Biomedical Engineering Reference
In-Depth Information
prospects as well as fi ne tune current market penetration efforts. An expert testi-
mony describes how the penetration-education interdependencies were carried out:
An unrestricted educational grant for $303,740 was granted to Handbooks in Health Care
Co. for the production of 75,000 copies of an epilepsy handbook. Approximately 96,000
high prescribers of anticonvulsant agents were identifi ed as targets for this topic and terri-
tory managers were instructed to introduce the topic to high prescribers in their territory,
(Exhibits B and 90).
24.4.3
Marketing Strategies and Confl icted Logics
in the Pharmaceutical Value Chain
Our analysis reveals that the marketing strategies and the deliberate structuring of
interdependencies confl ate the logics of appropriateness and consequences escalat-
ing the problem of confl icted logics within the value chain. As depicted in Fig. 24.1 ,
this confl ation occurs because pharmaceutical marketing strategies and the interde-
pendencies built among them exploit the logic of appropriateness for consequential
gains. For instance, our analyses reveals that the industry provides “unrestricted”
funds to produce favorable “research” that is published in peer-reviewed journals
through ghost writing. Upon publication, the “research” is disseminated using a
“medical education” strategy involving “grants” for continuing education and “sur-
rogate selling” strategy involving “contracted” thought leaders. Moreover, “thought
leaders” identifi ed through prescription tracking are awarded research grants for
clinical trials, and subsequently invited to populate speakers' bureau and disease
advisory boards to sway their peers through medical education and surrogate selling
strategies. Although we do not fully develop organizational role in instantiating
such complex strategies and interdependencies, in a separate analysis we have theo-
rized and empirically examined this issue (Singh and Jayanti 2013 ). Our analysis
shows that, the confl icted logics of the pharmaceutical value chain does not con-
strain organizational action. Rather, organizations deliberately internalize con-
fl icted logics to direct their sales professionals to display appropriateness-like roles
that cleverly camoufl age consequences related goals.
As long as the industry's efforts to camoufl age its confl ation are successful, the
strategy produces consequential results. Grants are considered a contribution to sci-
ence not marketing, research is viewed with credibility not tainted by commercial
intent, and thought leader's recommendations carry legitimate weight of an expert,
not a contracted spokesperson. However, these strategies undermine the very mech-
anisms (e.g., CME and Journal Publications) of interpersonal trust that are crucial
to the legitimacy of the medical profession. As a result, the more successful the
pharmaceutical marketing strategies are in achieving their objectives, the more
likely are they to amplify the confl icted logics of the value chain with one caveat;
the growing confl ict is latent and inert as long as the industry's deliberate confl ation
of logics remains undetected.
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