In the Wall Street Journal’s Health Section on January 10th, 2012, Jonathon Rockoff explores the new sales techniques employed by the top manufacturers of psychiatric medications. In the report, he identifies what one company, Eli Lilly, has done to change their Hard Sell techniques to a more Consultative Sales technique. Gone are the days of telling the physician the high points of the drug’s effects and where it can be used and for what diagnosis or disorder. The old technique of Hard Sell was all about getting the drug used, and in large quantities, even if it meant off-label applications. This is where the borders of ethics get softened and physicians were guided to believe that some drugs are safe in application to non-studied populations, such as children and the elderly, only to find it causes harm and the side effects were minimized or covered up. Pharm Reps were the “detail” oriented reps who condensed down the high points (all of which were positive toward the drug) of a particular study showing the efficacy of the new drug. Physicians are busy people, and they knew that. They also knew that the physician would not have time to read the study or studies and most didn’t have the savvy to know how to decipher the graphs or statistics and see the inherent flaws of study methods or distinguish what is a fact found in the study or a hypothesis purely extrapolated from the outcome. In Dr. Timothy Scott’s book, America Fooled, Chapter 7 – Tricks of the Trade, Dr. Scott fully exposes how the pharmaceutical industry works the studies into positives when, in fact, were negative or no better than placebo. The example he used in this chapter was GlaxoSmithKline’s cover-up of the suicide related side effects of Paxil, an antidepressant drug being studied and marketed as a choice for anxious children.

The particular sales rep Mr. Rockoff interviewed, Michaelene Greenly, demonstrates what best practices could and should be as a medical sales representative. This type of sales technique is widely used in the equipment and supply industry. Knowing that your buyer/customer is sophisticated enough to figure out the benefits of a product once the features are known allows that you are selling to an intelligent person, not someone who needs to be spoon-fed how to use a product and why it helps patients. Most of today’s sales reps are highly skilled at Consultative Selling skills and as a result, become resources for their customers. It is without a doubt the most effective sales approach today.

But changing a sales technique in the Pharma Industry does not create science when there is none. Near the end of the article, Ms. Greenly is working with psychiatrist Dr. Cottle on how best to use Zyprexa, an antipsychotic known to produce high weight gain in patients and often leads to Diabetes Type II. It says she had diagrams of the brain on her laptop and it showed how Zyprexa worked in the brain. This she could supply to the MD and he could explain this to his patient. This is where studies become blurred with opinions. Given that today there is no concrete, usable evidence that chemical imbalances cause mental illness, and that extrapolated theories dominate the social thinking about mental illness to the point of Direct to Consumer Advertising, we have a dilemma as a society and as a medical industry. No matter the sales technique, the message should be based in science and well tested studies, not on opinions. People’s lives are influenced by our actions and perpetuating falsehoods decrease the survival of all of us. Softer sales techniques do not create a good  science.


By Kenneth W Thomas, RN, BS