Payments in Medicine: Part 1

Direct to doctors’ marketing: the US experience

In the 1980s and 90s, medical reps often turned up unannounced at hospitals with lunch, using the opportunity to present new drugs and reinforce prescribing habits. Free samples abounded to build brand familiarity; the favoured few were invited to sponsored events or conferences, with all expenses covered.

Ethical standards were near nonexistent, and with no real industry marketing regulations, pharma spent heavily on direct-to-doc marketing. In 1997, total marketing spending in the US was $17.7 billion, of which approximately $15.6 billion (88%) was spent directly on healthcare professionals.

Drug reps would drop by unannounced with a full catered lunch—sandwiches, chips, dessert—clinics ran on free lunches. Food was at the core of doctors’ decisions: Feed them, and they listened; lunch was the easiest way to get face time with a busy, leg-weary doctor.

One key issue to medical rep success was knowing your client: Reps kept files for each doc. What they liked, disliked; they knew everyo…