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“Pharmaceutical representatives often confuse educating with selling, and evidence shows that doctors’ prescribing patterns can be heavily influenced by these sales representatives.” (Senator Herb Kohl, D., Wis.)

There are few people who want to see an end to Big Pharma’s massive sales force more than Big Pharma leaders themselves. In his blog, Life Sciences Chronicle, more than 6 months ago, and again a few weeks ago in MedTech Futures, a regular feature at MidwestBusiness.com, industry watcher Dr. Ogan Gurel echoed Big Pharma’s concerns that the sales program is simply unsustainable.

“From direct personal experience,” Dr. Gurel says, “I know that many top pharmaceutical executives are keenly interested in solutions to the problem rather than sustaining what is ultimately an unsustainable arms race.” Big Pharma wants to get back to the business of bringing innovative medicines to the public, he says, rather than trying to sustain massive sales teams.

Created to promote prescription drugs to physicians, the sales rep program has bloated to an estimated cost of $20-billion-a-year and 100,000 sales reps knocking on doctors’ doors day in and day out across the country. Its value to the industry is in serious question by everyone concerned.

Herb Kohl (D., Wisconsin), chairman of the Senate Special Committee on Aging, along with Sen. Chuck Grassley (R., Iowa), recently introduced a bill requiring Big Pharma to report all payments and gifts made to physicians. News reports said some Big Pharma companies welcomed the idea, and at least one was already doing so.

But things could get worse, rather than better, if a proposal for federal grants to counter Big Pharma’s sales efforts are approved. This past March, Sen. Kohl said he and Sen. Richard Durbin (D., Illinois) would introduce legislation to encourage “counter-detailing” grant programs.

Counter-detailing, or “academic detailing”, is the name for efforts, often made by medical insurers, to counter Big Pharma’s sales pitches, including its massive sales rep program which is referred to as “detailing.” Counter-detailing pushes doctors and patients toward cheaper generic drugs, and even tries to discredit Big Pharma’s claims about their more expensive branded products.

The grant programs would help create training materials informing physicians about safety issues and comparative effectiveness of different medications, and send trained health care professionals to physicians’ offices to provide the information to physicians.

These ideas could be worse than doing nothing at all. Government-subsidized attacks on Big Pharma brands would hit Big Pharma right in the pocket-book, resulting in even more money poured into its sales forces to compete. There seems little chance that the government’s counter-detailing would support branded products, helping Big Pharma ease up on its sales forces.

Neither of the Kohl-backed bills does anything to effectively replace the bloated and unsustainable drug-rep business model with a viable alternative — one that actually informs physicians about the efficacies and safety issues of both generic drugs and Big Pharma’s branded products (without all the expensive baloney of the sales rep program) while increasing real and predictable patient safety.

What’s needed, and where the government should put its money, is into rebuilding the FDA’s approvals and aftermarket safety programs with sensible and effective policies that help Big Pharma to get more innovative drugs into the pipeline, providing the kind of thoroughly tested and ethically marketed drugs that people need, want, expect and, by their recent actions in the courts of America, are now loudly demanding.

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