Biomedical Engineering Reference
In-Depth Information
Similar indication of market penetration strategy is evident as common industry
practice in the secondary data we collected to examine the validity of our fi ndings
(last column of Table
24.1
). Datamonitor (
2001
) reports that physician profi ling
through prescription tracking improves profi t margins by as much as 3 % and the
initial uptake of innovative drugs by 30 %. Research suggests that profi ling dates
back to 1940s when the American Medical Association collaborated with pharma-
ceutical companies to help assemble physician profi les (Greene
2007
), and pre-
scription writing data, and making both open to industry access (Grande
2007
).
The
evidence-based strategy
involved a three pronged approach: (a) industry
funding of clinical trials through research grants; (b) generating publications from
clinical trials with a bias for positive results; and (c) contractual arrangements with
commercial companies to write, process, and orchestrate publications in referred
journals without explicitly exposing their role (second row Table
24.1
; Fig.
24.1
).
Internal documents noted that research grants to physicians were intended to encour-
age clinical trials that induce familiarity with higher doses of Neurontin (Exhibit
39). The objective of the evidence-based strategy was to favor publishing articles
with positive fi ndings that “increase sales” (Exhibit 21), and return on investment
estimates were explicitly calculated to target disease indications with the greatest
revenue potential. The company entered into formal contracts with commercial
companies to develop a coordinated effort for executing publications by “life cycle
planning” (Exhibit 72) that involved a time-based program of sequentially publish-
ing scientifi c articles in peer-reviewed journals (Exhibit 57) in order to create a
“drumbeat in the literature,” (Exhibit 63; Table
24.1
). Company managers routinely
tracked the status of manuscripts processed for publication by contract companies
to coordinate their promotional efforts, as they also reviewed problems in keeping
the publications on track. For instance, AMM Adelphi, a commercial provider con-
tracted for evidence-based strategy, reported to a Parke Davis manager as follows:
… these physicians [designated authors] are clinicians rather than academicians or research-
ers, making them less accessible than scientifi c authors. Thus, these papers require more
time and management than is usual… We anticipate that by year's end, you will have sev-
eral manuscripts submitted to journals as well as either a paper or poster accepted for the
AAN, (Exhibit 64).
Parke-Davis internal documents reveal that the company contracted with Medical
Education Systems, Inc. to ghost write articles (e.g., failure to include an individual
as author who has made substantial contributions to research or writing of the man-
uscript) for $13,375-18,000 per article and to include physicians as guest authors
(e.g., include an individual as author who does not meet authorship criteria) for an
honorarium of $1,000 (Table
24.1
).
Our secondary data reveals that several companies including Scientifi c
Therapeutics Information and Health Sciences Communication openly advertise
their commercial intent to contract for publishing scientifi c articles for the pharma-
ceutical industry. Moreover, ghost writing and guest authorship in peer-reviewed
journals remains a common practice (Ross et al.
2008
). In a recent survey of six peer
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