Most of us prefer good-looking people to less attractive ones. Pharma seems to believe that doctors do, too. A recent New York Times article examined the industry's recruitment of cheerleaders, most of whom are attractive young women ("Gimme an Rx! Cheerleaders Pep Up Drug Sales," November 28, 2005). In the article, Dr. Thomas Carli of the University of Michigan observes, "There's a saying that you'll never meet an ugly drug rep." Hiring the beautiful might be good for business, but it also might be challenged as discrimination in a court of law.

Until recently, employers have mostly been free to discriminate against the unattractive. In the United States, only a few places, like the District of Columbia and Santa Cruz, California, have laws prohibiting discrimination in employment based on physical appearance. Elsewhere, employers can factor looks into employment decisions without fear of reprisal.

Thinner and Cuter

The market is asking for more post-marketing research. How can companies handle that demand? Hugo Stephenson, MD, president of Quintiles' Strategic Research Services, offers insight into the struggles pharma faces, and the solutions they're finding, to financing post-approval clinical trials.

Pharm Exec: Who conducts strategic research?

Stephenson: Historically, the Phase IIIb and IV market was split evenly among big contract research organizations (CROs), the small "mom and pop" CROs, and academic research organizations.

How is that changing?

The small CROs are cheap and nimble. But you wouldn't want them to conduct a study that had a chance of being audited. Before medical registries, these studies were under the radar. Now, there's full visibility, and all studies in the post-Vioxx era run the risk of being audited, or worse still, reviewed by lawyers as part of a court case.

Understanding how drugs are bought and paid for has always been a bit complicated. People used to say that pharma had two customers—physicians and patients. Only one of them used the drug, and neither of them knew the price. My, how times have changed. Now the industry has so many customers, it needs to stop and get to know them all over again. And that's at a time when drugs worth tens of billions of dollars are going off patent. To map pharma's shifting landscape, Pharm Exec convened a group of top market researchers to discuss the issues shaping an evolving industry. Topics ranged far and wide, from the advent of Medicare Part D, to the new focus on adherence, the role of international markets, even the brave new world of marketing to seniors' children.

The food and drug administration started 2006 with a bang, unveiling a long-anticipated final rule that significantly overhauls the way drugs and biologics are labeled. This new regulation, designed to improve the communication of risks and benefits, has been in the works for years, but has been delayed by industry concerns that it could expose companies to more liability suits. Implementation will be a massive, costly undertaking, but at this point industry has little choice but to comply.

This final decision on the format and content of professional labeling sets the stage for FDA to move forward with other initiatives. For example, the agency recently required manufacturers to submit all labeling

Reducing Research Failures

Pharma companies need to better manage their marketing and sales spend directed at healthcare professionals. Five states have already mandated that drug companies track, control, and report this data, and many more states have legislation pending with distinct requirements. These new reporting mandates will hold companies accountable for documenting their interactions with healthcare professionals. Companies that don't track this data will see the repercussions—from fines of up to $10,000 or injunctions on their products. While companies should start to change their methods of reporting, many are ill prepared for state-by-state compliance mandates. This article discusses how pharmaceutical companies can address these laws by collecting better and cleaner data from their reps.

Streamline Data Collection

Doctors don't respond well to the traditional sales and marketing push. But, they do respond well to each other. In fact, there are doctors who wield tremendous power of persuasion over their peers. These doctors have earned the respect and attention of other prescribers and have been recognized for their expertise and knowledge of innovative, emerging therapies. But more important, they are likely to try, adopt, and advocate for new products.

Jerry Maynor

Before a pharmaceutical company dispatches a sales rep to a medical practice, the marketing department learns some basic facts about the physician: how many new prescriptions she's written, how many refills, and how much upside prescribing growth she might generate. What the rep usually doesn't know: who else—nurse practitioners and physician assistants—prescribes medications in the office, at a nearby clinic, or sometimes in a separate practice just down the hall. The rep could make another sales call, but for a variety of reasons he usually does not. Physician assistants and nurse practitioners remain poorly recognized, and therefore rarely courted by pharma. One barrier to marketing to these clinicians is simple lack of prescribing data. Information offered for sale by the big data providers frequently excludes nurse practitioners and physician assistants. And in the pharmaceutical industry, where there is no data, there is no marketing.

Based o­n my experience in the biotechnology industry, beginning in the mid-1970s as an investor, company founder and now turnaround chief executive officer, it seems clear that there are two distinct businesses that populate the biotechnology sector—product development companies and service providers for such companies. The product development companies often are based o­n very esoteric technologies that seem to have the potential to create blockbuster products. Their strategy (or more precisely the venture capitalists that initially finance them) seems to be to raise lots of OPM (other people’s money) and bail out before anyone really understands what the company is all about.

If you have ever felt overwhelmed by the array of nutritional supplements o­n the shelves of pharmacies, health food stores, and grocery stores, you are surely not alone. In simpler days, a few brands of vitamin tablets found at the local pharmacy were the o­nly supplements most people knew or cared about. Today’s store aisles contain a bewildering variety of vitamins and minerals in countless combinations; herbs in capsules, tinctures, extracts, and teas; and dietary products that promise to help you gain weight, lose weight, overcome insomnia, improve memory, boost energy, combat stress, or shorten the duration of a cold. According to a 2002 U.S. Food and Drug Administration (FDA) report, “Surveys show that over half of the U.S. population now uses some type of dietary supplement, and the FDA estimates that the industry markets approximately 29,000 of these products, which are sold under 75,000 distinct labels”