Closing the Marketing Strategy-Tactics Gap: An Institutional Theory Analysis of Pharmaceutical Value Chain - Innovation and Marketing in the Pharmaceutical Industry - page 690

24.1 Introduction

Scholarly research in pharmaceutical marketing has disproportionately focused on
the tactical issues of optimizing the ROI of pharmaceutical promotion spend, 1 pay-
ing scarce attention to the marketing strategies that underlie these tactics. In an
integrative review of the literature, Manchanda and Chintagunta ( 2004 , p. 143)
articulate marketing literature's emphasis well by observing that much research
aims to identify “ways in which these [pharmaceutical] fi rms can increase the
amount of prescriptions (i.e., increase revenues) or reduce the number of salesper-
son calls (i.e., lower costs) via a more effi cient allocation of [promotion] effort.”
Enhancing the effectiveness and effi ciency of pharmaceutical promotion tactics is
the dominant theme in a diverse and rich body of marketing literature (Venkataraman
and Stremersch 2007 ; Manchanda and Chintagunta 2004 ; Narayanan et al. 2004 ;
Mizik and Jacobson 2004 ; Oliver and Van Horn 2004 ; Wittink 2002 ; Gönül et al.
2001 ). By contrast, studies of the nature and scope of pharmaceutical marketing
strategies are negligible. Strategy is a fi rm's organizing scheme for competitive
advantage and provides coherence to a fi rm's diverse tactical choices. Moreover,
strategy operationalizes the dominant logic of the fi rm's management for achieving
its goals and objectives by blueprinting the underlying logic that gives meaning to
organizational action (why are we doing this? why are we doing this way, and not
some other way?) (Prahalad and Bettis 1986 ; Porac et al. 1989 ). In the integrative
review cited above, mention, much less consideration, of strategy is largely absent
while the diverse perspectives and fi ndings related to detailing tactics and practices
are thoroughly reviewed (Manchanda and Honka 2005 ). Without consideration of
strategy, a tactical focus is as myopic as studying action without cognition, and
analyzing what and how without understanding why .
Curiously, inattention to pharmaceutical marketing strategy and the resultant
strategy-tactics gap has persisted despite surprisingly vigorous, and often unfl atter-
ing, analysis of pharmaceutical marketing strategies among medical practitioners
and public alike (DeAngelis 2006 ; Angell 2005 ; Brennan and Mello 2007 ; Heuvel
2007 ). For instance, medical scholars express uneasiness at the “[pharmaceutical
industry's] sophisticated and wide-reaching marketing strategies ,” (Moncrieff et al.
2005 , p. 84), and their ire appears focused on the “marketing strategies masquerad-
ing as evidence-based medicine,” (Eichacker et al. 2006 , p. 1642). Concerned that
“physicians have been the central target of marketing strategies ” (Studdert et al.
2004 , p. 1891), several studies fi nd this trend “at best very troubling” (Steinbrook

1 The promotion spend by the pharmaceutical industry in the United States is estimated to be
between $27.7 and 57.5 billion (Gagnon and Lexchin 2008 ). Pharmaceutical promotion practices
include detailing (where salespeople visit with physicians to update them on recent therapeutic
advances and encourage them to write prescriptions that favor the fi rm's products), sampling
(where samples of company's drugs are provided to encourage trial) and physician meetings
(where educational meetings are convened to show effi cacy evidence of company's drugs) among
other related practices.