to get them to expand demand for drug categories.

Among Professor Narayanan’s more intriguing findings on marketing second-generation antihistamines is that “fast learning” doctors increase the number of prescriptions written after only two or three visits from PCRs, whereas the “slow learners” take 17 or 18 visits to catch on. “Drug companies rely on HIO data to detect the fast and slow learners because physician surveys about prescribing tend to be problematic. Data on prescribing patterns coupled with detailing visits geared to differences in physician learning rates often spells the difference between heavy and light prescribers,” says Prof. Narayanan. It’s all part of the $8.5 billion that pharmaceutical companies spend annually marketing to consumers and physicians.

For John Krouse, MD, PhD, professor and vice-chair, director of Rhinology/Allergy in Detroit-based Wayne State University’s Department of Otolaryngology–Head and Neck Surgery, the data-driven approach may account for the canned spiels that aggressive PCRs use to steer the conversation their way. “I prefer PCRs who act professionally, are well educated, and want a good ongoing relationship with the physicians. It doesn’t take long to figure out which PCRs are only pushing product and which are the ones who can build a relationship on trust and comfort,” he says.

Prof. Narayanan’s research also indicates that some managers, having front-loaded both direct-to-consumer advertising (DTCA) and detailing months before a product’s launch and in the year immediately following increased revenues by 4 to 14%, a strategy that other pharmaceutical companies should have followed to achieve similar results. Dr. Krouse counters that seasoned otolaryngologists are familiar with drugs in the pipeline and would like a collegial conversation with PCRs rather than a hard-sell about the new product. Prof. Narayanan also found in subsequent research that detailing and DTCA have long-term effects on revenues that are four to seven times the current-period effects. Apparently, persistence pays off in pharmaceutical marketing, encouraging PCRs to keep hammering away at physicians to keep their prescription-writing pens busy.