100:(CME). The use of gifts, including pens and coffee mugs embossed with pharmaceutical product names, has been prohibited by PHRMA ethics guidelines since 2008. Of the 237,000 medical sites representing 680,000 physicians surveyed in SK&A's 2010 Physician Access survey, half said they prefer or require an appointment to see a rep (up from 38.5% preferring or requiring an appointment in 2008), while 23% won't see reps at all, according to the survey data. Practices owned by hospitals or health systems are tougher to get into than private practices, since appointments have to go through headquarters, the survey found. 13.3% of offices with just one or two doctors won't see representatives, compared with a no-see rate of 42% at offices with 10 or more doctors. The most accessible physicians for promotional purposes are allergists/immunologists – only 4.2% won't see reps at all – followed by orthopedic specialists (5.1%) and diabetes specialists (7.6%). Diagnostic radiologists are the most rigid about allowing details – 92.1% won't see reps – followed by pathologists and neuroradiologists, at 92.1% and 91.8%, respectively.
342:(DTCA): the United States and New Zealand. Since the late 1970s, DTCA of prescription drugs has become important in the United States. It takes two main forms: the promotion or creation of a disease out of a non-pathologic physical condition or the promotion of a medication. The rhetorical objective of direct-to-consumer advertising is to directly influence the patient-physician dialogue. Many patients will inquire about, or even demand a medication they have seen advertised on television. In the United States, recent years have seen an increase in mass media advertisements for pharmaceuticals. Expenditures on direct-to-users advertising almost quadrupled in the seven years between 1997 and 2005 since the FDA changed the guidelines, from $ 1.1 billion in 1997 to more than $ 4.2 billion in 2005, a 19.6% annual increase, according to the United States
190:
force optimization, call planning, and sales forces effectiveness. A few pharmaceutical companies have realized that training sales representatives on high science alone is not enough, especially when most products are similar in quality. Thus, training sales representatives on relationship selling techniques in addition to medical science and product knowledge, can make a difference in sales force effectiveness. Specialist physicians are relying more and more on specialty sales reps for product information, because they are more knowledgeable than primary care reps.
353:, which is considering a ban. Some feel it is better to leave the decision wholly in the hands of medical professionals; others feel that users education and participation in health is useful, but users need independent, comparative information about drugs (not promotional information). For these reasons, most countries impose limits on pharmaceutical mass marketing that are not placed on the marketing of other products. In some areas it is required that ads for drugs include a list of possible side effects, so that users are informed of both facets of a medicine.
233:
might have a sales force of 1000 representatives. The largest companies have tens of thousands of representatives around the world. Sales representatives called upon physicians regularly, providing clinical information, approved journal articles, and free drug samples. This is still the approach today; however, economic pressures on the industry are causing pharmaceutical companies to rethink the traditional sales process to physicians. The industry has seen a large scale adoption of Pharma CRM systems that works on laptops and more recently
202:
industry, through third-party prescribing data (e.g., Quintiles/IMS) switched to "script-tracking" technologies, measuring the number of total prescriptions (TRx) and new prescriptions (NRx) per week that each physician writes. This information is collected by commercial vendors. The physicians are then "deciled" into ten groups based on their writing patterns. Higher deciles are more aggressively targeted. Some pharmaceutical companies use additional information such as:
285:
prescription writing and patient level data. Doctor dinner meetings are an effective way for physicians to acquire educational information from respected peers and to influence the so-called "no-see" physicians - those that are reluctant to engage directly with pharmaceutical reps through detailing but may come to a dinner program where a local or national expert is talking. These meetings are sponsored by some pharmaceutical companies.
420:
389:
non-preferred drug product. But sometimes coupons for brand-name drugs could potentially distort the market and leading to higher overall healthcare costs since they encourage the overuse of more expensive drugs over generic alternatives. Consumers often realize too late that the continued use of these drugs without coupons necessitates either switching to a cheaper generic or facing steep out-of-pocket expenses.
484:(FDA) regulations require all prescription drug promotion to be truthful and not misleading, based on "substantial evidence or substantial clinical experience", to provide a "fair balance" between the risks and benefits of the promoted drug, and to maintain consistency with labeling approved by the FDA. The FDA Office of Prescription Drug Promotion enforces these requirements.
398:$ 29.9 billion with one estimate as high as $ 57 billion. When the US number are broken down 56% was free samples, 25% was detailing of physicians, 12.5% was direct to users advertising, 4% on hospital detailing, and 2% on journal ads. In the United States approximately $ 20 billion could be saved if generics were used instead of equivalent brand name products.
519:—has either settled recent government cases, under the False Claims Act, for hundreds of millions of dollars or is currently under investigation for possible health care fraud. Following charges of illegal marketing, two of the settlements in 2009 set records for the largest criminal fines ever imposed on corporations. One involved Eli Lilly's antipsychotic
198:
patients with that disease state, how many sales representatives to devote to office and group practice and how many to devote to hospital accounts if needed. To aid this decision, customers are broken down into different classes according to their prescription behavior, patient population, their business potential, and event their personality traits.
357:'s limitations on pharmaceutical advertising ensure that commercials that mention the name of a product cannot in any way describe what it does. Commercials that mention a medical problem cannot also mention the name of the product for sale; at most, they can direct the viewer to a website or telephone number operated by the pharmaceutical company.
715:
Direct-to-users marketers are also recognizing the need to shift to digital channels as audiences become more fragmented and the number of access points for news, entertainment and information multiplies. Standard television, radio and print direct-to-users (DTC) advertisements are less relevant than
401:
Although pharmaceutical companies have made large investments in marketing their products, overall promotional spending has been decreasing over the last few years, and declined by 10 percent from 2009 to 2010. Pharmaceutical companies are cutting back mostly in detailing and sampling, while spending
397:
Pharmaceutical company spending on marketing exceeds that spent on research. In 2004 in Canada $ 1.7 billion a year was spent marketing drugs to physicians and in the United States $ 21 billion were spent in 2002. In 2005 money spent on pharmaceutical marketing in the United States was estimated at
317:
that restrict the number and types of drugs that the insurer will cover. Not only can the insurer affect drug sales by including or excluding a particular drug from a formulary, they can affect sales by tiering, or placing bureaucratic hurdles to prescribing certain drugs. In
January 2006, the United
263:
Key opinion leaders (KOL), or "thought leaders", are respected individuals, such as prominent medical school faculty, who influence physicians through their professional status. Pharmaceutical companies generally engage key opinion leaders early in the drug development process to provide advocacy and
152:
It is argued that a benefit to free samples is the "try it before you buy it" approach. Free samples give immediate access to the medication and the patient can begin treatment right away. It also saves time from going to a pharmacy to get it filled before treatment begins. Since not all medications
193:
The United States has 81,000 pharmaceutical representatives or 1 for every 7.9 physicians. The number and persistence of pharmaceutical representatives has placed a burden on the time of physicians. "As the number of reps went up, the amount of time an average rep spent with doctors went down—so far
707:
In 2008, 84% of U.S. physicians used the
Internet and other technologies to access pharmaceutical, biotech or medical device information—a 20% increase from 2004. At the same time, sales reps are finding it more difficult to get time with doctors for in-person details. Pharmaceutical companies are
201:
Marketers attempt to identify the set of physicians most likely to prescribe a given drug. Historically, this was done by drug reps 'on the ground' using zip code sales and engaging in recon to figure out who the high prescribers were in a particular sales territory. However, in the mid-1990s the
703:
The emergence of new media and technologies in recent years is quickly changing the pharmaceutical marketing landscape in the United States. Both physicians and users are increasing their reliance on the
Internet as a source of health and medical information, prompting pharmaceutical marketers to
275:
Alternatives to segmenting physicians purely on the basis of prescribing do exist, and marketers can call upon strategic partners who specialize in delineating which characteristics of true opinion leadership, a physician does or does not possess. Such analyses can help guide marketers in how to
189:
Because of the large size of the pharmaceutical sales force, the organization, management, and measurement of effectiveness of the sales force are significant business challenges. Management tasks are usually broken down into the areas of physician targeting, sales force size and structure, sales
271:
to uncover thought leaders; because it does not introduce respondent bias, which is commonly found in primary research; it can identify and map out the entire scientific community for a disease state; and it has greater compliance with state and federal regulations; because physician prescribing
232:
Physicians are perhaps the most important component in sales. They write the prescriptions that determine which drugs will be used by people. Influencing the physician is the key to pharmaceutical sales. Historically, by a large pharmaceutical sales force. A medium-sized pharmaceutical company
249:
More specifically, drug reps help to create a culture of gifting, or the "pharmaceutical gift exchange," where actual monetary transactions are rare. In reality, gifts, both large and small, ranging from cups of coffee to travel to medical conferences are exchanged on a routine basis with high
145:
Free samples have been shown to affect physician prescribing behavior. Physicians with access to free samples are more likely to prescribe brand name medication over equivalent generic medications. Other studies found that free samples decreased the likelihood that physicians would follow the
103:
E-detailing is widely used to reach "no see physicians"; approximately 23% of primary care physicians and 28% of specialists prefer computer-based e-detailing, according to survey findings reported in the 25 April 2011 edition of
American Medical News (AMNews), published by the American Medical
495:
were given to a broad range of patients, from preschoolers to octogenarians. In 2010, more than a half-million youths took antipsychotic drugs, and one-quarter of nursing-home residents have used them. Yet the government warns that the drugs may be fatal to some older patients and have unknown
284:
Physicians acquire information through informal contacts with their colleagues, including social events, professional affiliations, common hospital affiliations, and common medical school affiliations. Some pharmaceutical companies identify influential colleagues through commercially available
197:
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio of drugs to the target market. Factors influencing this decision are the optimal reach (how many physicians to see) and frequency (how often to see them) for each individual physician, how many
185:
in the United States pursuing some 830,000 pharmaceutical prescribers. A pharmaceutical representative will often try to see a given physician every few weeks. Representatives often have a call list of about 200–300 physicians with 120–180 targets that should be visited in 1–2 or 3 week cycle.
388:
charged by health insurers for prescription medication. These coupons are generally used to promote medications that compete with non-preferred products and cheaper, generic alternatives by reducing or eliminating the extra out-of-pocket costs that an insurers typically charge a patient for a
245:
Pharmaceutical and medical device companies have also paid physicians to use their drugs, which could affect how often a drug is prescribed. For example, one study that looked at physician payments and pimavanserin found that "extensive physician payments have been associated with increased
708:
exploring online marketing as an alternative way to reach physicians. Emerging e-promotional activities include live video detailing, online events, electronic sampling, and physician customer service portals such as PV Updates, MDLinx, Aptus Health (former
Physicians Interactive), and
123:
Prohibits company sales representatives providing restaurant meals to healthcare professionals, but allows them to provide occasional modest meals in healthcare professionals' offices in conjunction with informational
153:
work for everyone, and many do not work the same way for each person, free samples allow patients to find which dose and brand of medication works best before having to spend money on a filled prescription at a
85:
747:
Pharmaceuticals
Corporation as the websites promoted a drug for an unapproved use, the websites failed to disclose the risks associated with the use of the drug and made unsubstantiated dosing claims.
1819:
487:
In the 1990s, antipsychotics were "still seen as treatments for the most serious mental illnesses, like hallucinatory schizophrenia, and recast them for much broader uses". Drugs such as
130:
Provides that each company will state its intentions to abide by the Code and that company CEOs and compliance officers will certify each year that they have processes in place to comply.
2057:
Alexander GC, Zhang J, Basu A (April 2008). "Characteristics of patients receiving pharmaceutical samples and association between sample receipt and out-of-pocket prescription costs".
1064:
Alexander GC, Zhang J, Basu A (April 2008). "Characteristics of patients receiving pharmaceutical samples and association between sample receipt and out-of-pocket prescription costs".
276:
optimize KOL engagements as bona fide advisors to a brand, and can help shape clinical development and clinical data publication plans for instance, ultimately advancing patient care.
467:
127:
Includes new provisions requiring companies to ensure their representatives are sufficiently trained about applicable laws, regulations, and industry codes of practice and ethics.
113:
81:
1192:
Mehta HB, Moore TJ, Alexander GC (January 2021). "Association of
Pharmaceutical Industry Payments to Physicians With Prescription and Medicare Expenditures for Pimavanserin".
149:
Receiving pharmaceutical samples does not reduce prescription costs. Even after receiving samples, sample recipients remain disproportionately burdened by prescription costs.
538:
from 1991 to 2012, rank ordered by the size of the total settlement. Legal claims against the pharmaceutical industry have varied widely over the past two decades, including
267:
Some pharmaceutical companies identify key opinion leaders through direct inquiry of physicians (primary research). Recently, pharmaceutical companies have begun to use
360:
Reynold
Spector has provided examples of how positive and negative hype can affect perceptions of pharmaceuticals using examples of certain cancer drugs, such as
72:
marketing activities is widely variable across the world, pharmaceutical marketing is usually strongly regulated by international and national agencies, like the
822:
50:
194:
down, that tactical scaling has spawned a strategic crisis. Physicians no longer spend much time with sales reps, nor do they see this as a serious problem."
116:(PhRMA) released updates to its voluntary Code on Interactions with Healthcare Professionals on 10 July 2008. The new guidelines took effect in January 2009.
119:
In addition to prohibiting small gifts and reminder items such as pens, notepads, staplers, clipboards, paperweights, pill boxes, etc., the revised Code:
1423:
Steinman MA, Bero LA, Chren MM, Landefeld CS (August 2006). "Narrative review: the promotion of gabapentin: an analysis of internal industry documents".
463:
1033:
743:'s Division of Drug Marketing, Advertising and Communications issued a warning letter concerning two unbranded consumer targeted Web sites sponsored by
305:, are used, including paying to publish articles about promoted drugs for the medical literature, and alleged suppression of unfavorable study results.
1787:
96:
Marketing to health-care providers takes three main forms: activity by pharmaceutical sales representatives, provision of drug samples, and sponsoring
1938:
1352:
454:. Among other things, it requires member states to prohibit off-label marketing, and direct-to-consumer marketing of prescription-only medications.
1827:
1902:
2349:
2274:
2255:
2141:
1176:
603:
473:
237:. The new age pharmaceutical representative is armed with key data at his fingertips and tools to maximize the time spent with physicians.
1939:"Justice Department Announces Largest Health Care Fraud Settlement in Its History: Pfizer to Pay $ 2.3 Billion for Fraudulent Marketing"
1615:"New Zealand deserves better. Direct-to-consumer advertising (DTCA) of prescription medicines in New Zealand: for health or for profit?"
1323:
182:
2030:
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PharmRepSelect : pharmaceutical sales representative selection : your complete guide to getting a pharmaceutical sales job
998:
343:
2374:
817:
807:
477:
1884:
1756:
Brezis M (2008). "Big pharma and health care: unsolvable conflict of interests between private enterprise and public health".
797:
339:
294:
980:
757:
740:
481:
298:
166:
97:
73:
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revealing new marketing strategies for drugs. Activities once considered independent of promotional intent, including
917:
Sufrin CB, Ross JS (September 2008). "Pharmaceutical industry marketing: understanding its impact on women's health".
1841:
136:
Provides additional guidance and restrictions for speaking and consulting arrangements with healthcare professionals.
1975:"Abbott Labs to Pay $ 1.5 Billion to Resolve Criminal & Civil Investigations of Off-label Promotion of Depakote"
1921:"GlaxoSmithKline to Plead Guilty and Pay $ 3 Billion to Resolve Fraud Allegations and Failure to Report Safety Data"
1567:
Mogull SA, Balzhiser D (September 2015). "Pharmaceutical
Companies Are Writing the Script for Health Consumerism".
1517:
1883:
Almashat S, Preston C, Waterman T, Wolfe S, et al. (Public
Citizen's Health Research Group) (December 2010).
349:
The mass marketing to users of pharmaceuticals is banned in over 30 industrialized nations, but not in the US and
2384:
77:
1614:
1270:
Oldani MJ (September 2004). "Thick prescriptions: toward an interpretation of pharmaceutical sales practices".
999:"Less than 30% of doctors prefer detailing, according to surveys: Doctor emails are primary promotional method"
771:
319:
1993:"Eli Lilly and Company Agrees to Pay $ 1.415 Billion to Resolve Allegations of Off-label Promotion of Zyprexa"
1136:
250:
prescribers in an effort to shift their obligations from patients to prescriptions and have proven effective.
1676:
1044:
1949:
1885:"Rapidly increasing criminal and civil monetary penalties against the pharmaceutical industry: 1991 to 2010"
1802:
725:
535:
268:
69:
46:
42:
961:
327:
1360:
1121:
527:. In the Bextra case, the government also charged Pfizer with illegally marketing another antipsychotic,
451:
673:
54:
219:
2248:
Selling sickness : how the world's biggest pharmaceutical companies are turning us into patients
1702:
812:
619:
516:
500:
314:
1235:
Wazana A (January 2000). "Physicians and the pharmaceutical industry: is a gift ever just a gift?".
802:
721:
649:
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of the physician (that is, how readily the physician adopts new drugs in place of older treatments)
2082:
1868:
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1522:
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2011:
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1992:
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1376:"Beyond the naïve "no-see": ethical prescribing and the drive for pharmaceutical transparency"
1287:
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1081:
934:
878:
792:
763:
717:
2342:
Drugs, doctors and dinners : how drug companies influence health in the developing world
1334:
1305:
531:; Pfizer settled that part of the claim for $ 301 million, without admitting any wrongdoing.
2066:
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1387:
1279:
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1201:
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302:
133:
Includes more detailed standards regarding the independence of continuing medical education.
1920:
1863:
1974:
572:
323:
234:
57:. By extension, this definition is sometimes also used for marketing practices applied to
2267:
Disease-mongers : how doctors, drug companies, and insurers are making you feel sick
1006:
1107:
472:
In the United States, marketing and distribution of pharmaceuticals is regulated by the
873:
846:
539:
170:
80:. Local regulations from government or local pharmaceutical industry associations like
62:
450:
In the European Union, marketing of pharmaceuticals is regulated by EU (formerly EEC)
419:
313:
Public and private insurers affect the writing of prescriptions by physicians through
215:
Effect of managed care formularies on the ability of the physician to prescribe a drug
17:
2363:
1742:
1221:
946:
663:
586:
543:
58:
38:
2086:
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1452:
1409:
1093:
1137:"Tales from the Script: An Insider/Outsider View of Pharmaceutical Sales Practices"
787:
729:
2172:
Be brief, be bright, be gone: career essentials for pharmaceutical representatives
1718:
2070:
1077:
930:
863:
776:
631:
512:
381:
350:
1392:
1375:
1034:"Code on Interactions with Healthcare Professionals: Principles & Practice"
1546:"Chronology of Direct-to-Consumer Advertising Regulation in the United States"
1283:
1205:
782:
687:
639:
627:
594:
1726:
1588:
1580:
709:
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look at digital channels for opportunities to reach their target audiences.
635:
590:
504:
385:
34:
2153:
The Soviet Pharmaceutical Business During the First Two Decades (1917–1937)
2078:
1769:
1734:
1633:
1487:
1466:
Henney JE (August 2006). "Safeguarding patient welfare: who's in charge?".
1444:
1401:
1291:
1256:
1248:
1213:
1085:
938:
882:
744:
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to reach the over 145 million U.S. adults online for health information.
154:
86:
European Federation of Pharmaceutical Industries and Associations (EFPIA)
847:"Following the script: how drug reps make friends and influence doctors"
1788:"Pharmaceutical marketing to medical students: the student perspective"
520:
488:
361:
2134:
The cosmetics baron you've never heard of: E. Virgil Neal and Tokalon
2115:
The Rx factor : strategic creativity in pharmaceutical marketing
1703:"States on the Front Line: Addressing America's Drug Pricing Problem"
1637:
840:
838:
610:
534:
The following is a list of the four largest settlements reached with
528:
524:
508:
492:
369:
365:
354:
2191:
The $ 800 million pill : the truth behind the cost of new drugs
212:
Tendency of the physician to use the pharmaceutical company's drugs
1545:
764:
Big Pharma: How the World's Biggest Drug Companies Control Illness
318:
States instituted a new public prescription drug plan through its
293:
Legal cases and US congressional hearings have provided access to
1786:
Barfett J, Lanting B, Lee J, Lee M, Ng V, Simkhovitch P (2004).
2210:
Pharmaceutical Marketing: Principles, Environment, and Practice
1903:"GlaxoSmithKline Agrees to Pay $ 3 Billion in Fraud Settlement"
2032:
Unbranded Web Sites: FDA Finds Violative Promotional Practices
414:
380:
In the United States, pharmaceutical companies often provide
246:
pimavanserin prescription volume and Medicare expenditures."
1041:
Pharmaceutical Research and Manufacturers of America (PhRMA)
225:
The tendency of the physician to use a wide palette of drugs
1654:
Spector R (2018). "Drug Therapy Hype: The Misuse of Data".
1324:"Finding Key Opinion Leaders Using Social Network Analysis"
88:
can further limit or specify allowed commercial practices.
1005:. Medical Marketing Service Inc. June 2011. Archived from
716:
in the past, and companies are beginning to focus more on
326:, this program engages private insurers to negotiate with
402:
in mailings and print advertising grew since last year.
2326:(7th ed.). Arlington, TX: Principle Publications.
431:
2305:
360 Degree Selling: How To Sell Biotechnology Products
1353:"Marketing to Professionals: Tomorrow's Changes Today"
1171:(3rd ed.). Oxford University Press. p. 524.
468:
List of off-label promotion pharmaceutical settlements
2324:
Insider's guide to the world of pharmaceutical sales
272:
patterns are not used to create the social network.
114:
Pharmaceutical Research and Manufacturers of America
82:
Pharmaceutical Research and Manufacturers of America
1608:
1606:
962:"New pharma ethics rules eliminate gifts and meals"
580:
Off-label promotion/failure to disclose safety data
546:promotion, and inadequate manufacturing practices.
228:
Influence that physicians have on their colleagues.
2012:"Why Digital Is The Future For Pharma Advertising"
1820:"The ax comes out for pharma promotional spending"
1059:
1057:
330:for the placement of drugs on tiered formularies.
1842:"Advertising of medicinal products for human use"
981:"Docs are visited by 20 reps a week, survey says"
1677:"Check out drug coupons, then check bottom line"
165:Hours spent by physicians in industry-supported
1511:
1509:
1507:
1505:
1613:Toop L, Richards D, Saunders B (August 2003).
1701:Riley, Trish; Lanford, Sarah (3 April 2019).
823:Prescription drug prices in the United States
8:
2193:. Berkeley: University of California Press.
289:Journal articles and technical documentation
2212:. New York: Pharmaceutical Products Press.
2208:Kolassa EM, Perkins JG, Siecker BR (2002).
1857:
1855:
1781:
1779:
1028:
1026:
1024:
1022:
1020:
1018:
1016:
912:
464:List of largest pharmaceutical settlements
181:Currently, there are approximately 81,000
2344:. London: Consumers International. 2007.
1391:
910:
908:
906:
904:
902:
900:
898:
896:
894:
892:
872:
862:
1516:The Editorial Board (27 November 2015).
567:Laws allegedly violated (if applicable)
548:
206:Profitability of a prescription (script)
1480:10.7326/0003-4819-145-4-200608150-00013
1437:10.7326/0003-4819-145-4-200608150-00008
834:
169:(CME) is greater than that from either
27:Advertising by pharmaceutical companies
919:Obstetrical & Gynecological Survey
499:Every major company selling the drugs—
2231:. Dowingtown, PA: Black Dog Pub. Co.
2229:How to conduct doctor dinner meetings
845:Fugh-Berman A, Ahari S (April 2007).
7:
2307:. Dowiningtown, Pa.: Black Dog Pub.
2136:. Englewood, CO: Altus History LLC.
1901:Thomas K, Schmidt MS (2 July 2012).
474:Federal Food, Drug, and Cosmetic Act
338:Only two countries as of 2008 allow
183:pharmaceutical sales representatives
37:science and practice focused on the
1864:"Side Effects May Include Lawsuits"
1306:"Glossary Term: Key Opinion Leader"
1948:. 2 September 2009. Archived from
1826:. 11 February 2011. Archived from
1675:Lunzer Kritz F (3 December 2007).
1518:"Turn the Volume Down on Drug Ads"
985:Haymarket Marketing Communications
25:
2288:. Downingtown, Penn.: Black Dog.
2174:. San Jose : Writers Club Press.
732:campaigns, place-based media and
295:pharmaceutical industry documents
2286:Selling To Specialist Physicians
418:
384:to consumers to help offset the
344:Government Accountability Office
1628:(1180): U556, discussion U556.
1622:The New Zealand Medical Journal
1108:"ZS Associates; Pharmaceutical"
818:Prescription Drug Marketing Act
808:National pharmaceuticals policy
720:efforts like product websites,
478:Prescription Drug Marketing Act
241:Pharmaceutical Company Payments
2250:. Vancouver: Greystone Books.
2246:Moynihan R, Cassels A (2005).
1272:Medical Anthropology Quarterly
798:Ethics in pharmaceutical sales
340:direct to consumer advertising
209:Accessibility of the physician
177:Pharmaceutical representatives
68:Whilst rule of law regulating
1:
2117:. New Delhi: Response Books.
1719:10.1080/01947648.2019.1645544
2071:10.1097/MLR.0b013e3181618ee0
1764:(2): 83–9, discussion 90–4.
1078:10.1097/MLR.0b013e3181618ee0
931:10.1097/OGX.0b013e31817f1585
864:10.1371/journal.pmed.0040150
758:Big Pharma conspiracy theory
482:Food and Drug Administration
299:continuing medical education
167:continuing medical education
161:Continuing medical education
146:standard of care practices.
98:continuing medical education
74:Food and Drug Administration
2098:(2nd ed.). : PRS Pub.
1862:Wilson D (2 October 2010).
1468:Annals of Internal Medicine
1425:Annals of Internal Medicine
1169:Global Marketing Management
979:Comer B (14 October 2010).
540:Medicare and Medicaid fraud
309:Private and public insurers
173:or professional societies.
2401:
2029:Dunne D (4 October 2010),
2010:Silk B (15 October 2019).
1997:U.S. Department of Justice
1979:U.S. Department of Justice
1946:U.S. Department of Justice
1925:U.S. Department of Justice
1801:(1): 21–27. Archived from
1795:McGill Journal of Medicine
1758:Isr J Psychiatry Relat Sci
1393:10.1016/j.pmrj.2008.11.003
722:online display advertising
461:
1707:Journal of Legal Medicine
1374:Oldani M (January 2009).
1284:10.1525/maq.2004.18.3.325
1206:10.1176/appi.ps.202000251
523:, and the other involved
368:, in the former case and
264:key marketing feedback.
78:European Medicines Agency
49:, like specialist drugs,
45:and commercialization of
2370:Drug marketing and sales
2269:. New York: John Wiley.
2155:. New York: Peter Lang.
1310:Pharma Marketing Network
536:pharmaceutical companies
328:pharmaceutical companies
92:To health care providers
31:Pharmaceutical marketing
1581:10.1145/2826972.2826976
987:. Haymarket Media, Inc.
726:search engine marketing
269:social network analysis
70:pharmaceutical industry
47:pharmaceutical products
2375:Pharmaceuticals policy
1824:World of DTC Marketing
1333:. 2007. Archived from
1249:10.1001/jama.283.3.373
1144:Kroeber Society Papers
1043:. 2009. Archived from
699:Evolution of marketing
692:False Claims Act/FDCA
668:False Claims Act/FDCA
644:False Claims Act/FDCA
55:over-the-counter drugs
18:Medical representative
1808:on 27 September 2011.
517:Johnson & Johnson
496:effects on children.
2094:Alexander L (2002).
1643:on 28 February 2006.
1363:on 17 December 2007.
1194:Psychiatric Services
813:Pharmaceutical lobby
618:Off-label promotion/
501:Bristol-Myers Squibb
406:Regulation and fraud
324:Medicare Part D
2322:Williams J (2004).
2227:Magnani JL (1998).
2113:Choudary P (1997).
1569:Commun. Des. Q. Rev
1167:, Carter S (2012).
1122:"www.pharmexec.com"
803:Inverse benefit law
767:(2006) by Jacky Law
681:Off-label promotion
657:Off-label promotion
650:Abbott Laboratories
452:Directive 92/28/EEC
259:Key opinion leaders
104:Association (AMA).
2303:Peters VF (2000).
2284:Peters SM (2004).
2189:Goozner M (2004).
2170:Currier D (2001).
2151:Conroy MS (2006).
2132:Conroy MS (2009).
1999:. 15 January 2009.
1955:on 29 October 2013
1907:The New York Times
1869:The New York Times
1657:Skeptical Inquirer
1544:Mogull SA (2008).
1523:The New York Times
734:mobile advertising
430:. You can help by
322:program. Known as
2351:978-1-902391-59-5
2276:978-0-471-00737-1
2257:978-1-55365-131-4
2143:978-0-615-27278-8
1830:on 12 April 2011.
1681:Los Angeles Times
1357:www.pharmexec.com
1178:978-0-19-960970-3
1135:Oldani M (2002).
1050:on 11 March 2016.
960:Seaman M (2008).
793:Disease mongering
718:digital marketing
696:
695:
448:
447:
220:adoption sequence
16:(Redirected from
2392:
2385:Drug advertising
2355:
2337:
2318:
2299:
2280:
2265:Payer L (1992).
2261:
2242:
2223:
2204:
2185:
2166:
2147:
2128:
2109:
2090:
2044:
2043:
2042:
2040:
2035:, Stradley Ronon
2026:
2020:
2019:
2007:
2001:
2000:
1989:
1983:
1982:
1971:
1965:
1964:
1962:
1960:
1954:
1943:
1935:
1929:
1928:
1917:
1911:
1910:
1898:
1892:
1891:
1889:
1880:
1874:
1873:
1859:
1850:
1849:
1848:. 31 March 1992.
1838:
1832:
1831:
1816:
1810:
1809:
1807:
1792:
1783:
1774:
1773:
1753:
1747:
1746:
1698:
1692:
1691:
1689:
1687:
1672:
1666:
1665:
1651:
1645:
1644:
1642:
1636:. Archived from
1619:
1610:
1601:
1600:
1564:
1558:
1557:
1541:
1535:
1534:
1532:
1530:
1513:
1500:
1499:
1463:
1457:
1456:
1420:
1414:
1413:
1395:
1371:
1365:
1364:
1359:. Archived from
1348:
1342:
1341:
1340:on 12 July 2011.
1339:
1328:
1320:
1314:
1313:
1302:
1296:
1295:
1267:
1261:
1260:
1232:
1226:
1225:
1189:
1183:
1182:
1161:
1155:
1154:
1152:
1150:
1141:
1132:
1126:
1125:
1118:
1112:
1111:
1104:
1098:
1097:
1061:
1052:
1051:
1049:
1038:
1030:
1011:
1010:
1009:on 4 March 2016.
995:
989:
988:
976:
970:
969:
957:
951:
950:
914:
887:
886:
876:
866:
842:
600:False Claims Act
549:
480:, respectively.
443:
440:
422:
415:
303:medical research
21:
2400:
2399:
2395:
2394:
2393:
2391:
2390:
2389:
2360:
2359:
2358:
2352:
2340:
2334:
2321:
2315:
2302:
2296:
2283:
2277:
2264:
2258:
2245:
2239:
2226:
2220:
2207:
2201:
2188:
2182:
2169:
2163:
2150:
2144:
2131:
2125:
2112:
2106:
2093:
2056:
2052:
2050:Further reading
2047:
2038:
2036:
2028:
2027:
2023:
2016:Ethoseo Digital
2009:
2008:
2004:
1991:
1990:
1986:
1973:
1972:
1968:
1958:
1956:
1952:
1941:
1937:
1936:
1932:
1919:
1918:
1914:
1900:
1899:
1895:
1887:
1882:
1881:
1877:
1861:
1860:
1853:
1840:
1839:
1835:
1818:
1817:
1813:
1805:
1790:
1785:
1784:
1777:
1755:
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1750:
1700:
1699:
1695:
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1683:
1674:
1673:
1669:
1653:
1652:
1648:
1640:
1617:
1612:
1611:
1604:
1566:
1565:
1561:
1543:
1542:
1538:
1528:
1526:
1515:
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1503:
1465:
1464:
1460:
1422:
1421:
1417:
1373:
1372:
1368:
1350:
1349:
1345:
1337:
1326:
1322:
1321:
1317:
1304:
1303:
1299:
1269:
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1234:
1233:
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1191:
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1129:
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1101:
1063:
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1055:
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1031:
1014:
997:
996:
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978:
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973:
959:
958:
954:
916:
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890:
844:
843:
836:
832:
827:
753:
701:
573:GlaxoSmithKline
470:
460:
444:
438:
435:
428:needs expansion
413:
408:
395:
378:
372:in the latter.
336:
311:
291:
256:
243:
179:
171:medical schools
163:
143:
110:
94:
63:medical devices
41:, differential
33:is a branch of
28:
23:
22:
15:
12:
11:
5:
2398:
2396:
2388:
2387:
2382:
2377:
2372:
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2357:
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2350:
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2332:
2319:
2313:
2300:
2294:
2281:
2275:
2262:
2256:
2243:
2237:
2224:
2218:
2205:
2199:
2186:
2180:
2167:
2161:
2148:
2142:
2129:
2123:
2110:
2104:
2091:
2065:(4): 394–402.
2053:
2051:
2048:
2046:
2045:
2021:
2002:
1984:
1966:
1930:
1927:. 2 July 2012.
1912:
1893:
1875:
1851:
1833:
1811:
1775:
1748:
1693:
1667:
1646:
1602:
1559:
1536:
1501:
1458:
1415:
1366:
1343:
1315:
1312:. 27 May 2017.
1297:
1262:
1227:
1184:
1177:
1156:
1127:
1113:
1099:
1072:(4): 394–402.
1053:
1012:
990:
971:
952:
888:
833:
831:
828:
826:
825:
820:
815:
810:
805:
800:
795:
790:
779:
768:
760:
754:
752:
749:
700:
697:
694:
693:
690:
685:
682:
679:
676:
670:
669:
666:
661:
658:
655:
652:
646:
645:
642:
625:
622:
616:
613:
607:
606:
597:
584:
581:
578:
575:
569:
568:
565:
562:
559:
556:
553:
459:
456:
446:
445:
425:
423:
412:
411:European Union
409:
407:
404:
394:
391:
377:
374:
335:
332:
310:
307:
290:
287:
282:
281:
261:
260:
255:
254:Peer influence
252:
242:
239:
230:
229:
226:
223:
216:
213:
210:
207:
178:
175:
162:
159:
142:
139:
138:
137:
134:
131:
128:
125:
124:presentations"
109:
106:
93:
90:
59:nutraceuticals
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
2397:
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2383:
2381:
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2376:
2373:
2371:
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2353:
2347:
2343:
2339:
2335:
2333:0-9704153-6-2
2329:
2325:
2320:
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2314:0-9656231-3-0
2310:
2306:
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2295:0-9656231-5-7
2291:
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2278:
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2263:
2259:
2253:
2249:
2244:
2240:
2238:0-9656231-1-4
2234:
2230:
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2221:
2219:0-7890-1582-X
2215:
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2206:
2202:
2200:0-520-23945-8
2196:
2192:
2187:
2183:
2181:0-595-17418-3
2177:
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2164:
2162:0-8204-7899-7
2158:
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2149:
2145:
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2126:
2124:0-8039-9378-1
2120:
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2105:0-9724675-1-3
2101:
2097:
2092:
2088:
2084:
2080:
2076:
2072:
2068:
2064:
2060:
2055:
2054:
2049:
2034:
2033:
2025:
2022:
2017:
2013:
2006:
2003:
1998:
1994:
1988:
1985:
1981:. 7 May 2012.
1980:
1976:
1970:
1967:
1951:
1947:
1940:
1934:
1931:
1926:
1922:
1916:
1913:
1908:
1904:
1897:
1894:
1886:
1879:
1876:
1871:
1870:
1865:
1858:
1856:
1852:
1847:
1843:
1837:
1834:
1829:
1825:
1821:
1815:
1812:
1804:
1800:
1796:
1789:
1782:
1780:
1776:
1771:
1767:
1763:
1759:
1752:
1749:
1744:
1740:
1736:
1732:
1728:
1724:
1720:
1716:
1712:
1708:
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1697:
1694:
1682:
1678:
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1668:
1663:
1659:
1658:
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1647:
1639:
1635:
1631:
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1555:
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1524:
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1481:
1477:
1473:
1469:
1462:
1459:
1454:
1450:
1446:
1442:
1438:
1434:
1431:(4): 284–93.
1430:
1426:
1419:
1416:
1411:
1407:
1403:
1399:
1394:
1389:
1385:
1381:
1377:
1370:
1367:
1362:
1358:
1354:
1347:
1344:
1336:
1332:
1325:
1319:
1316:
1311:
1307:
1301:
1298:
1293:
1289:
1285:
1281:
1278:(3): 325–56.
1277:
1273:
1266:
1263:
1258:
1254:
1250:
1246:
1243:(3): 373–80.
1242:
1238:
1231:
1228:
1223:
1219:
1215:
1211:
1207:
1203:
1199:
1195:
1188:
1185:
1180:
1174:
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1166:
1160:
1157:
1145:
1138:
1131:
1128:
1123:
1117:
1114:
1109:
1103:
1100:
1095:
1091:
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1083:
1079:
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1071:
1067:
1060:
1058:
1054:
1046:
1042:
1035:
1029:
1027:
1025:
1023:
1021:
1019:
1017:
1013:
1008:
1004:
1000:
994:
991:
986:
982:
975:
972:
967:
963:
956:
953:
948:
944:
940:
936:
932:
928:
925:(9): 585–96.
924:
920:
913:
911:
909:
907:
905:
903:
901:
899:
897:
895:
893:
889:
884:
880:
875:
870:
865:
860:
856:
852:
851:PLOS Medicine
848:
841:
839:
835:
829:
824:
821:
819:
816:
814:
811:
809:
806:
804:
801:
799:
796:
794:
791:
789:
785:
784:
780:
778:
774:
773:
769:
766:
765:
761:
759:
756:
755:
750:
748:
746:
742:
739:In 2010, the
737:
735:
731:
727:
723:
719:
713:
711:
705:
698:
691:
689:
686:
683:
680:
678:$ 1.4 billion
677:
675:
672:
671:
667:
665:
662:
659:
656:
654:$ 1.5 billion
653:
651:
648:
647:
643:
641:
637:
633:
629:
626:
623:
621:
617:
615:$ 2.3 billion
614:
612:
609:
608:
605:
601:
598:
596:
592:
588:
585:
582:
579:
576:
574:
571:
570:
566:
563:
560:
557:
554:
551:
550:
547:
545:
541:
537:
532:
530:
526:
522:
518:
514:
510:
506:
502:
497:
494:
490:
485:
483:
479:
475:
469:
465:
458:United States
457:
455:
453:
442:
439:February 2016
433:
429:
426:This section
424:
421:
417:
416:
410:
405:
403:
399:
392:
390:
387:
383:
375:
373:
371:
367:
363:
358:
356:
352:
347:
345:
341:
333:
331:
329:
325:
321:
316:
308:
306:
304:
300:
296:
288:
286:
279:
278:
277:
273:
270:
265:
258:
257:
253:
251:
247:
240:
238:
236:
227:
224:
221:
217:
214:
211:
208:
205:
204:
203:
199:
195:
191:
187:
184:
176:
174:
172:
168:
160:
158:
156:
150:
147:
140:
135:
132:
129:
126:
122:
121:
120:
117:
115:
107:
105:
101:
99:
91:
89:
87:
83:
79:
75:
71:
66:
64:
60:
56:
52:
51:biotech drugs
48:
44:
40:
39:communication
36:
32:
19:
2341:
2323:
2304:
2285:
2266:
2247:
2228:
2209:
2190:
2171:
2152:
2133:
2114:
2095:
2062:
2059:Medical Care
2058:
2037:, retrieved
2031:
2024:
2015:
2005:
1996:
1987:
1978:
1969:
1957:. Retrieved
1950:the original
1945:
1933:
1924:
1915:
1906:
1896:
1878:
1867:
1845:
1836:
1828:the original
1823:
1814:
1803:the original
1798:
1794:
1761:
1757:
1751:
1713:(2): 81–93.
1710:
1706:
1696:
1684:. Retrieved
1680:
1670:
1661:
1655:
1649:
1638:the original
1625:
1621:
1575:(4): 35–49.
1572:
1568:
1562:
1553:
1550:AMWA Journal
1549:
1539:
1527:. Retrieved
1521:
1474:(4): 305–7.
1471:
1467:
1461:
1428:
1424:
1418:
1383:
1379:
1369:
1361:the original
1356:
1346:
1335:the original
1331:Lnx Research
1330:
1318:
1309:
1300:
1275:
1271:
1265:
1240:
1236:
1230:
1200:(1): 77–80.
1197:
1193:
1187:
1168:
1159:
1147:. Retrieved
1143:
1130:
1116:
1102:
1069:
1066:Medical Care
1065:
1045:the original
1040:
1007:the original
1002:
993:
984:
974:
966:USATODAY.com
965:
955:
922:
918:
854:
850:
788:Ben Goldacre
781:
772:Side Effects
770:
762:
738:
730:social media
714:
706:
702:
558:Violation(s)
533:
498:
486:
471:
449:
436:
432:adding to it
427:
400:
396:
382:drug coupons
379:
376:Drug coupons
359:
348:
337:
334:To consumers
312:
292:
283:
274:
266:
262:
248:
244:
231:
200:
196:
192:
188:
180:
164:
151:
148:
144:
141:Free samples
118:
111:
102:
95:
67:
30:
29:
1959:22 November
1686:20 November
1664:(2): 44–49.
1529:27 November
1386:(1): 82–6.
857:(4): e150.
777:Alison Bass
577:$ 3 billion
513:AstraZeneca
351:New Zealand
315:formularies
43:positioning
2364:Categories
1380:PM & R
1351:Myers KD.
830:References
786:(2012) by
783:Bad Pharma
775:(2008) by
591:Wellbutrin
564:Product(s)
555:Settlement
462:See also:
386:copayments
280:Colleagues
108:PhRMA Code
1743:202553824
1727:0194-7648
1589:2166-1200
1222:221308577
1003:MMS Lists
947:205898514
710:Epocrates
674:Eli Lilly
620:kickbacks
544:off-label
505:Eli Lilly
393:Economics
346:, 2006).
35:marketing
2380:Pharmacy
2087:10207092
2079:18362819
1770:18982834
1735:31503529
1634:14581976
1597:14908255
1496:39262014
1488:16908923
1453:20779923
1445:16908919
1410:27080056
1402:19627878
1292:15484967
1257:10647801
1214:32838675
1149:13 April
1094:10207092
1086:18362819
939:18713478
883:17455991
751:See also
745:Novartis
664:Depakote
476:and the
320:Medicare
155:pharmacy
76:and the
1846:EUR-Lex
874:1876413
688:Zyprexa
587:Avandia
552:Company
521:Zyprexa
489:Abilify
370:statins
362:Avastin
235:tablets
2348:
2330:
2311:
2292:
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