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“It's my job to figure out what a physician's price is. For some it's dinner at the finest restaurants, for others it's enough convincing data to let them prescribe confidently and for others it's my attention and friendship . . . but at the most basic level, everything is for sale and everything is an exchange.” So writes one former pharmaceutical representative in an article explaining to doctors just how drug reps work their clients. In the US an estimated 2.5 drug reps exist for every targeted doctor, and their approach to changing prescribing habits has developed into a science. Grooming doctors, known in the industry as detailing, involves profiling their psychology, tracking their prescriptions using data from pharmacies, targeting their weaknesses, and massaging their vanity, he writes. Even sceptics can be turned around with the right combination of humility and the academic veneer provided by armfuls of publications and invitations to teach. Doctors who won't see reps are targeted through their staff instead.
Detailing is expensive—each drug costs an estimated $25-$30m (£13-15m; €18-22m) a year—but companies know that it works. How can you avoid it? You can't. If you write enough prescriptions, they will find you.