The pharmaceutical industry is now acknowledging that it needs a new marketing strateggy after experiencing waning patience from Congress, incredulousness from the medical community and growing angst among the general public. As a result of this unrest, the Pharmaceutical Research and Manufacturers of America is examining how it brings medications to market.
Some companies are realizing that waiting rooms provide a marketing opportunity, and are outfitting them with television and interactive touch screens, which promote products and educate patients about ailments and procedures.
A new study from the Advertising Research Foundation has found that event marketing can increase a consumer's purchase intent by up to 52 percent. Purchase intent rose 11 percent to 52 percent among consumers who attended brand-sponsored events such as sports championships, walkathons and theme park sponsorships, according to the "Engaging Events Pay Out" study.
Hospital ads are posted mainly as a component of creating a broader brand identity. In this regard, they are remarkably similar to many other corporate ads. But unlike other industries that use it to drive sales, brand identity in the medical field is probably minimally important in generating and maintaining a sufficient level of clinical business. Perhaps more important, it helps create a mindset that the hospital has standing and stature and permanence in the community.
In last week's column, I praised the SMDC Health System in Duluth, MN, which banned all pharmaceutical promotional products--from pens to whiteboards to squishy stress balls from their halls. I thought it was well worth the estimated $100,000 it would cost them to buy their own supplies to avoid the impression--true or not--that drug company reps could buy them with cheap trinkets. A reader who said he used to work in the pharmaceutical industry and now works with drug companies as a consultant, begged to differ. "I would hate for people to go into their doctor's office and start to think badly of their doctor because they see a Viagra pen," he wrote.
In his e-mail, the consultant suggested doctors deserve more credit than I gave them.
What a silly article. When I go to my doctor's office, the last thing I think about is that my doctor is being influenced by a pen that a drug rep gave them. I know firsthand, so no, I'm not being naive. Give your doctor more credit than that.
Managed care has squeezed doctors' margins enough. So what if some office supplies are given to them by a drug rep? I wonder how SMDC passed along the extra $100,000 they are spending on office supplies? I'd rather have my doctor using the Internet to search Medscape for best clinical studies and articles instead of Staples.com and OfficeMax.com looking for the cheapest pen. I worry more about the quality of the interactions between patient and doctor as the doctor cattles more patients through the office due to managed care pressures.
The reality is that a pen or clipboard won't influence a doctor's prescribing. In the '80s or even early '90s, drug companies could more easily unduly influence a doctor's prescribing with larger incentives like trips mentioned in your article. Trips and other major incentives are just not prevalent anymore. Today, many honorable drug companies and reps can truly partner with a physician to improve the patient experience.
In an e-mail response, however, another reader took a different view, saying that drug advertising--not the cost of office supplies--has contributed to increased healthcare costs.
I thoroughly enjoyed your article. I have been involved in healthcare for more than 30 years. Many if not most changes are for the good. However, I would like to see an analysis of the sudden increase in cost of healthcare, the portion of that increase that is pharmaceuticals, and its association to the public advertising of prescription drugs that has opened up in the last 10 years.
My surgeons say that since the approval of public advertising of prescription drugs, they are being constantly badgered by their patients for drugs they don't need. However, if the surgeon consistently refuses to prescribe, the patient will leave and seek a surgeon that will. Therefore, it is the opinion of many surgeons that, if the requested drug is not harmful, they will go ahead and prescribe it in order to keep their patient. Carolyn E. Skaff, CEO ASC Durango at Mercy Regional Medical Center Durango
And an on-line commenter painted a vivid picture of the "invasion" of drug reps and the physicians who encourage them.
Your article was "spot on!" In my previous position as COO of a large, multi-specialty clinic (70 physicians, two large office complexes about 5 miles apart), the drug reps were everywhere, and during the lunch hour it was almost like an invasion.
Tons of freebies throughout the facility, and different vendors were actually scheduled on a rotating basis to bring lunch on different days of the week to each of the different clinics. When food arrived, the aroma permeated the air, and made patients wonder what the priority was . . . lunch or their care, as staff members would disappear, reappear, then disappear again . . . some shoving food in their mouths before resuming duties, or bringing plates of food back to their work areas, in view of the patients.
One time, when there was an obvious schedule mix up, and one clinic did not have anyone bring them lunch, the physician director of that clinic called the drug rep he thought should have been there and told him in no uncertain terms that no lunch meant no further visits. Lunch arrived about 45 minutes later.
One provider even gave the building security access code to one of the drug reps so she could get in and out of the back door of the clinic more easily with food, without disrupting the clinic operations. Although senior management (non-physicians) were able to make some changes, the physician-owned group called the shots, and they were not about to give up their lunches. It was absolutely ridiculous to see the anger or foul words generated over schedule mix-ups or food that was not as good as the next clinic had.
Congratulations for bringing this issue forward. I think it is a long overdue lesson for everyone.
So what do you think? Was I spot-on, or did I miss the mark? Do drug reps improve the patient experience? Or just fill up physicians' tummies? You know what I think--now I want to hear what you think. Leave a comment on the site (just click on the button at the bottom or top of this column) and maybe I'll send you a HealthLeaders Media pen.
Gienna Shaw is an editor with HealthLeaders magazine. She can be reached at gshaw@healthleadersmedia.com.
California's yearlong flirtation with broad-scale healthcare reform ended earlier this week with only one member of a key state panel voting in favor of the proposal.
Supporters of the reform plan negotiated by Gov. Arnold Schwarzenegger and the Democratic leadership in the state Assembly remained positive and said the fight is far from over, but I'm not so sure I share their optimism.
Last year around this time, Schwarzenegger was declaring 2007 to be the year of healthcare reform in California. In broad terms he outlined a plan that would ensure that most Californians had coverage, either through their employer, an individual policy or by enrolling in a state-run program or purchasing pool.
The plan promised that everyone would reap the rewards because nearly everyone--insurers, employers, providers and individuals--would have skin in the game. In the end, however, overcoming resistance from all these quarters, while battling a growing budget deficit proved too difficult.
The bill was heard last week by the Senate's Health Committee, and at the time appeared to be just two votes shy of passage. The vote was delayed to allow for some additional politicking, but that extra time ultimately was the bill's undoing. During the break, Senators were able to dig deeper into a state analyst's evaluation of the bill and its potential for driving the state deeper into debt. That report warned of a $4 billion funding shortfalls within five years if the average policy exceeded $250 per person.
The final vote came with seven Senators opposed, one in favor and three abstaining from the controversial measure.
Key concerns over the proposal centered around the revenue stream that would fund the expansion of coverage and the end cost to low-income Californians--concerns that are not going away any time soon. Personally, I agree with the concept that everyone should have skin in the game, but I seriously doubt that the state's entrenched political interests can overcome their differences under the fiscal realities--a looming $14.5 billion deficit and deep cuts proposed for existing healthcare programs--that conspired to kill this proposal.
In a statement conceding the battle but not the war, Schwarzenegger noted California's long struggle with the issue of universal healthcare coverage.
"Despite the Senate's rejection of our comprehensive healthcare reform bill, I want the people of California to know I will not give up trying to fix our broken healthcare system. The issue is too important and the crisis is too serious to walk away after all the great progress we have made. The problems will not disappear. In fact, they are likely to get worse," Schwarzenegger said, adding "If [healthcare reform] were easy, California would have gotten universal coverage 80 years ago--that's when Governor Earl Warren's reform plan fell short by a single vote."
If only things would have been that close this time around, then Los Angeles Senator Mark Ridley-Thomas wouldn't have been the lone voice in favor of the bill. "Opportunities like this don't come around very often. I fear that by letting this opportunity pass, in the hopes of something better down the road, we will be stuck with a failing healthcare system for the foreseeable future," he noted after the vote went down.
It's sad to say, but by the look of things, he's probably right.
Brad Cain is editor of California Healthfax and executive editor for managed care with HealthLeaders Media. He may be reached at bcain@healthleadersmedia.com.
Jim Kerr, vice president of business development at CareGuide, talks about his company's One Care Street, which is a survey-based predictive model, and how the program is impacting health and costs.
While financially troubled CheckUps is shutting 23 walk-in health clinics in Wal-Marts, at least four other firms are roaring ahead and starting more than 20 clinics inside retail stores in the Florida counties of Broward and Miami-Dade. Walgreens is starting 16 clinics in the two counties, and has two already operating there. CVS already has 13 in Miami-Dade and Broward and is continuing to expand.
California Gov. Arnold Schwarzenegger has pledged to work with Assembly Speaker Fabian Núñez and representatives of two dozen interest groups to salvage a plan to reform the state's ailing healthcare system. Senate President Pro Tem Don Perata, however, said he will not revive the healthcare bill, which the Senate Health Committee rejected by a 7-1 vote.
The failure of an ambitious plan to overhaul healthcare in California has illustrated the difficulty of sweeping reform and puts renewed focus on the presidential race, where healthcare has become a top domestic concern. Presidential candidates are proposing a raft of ways to solve a daunting social challenge, and their plans largely center on reining in costs and expanding coverage to the country's 47 million uninsured residents.
