Targets of Pharma Marketing

Pharmaceutical companies identify multiple targets to be the beneficiaries of marketing strategies to increase prescribing behaviors. In the case of gabapentin, industry documents revealed four main targets: These included 1) Frequent prescribers, 2) Peer-influencing physicians, 3) “Thought leaders” or “key influencers,” and 4) Residents.

Frequent Prescribers

Pharmaceutical companies obtained physician prescribing data for physicians who frequently prescribed anticonvulsant agents. Physicians who were deemed frequent prescribers, as categorized by the dollar value of prescriptions generated, were specifically targeted for marketing strategies.

It should be noted that in May 2006, the American Medical Association implemented the Physician Data Restriction Program in which physicians can deny access of their prescribing data to pharmaceutical sales representatives and sales managers. For more information, please see www.ama-assn.org/go/prescribingdata

Peer-Influencing Physicians

Pharmaceutical representatives identified physicians who were supportive of gabapentin and recruited them to serve as speakers in “peer to peer selling” programs. The intent of the “peer to peer” program was to influencing other physicians to prescribe the drug.

“Thought Leaders” and “Key Influencers”

“Thought leaders” and “key influencers” are influential physicians typically identified by their affiliation with academic medical centers. Pharmaceutical industries have targeted these physicians by providing them with honoraria, research grants or educational grants with the goal of influencing favorable opinions for specific drugs.

Pharmaceutical industry presence in academic medical centers can present ethical challenges. For more information regarding strategies to avoid potential conflict of interest, please see:

Brennan, T.A., Rothman, D.J., Blank, L, Blumenthal, D., Chimonas, S.C, Cohen, J.J., Goldman, J., Kassirer, J.P., Kimball, J.P., Naughton, J., Smelser, N. (2006). Heath industry practices that create conflict of interest: A policy proposal for Academic Medical Centers. JAMA, 295(4):429-433.

Residents

In the case of gabapentin, pharmaceutical industry representatives provided multiple educational opportunities for residents such as video case series and specialized courses. The industry stated goal was to “influence physicians from the bottom up” in an attempt to influence future prescribing behavior.

There has been much research regarding the impact of pharmaceutical industry marketing efforts on resident prescribing behavior. For a review of the research, please see:

Zipkin, D.A. and Steinman, M.A. (2005). Interactions between pharmaceutical representatives and doctors in training: A thematic review. Journal of General Internal Medicine, 20:777-786.