'Round the Sphere: Cupcake Capers Continue, PharmaFraud Blog?

The AstraZeneca Cupcake Caper has escaped the gravity of the Pharma Blogosphere^TM and entered the realm of mainstream blogging.

These young ladies -- Nichelle, alizinha, and Rachel -- are
self-proclaimed cupcake fans and authors of the All Cupcakes, All the Time Blog (there had to be at least one blog dedicated to cupcakes!). The trio have picked up on the stories published recently in our part of the blog universe (see "Cupcakes and cancer controversy").

The cupcake blog's mission is to share with the world everything you wanted to know about cupcakes (I'm sure, one day, they will regret their homage to this tasty treat). That also seems like the mission of a few blogs in the Pharma Blogosphere.

The latest brouhaha was initiated by Ed Silverman at Pharmalot. He questioned how AZ expensed the pink cupcakes their reps allegedly handed out to patients in doctors' offices (see "Taxing Question: How Did AstraZeneca Account For Pink Cupcakes Given To Patients?").

I decided to post a reply to Ed's question in an attempt to show that it is both possible to expense such items and that it may violate AZ policy but does not necessarily violate HIPAA privacy regulations (see "On Cupcakes and HIPAA").

The pace of commentary then picked up when Ed and Peter Rost of Question Authority apparently simultaneously received and published a copy of an AZ internal memo from the AZ Group of Seven (see "Astrazeneca's Cupgate: Don't Feed the Patients" and "AstraZeneca FORBIDS PINK CUPCAKES to patients!"); the memo, dated May 1, specifically forbade AZ reps from feeding cupcakes to patients.

As a proponent of the Free Lunch for Patients Program, I was outraged and railed against this AZ policy in my own post to Pharma Marketing Blog (see "AZ: No Cupcakes for You!"):

I cannot see how it is perfectly OK for reps to feed pizza to docs, but not give cupcakes to patients!

It’s time that we patients stood up and demanded our share of the pharma giveaway program!

Citing HIPAA as an excuse for not giving patients cupcakes is a red herring. That law was never intended to leave patients in the cold while docs feasted on gourmet deli sandwiches!

It’s all because of pharma bloggers — Ed Silverman, Peter Rost, Jack Friday — that this memo was written!

Does anyone think that a cupcake could influence me to ask my doctor for a course of Arimidex? Certainly not!

On to more serious matters...

Peter Rost may soon share the whistleblower limelight with another blog entry to the Pharma Blogosphere: PharmaFraud. This new orb is still a random collection of gaseous matter and claims:

"When this site goes live the Pharma Industry will long for the days when Peter Rost was their biggest worry."

I don't know if the blog can fulfill this promise. To beat Rost at the pharma whistleblower game, you have to have some pretty shocking stories to tell!

No fear, Question Authority and PharmaFraud seem intent on collaboration rather than competition. We'll see.

'Round the Sphere: Pharmalot Goes Green, Pharma Gossip Goes BBQ, Drug Wonks Just Go Berserk!

Ed Silverman has been busy over the weekend. Like most of us he probably spent some quality time with his family and lawn, but be also managed to launch a makeover of his blog, Pharmalot.


Pharmalot now sports a new green glow and offers several new features and improvements, according to Ed:

- More visibility for comments;
- More links to the rest of the Internet;
- Easier to find entries, and new topic pages;
- Enhanced archives;
- Easier-to-follow comment discussions;
- Smaller file sizes;
- Easier-to-use Anonymous Tips link;
- Lighter colors and bigger type;
- No mediciney taste!

I especially like the new color scheme, larger font, and the fact that recent comments are highlighted in the right hand column. I predict that this will encourage more people to post comments, which will make Ed even busier!

There's also a calendar that allows you to look at archives by day, rather than by month. This is very useful since Ed makes several posts per day.

Anyway, good luck Ed!

Meanwhile, Jack Friday over at PharmaGossip also initiated a bit of a makeover. Insider, however, only went so far as to pimp the logo as soon below:

Will we see more PharmaGossip logo variations a la Google?

Have you used Cafe Pharma's Pharmagather lately? If you have, you will have noticed something weird. Here's a screen shot I took this morning (click on it to enlarge it):

Notice how many times DrugWonks appears. You might think these are all new posts because that's how pharmagather works -- it lists posts from several blogs in reverse chronological order. This helps us find the most recent posts mad in the Pharma Blogosphere^TM.

But if you look more closely at the DrugWonks entries, most of them are labeled "posted 75 minutes ago." Actually, most of these were posted several days ago!

So, what's the big deal? Well, just as on search engine pages, visitors to Pharmagather are not going to scroll down too far to access posts made to other blogs. DrugWonks is dominating the top positions on the Pharmagather page even though there aren't that many recent posts being made to the blog! This unfairly hogs the limelight.

This could have been a fluke, but I just checked and again DrugWonks dominates the top positions.

Either DrugWonks has found a way to game the system used by Pharmagather -- such as "republishing" old posts -- or there is something wrong with DrugWonks' feed.

Whatever the problem, I wish Pharmagather would fix it!

'Round the Sphere: Health Care Renewal Rebuffed by In the Pipeline on Avandia

Seems like Derek Lowe over at In the Pipeline and a few other people as well are detecting a hidden "agenda" at the Healthcare Renewal blog.

It started with PharmaGossip recommending an article on Avandia at the Health Care Renewal site, calling it "essential reading". The article in question is "Expanded Avandia Story Now Echoes Familiar Themes."

In the article, the author, Roy M. Poses MD, compares the Avandia case to the Vioxx case and cites these "familiar themes":

• Early warnings from at least one whistle-blower were apparently ignored.
• The pharmaceutical promoted the drug enthusiastically, apparently again in a way designed to distract attention from particular adverse effects.
• Just to muddy the water, the whistle-blower had financial relationships to manufacturers of competing drugs, possibly leading to questions about whether his whistle-blowing may have been influenced by them.

I also warned that GSK may be following the same path as did Merck (see GSK May "Step Into the [DTC] Void" to Defend Avandia and Advice to GSK on Handling the Avandia Avalanche: Don't Do What Merck Did). Peter Rost went so far as to call me "stupid" for giving GSK free advice, but I know he meant that in the nicest possible way.

Anyway, Derek had this to say:

"[The] article has some good points in it, but to my ear they're phrased oddly. For example, it advocates a skeptical attitude toward the marketing claims made by drug companies, which is very good advice. But that's very good advice for evaluating the marketing claims of companies in every other industry, too. They're trying to sell you something. They will present their product in the most favorable light possible, whether that product is a car, a diabetes drug, or a burrito.

"...one of the things that I dislike about the Health Care Renewal piece is the hand-rubbing now-we've-got-'em tone that I detect in it. You don't have to go far to find it from plenty of other sources, either, which is why people like me are perhaps too touchy on the subject."

[You can find Derek's complete post here: More Avandia, And More on Marketing]

What I found disturbing about the Health Care Renewal piece is the following claim that Dr. Poses made:

"Once again, it appears that a drug company was pushing one its products beyond what the clinical research evidence supported."

The way I interpret this is that GSK made efficacy (benefit) claims beyond what the evidence supports. This is different than saying it tried to gloss over the adverse side effects, which is what the FDA warning letters (mentioned in the NYT article) say. The FDA never, to my knowledge, claimed that GSK was making unsubstantiated benefit claims.

This is an important distinction, because any decision by the FDA to request that Avandia be taken off the market will be based on how the risks stack up against the benefits. Other commentators -- including Bob Ehrlich -- also point out that the benefits of Avandia may outweigh the risks:

"In my view, here is another useful drug accused of being dangerous in the unrealistic desire for risk free medications...Properly warned, patients and their physicians need to weigh the risk and benefits of any drug. In some of those carefully considered cases, patients will still die because of a reaction to a drug intended to make them better. That has and always will be the case. Those deaths pale in comparison to lives saved. That part of the story gets lost because 'greedy uncaring drug company' makes better copy." [DTC Perspectives Issue 262]

I am not sure that Avandia's risks outweigh its benefits, but if intelligent bloggers -- and MDs to boot! -- can't get it right, then God help patients who need to make a decision!

HHS Launches the Pandemic Flu Blog

HHS CONVENES AMERICA'S LEADERS TO HELP AMERICANS PREPARE FOR PANDEMIC FLU

Influential business, health care, faith-based and community leaders participate in pandemic preparedness blog and forum hosted by HHS

[ASIDE: It's a great time for "faith-based" organizations to share the largesse of big government! I wonder what these failth-based leaders think of flu vaccine? You can get the flu from sexual intercourse, you know!]

The U.S. Department of Health and Human Services (HHS) has launched the Pandemic Flu Leadership Blog, a five-week-long blog about pandemic preparedness. Participant bloggers include some of the nation's most influential business, health care, faith-based and community leaders. This online event is part of a new campaign to help Americans prepare for a potential influenza pandemic and engage U.S. leaders in the challenge to help others prepare.

"The conversation about individual preparedness for pandemic flu must extend nationwide through all possible channels, including social media and the Internet," HHS Secretary Mike Leavitt said. "The blog summit is an innovative and efficient forum for bringing together leaders for a lively discussion on the pandemic preparedness movement."

HHS is one of the first government agencies to utilize the participatory nature of the Internet to create a dialogue around a specific issue or campaign. This effort to engage individuals in an online conversation is the one of many steps HHS will be taking to carry out its campaign to encourage Americans to prepare. By preparing now, individuals will be better able to withstand the impact of a pandemic, slow the spread of disease, and lessen the overall impact to themselves, their families and to society.

Ideas and dialogue generated during the leadership blog will contribute to HHS' upcoming pandemic influenza leadership forum in June, an event which will bring together approximately 80 U.S. leaders representing the business, faith, civic and health care communities. The dynamic leadership forum will call on participants to help Americans become more prepared for an influenza pandemic by leveraging their influence and expertise in their communities to actively promote individual pandemic preparedness.

"It may not be possible to predict with certainty when the next flu pandemic will occur or how severe it will be, but it is essential to prepare ahead of time and that time is now," Secretary Leavitt said. "We are the first generation ever to have an opportunity to prepare in advance of a pandemic. Government alone can't prepare the nation for a pandemic. This is a shared responsibility and the challenge requires leadership from those most trusted and respected in their communities."

The pandemic-focused leadership blog gives national leaders the opportunity to participate in an ongoing and critical conversation about the potential impact of a pandemic on individuals, families, communities and workplaces. Participating bloggers will be asked specific questions related to the threat of a pandemic in the U.S. and will collaborate on ideas for what can be done to help their employees, constituents,
customers, congregations and clients prepare now.

Approximately 16 influential leaders, including leading authorities on pandemic flu, will blog throughout the next five weeks. A few of the participant bloggers include Pierre Omidyar, Founder and Chairman of Ebay and Co-founder of Omidyar Network; David Eisner, CEO of the Corporation for National and Community Service; and Greg Dworkin, Founding Editor of Flu Wiki and Chief of Pediatric Pulmonology and Medical Director of the Pediatric Inpatient Unit at Danbury Hospital in Danbury, Conn.

The Pandemic Flu Leadership Blog will continue through June 27 and is open to the public and media. Comments are welcome and encouraged by all who visit the blog at http://blog.pandemicflu.gov.

In conjunction with the blog, HHS will hold a Pandemic Influenza Leadership Forum on June 13 in Washington, DC with representatives of the business, faith, civic and health care communities. Using materials prepared by HHS, local leaders will be asked to reach out to the people they represent with the essential steps necessary for pandemic flu preparedness. By preparing now, individuals will be better able to withstand the impact of a pandemic, slow the spread of disease, and lessen the overall impact to themselves, their families and society.

An influenza pandemic occurs when a new influenza ("flu") virus appears in humans; the new virus causes serious illness and death, and spreads easily from person to person worldwide. Past influenza pandemics, like the one that occurred in 1918, have led to: high levels of illness; death; disruption in normal, everyday activities like going to school, work, or other public gatherings, and economic loss. For more information visit: www.pandemicflu.gov.

'Round the Sphere: Moore (sic) Movies, Avandia Avalanche

Several new Moore SiCKO sightings, news, and video clips have been posted by bloggers in the Pharma Blogosphere^TM.

PharmaGossip posted several links to reviews in the press as well as a video clip (trailer) from the movie (see "SiCKO - what the papers say").

Most reviews are pretty positive. I haven't seen one inch devoted to what the movie says about the pharmaceutical industry. Moore seems mostly concerned with hospitals and insurance companies as the bad guys.

I am still trying to get a screening for us pharma bloggers (see "Mr. Moore Don't Ignore: Please Invite Me to a Screening of Your Movie") and have made some progress on that front that I will be able to talk about later.

Drug Wonks, those "Tricky Wonkers" who attempted a "Wonky PR Trick" pre-debut, has been quiet apres le debut -- I guess all the positive media reviews (even from conservative FOX!) is too much for these PR wonks to spin in the opposite direction!

For a treasure trove of SiCKO blog links (mostly outside our sphere of influence), take a look at this Google Blog Search page.

INNERSTATE: Is it DTC Advertising?
SiCKO wasn't the only movie on pharma bloggers's minds this week. Centocor's 58-minute disease awareness documentary INNERSTATE was also a hot topic in the Sphere.

After finally seeing the movie, Pharm Aid was enthusiastic about it:

"Johnson & Johnson has a long history these kind of broader issues-based campaigns. Since the J&J product, Remicade, is never mentioned in the film and no treatment option is pushed (contrary to Avorn’s comments that this is a “commercial”), it’s not clear if J&J is thinking of InnerState as an issues campaign or if this is more traditional product push."

Unfortunately, as I pointed out on Pharma Marketing Blog and as Ed Silverman pointed out on Pharmalot, INNERSTATE may actually be a commercial. True, the movie itself never mentions Remicade (Centocor's product), but, according to evidence submitted to me by SEIU Local 32BJ, Remicade product information -- a medication guide -- was distributed at a showing of the movie in the King of Prussia Mall in PA in April. I also received the INNERSTATE DVD in the mail containing this product information along with the movie. IMHO, this makes the entire campaign a DTC promotion rather than an unbranded disease awareness campaign, which is how it has been generally described in the press and on other blogs.

Of course, SEIU Local 32BJ has a bone to pick with J&J and has sent letters to FDA and PhRMA claiming that Centocor is in violation of FDA regulations and PhRMA DTC guidelines. However, as I explained to the union's representative, I do not believe Centocor is in violation because it included all the necessary fair balance information.

Anyway, you can find all sides of the story here, including a lengthy statement from Michael Parks, Centocor's Director of Public Relations, and Executive Producer of INNERSTATE. This level of engagement with bloggers is unprecedented and earns Centocor kudos from me.

Avandia Avalanche
As expected, many pharma bloggers have precipitated an avalanche of posts about Avandia, which is being characterized in the press and on blogs as the Vioxx II.

While I love to see a big pharmaceutical company squirm -- especially a British pharma company -- as much as the next American guy, I offered GSK some advice on how to handle the situation. See "Advice to GSK on Handling the Avandia Avalanche: Don't Do What Merck Did".

Steve Woodruff from Impactiviti Blog added his own piece of advice in a comment to my post:

Make a Public Pledge

Something along these lines: "According to the information we have right now, we are convinced that Avandia is a safe and effective treatment. However if, in collaboration with the FDA and clinical researchers, we come to the conclusion in the future that this (or any) drug that we offer has risks that outweigh its benefits, we will immediately withdraw it from the market."

- Take a strong stand based on current information
- Show openness to the implications of new (well-founded) information
- Follow through on the pledge no matter what the cost

This kind of no-nonsense stance, joined to responsible disclosure and clear communication to the marketplace, will go a long way toward countering the negative view of "Big Pharma" - particularly when there are Vioxx-type side effect problems...

Be sure to visit Impactiviti Blog for more insights on GSK.

Meanwhile, Drug Wonks has an interesting perspective on why the Avandia story is breaking now. See "Sneak Attack on PDUFA," which should be stored under "it ain't over until the fat (diabetic) lady sings."

Riding in Peter Rost's Wake

When will I learn?

Never underestimate the value of riding in Peter Rost's (Question Authority's) wake as he jets through the Pharma Blogosphere^TM.

Last week I wrote:

"Corruption regarding the sale of a plant in India has very little relevance to "me", which is what is really important. Maybe that's why not many other blogs are picking up on this latest whistle blower story." (see "Whistle Blower Blowout")

It seems my comment was a bit premature. Rost now lists quotes from several bloggers who are paying homage to his latest revelations regarding whistleblowing in India, which is aimed against Pfizer.

"I guess John is eating his words about right now," says Rost.

Well yes, I was wrong about other blogs following in Peter's wake, which they have now done in droves, and for good reason: Quoting Rost and linking to his blog -- riding his search engine visibility coat tails -- is a sure way to increase traffic to your blog.

Rost also reciprocates and links back to other bloggers, which is a nice gesture of camaraderie and a reward to faithful followers; it's the ultimate in "scratch my back and I'll scratch yours" Internet visibility strategy. We've all engaged in it and I am doing it right now. Some, however, may say that my scratching digs a bit too deep!

Back in the day when the Internet was young (1995), it was common practice for web sites to solicit links to one another. Web sites even set up a special page for these links and expected linked sites to reciprocate.

I don't believe in the "reciprocal link" strategy to build visibility, although I understand that links are an important part of Google's search algorithm and we are all slaves to that master.

Where's the Added Value?
But bloggers also link to other bloggers for reasons other than getting higher visibility in search engines. The best reason for linking to other bloggers is because you have something to add to the conversation that the other blogger started.

Most of the bloggers who linked back to Rost's latest whistleblower posting merely re-iterated the story and referred back to Rost for details. Some suggested that Pfizer should have rewarded Rost and prevented all the bad publicity he is now generating.

But from what I see, few other bloggers had anything substantive to add to the conversation. You know, some more information about pharma's foreign subsidiaries, Pfizer's world domination, common business practices in foreign countries like India, etc.

No blogger I know of offered a critical analysis or helped us better understand the issue. I could have used more views on the topic -- not more links back to Rost -- in order to understand what appears to be a complicated case.

Trolling through all the blogs that cited Rost, the best I could come up with that added something new to think about, was a comment made to an Impactiviti post by Dr. Jane Chin:

"When industry conducts itself in a manner worth cheering, you’ll find that its cheerleaders may once again emerge.

"Riding on the laurels of saying (but not practicing) 'we want to do the right thing', using the rising cost of R&D as the perennial reason for rising cost of drugs, and expecting consumers to admire drug companies for doing drug companies’ expected jobs of producing life-saving or life-improving drugs are no longer enough to keep me defending the industry."

Food for thought, which is what other bloggers failed to deliver in this case, IMHO.

Check It Out: Google Blog Search

Fabio at IgniteBlog turned me on to Google's new Universal Search (see "Google 2.0: Google Universal Search Launched!"; also see "Google Universal Search & Healthcare Social Media: Game Changing Or More Of The Same?" over at HealthcareVOX).

Part of Google 2.0 is Google Blog Search, which could be Game Over for other search sites that specialize in blogs.

Check it out here.

'Round the Sphere with Christiane Truelove: Tricky Wonkers or Wonky Tricks?

If you are not already a subscriber to PharmaLive's e-newsletter "Pharma Blogs: Week in Review" edited by Christiane Truelove, do it now! (subscribe here) It's a nice Friday morning treat, especially when she highlights comments form some of my favorite bloggers in the Pharma Blogosphere^TM, although this week "not so much" viz-a-viz my favorites.

Everyone, it seems has an opinon of Michael Moore's new documentary SiCKO, but no-one has seen it! I'm on record with my "Mr. Moore, Don't Ignore" campaign to get a special screening for us pharma bloggers.

Wonky Tricks
Christiane quotes Drug Wonks' Peter ("industry pit bull") Pitts declaring that Moore's film is not doing well in test-market trials. "Can anyone take a film about health care from a clinically obese person seriously?" Mr. Pitts asks.

How does Peter know about SiCKO test market trials? Simple. All he has to do is qualify his statement with "according to inside sources," which he never cites (don't take my word for it; see "Sicko flops in test market trials").

Of course, if you do a Google search on "SiCKO test market", you will find Peter's post plus pundits who pander to Peter by citing his post. A complete circle jerk and PR wonky trick!

According to my inside source -- ie, my gut -- Peter Pitts is full of sh*t!

Jack Friday on Holiday -- in Cannes?

Jack Friday of PharmaGossip fame is taking a "Long Weekend" and from what I see posted on his site, it involves flying somewhere.

Could it be Cannes to view Michael Moore's new documentary SiCKO?

Inquiring minds want to know.

'Round the Sphere: Bloggers Side with SiCKO (to a point and for now); Tongue-in-Cheek Free Lunch

Michael Moore's long-awaited documentary film SiCKO (why the lowercase "i"?), about the pharmaceutical-health-insurance-industry complex, is set to debut in Cannes this Saturday.

I wish I could be there, but I am temporarily without passport! So, I wrote an open letter to Moore and urged him to invite us bloggers to a special screening in NYC. If Centocor can do it with its film Moore should be able to as well! (See "Mr. Moore Don't Ignore: Please Invite Me to a Screening of Your Movie").

While I continue to advance the interests of pharma bloggers, other bloggers have pitched in with their own commentary on this film and Michael Moore.

Mark Senak, who confesses not to have seen any of Mike's films, nevertheless has some good advice on putting this movie into perspective:

"I would like to think that SiCKO is perhaps an opportunity for industry and for industry critics to do some soul-searching, asking the real tough questions about how people got to feeling the way they do about the healthcare and pharmaceutical industries, and what can be done about it. But for people on each side of the issue to spend time this summer calling the movie or its maker names isn't likely to advance anyone's image - industry or its critics." (See "The Summer of SiCKO - Cannes Film Festival Begins Today.")

This comment got a hearty "hear, hear" comment. Mark, if Moore takes my challenge and invites me to a special screening of SiCKO, I'll be sure to put in a good word for you as well.

Ed Silverman over at Pharmalot expressed a similar point of view:

"Getting beat up in a widely publicized movie isn't likely to make execs and their employees feel warm and fuzzy. Few people respond well to harsh criticism. So ignoring or chastising Moore and his film is likely to be a typical reaction. But that won't make the issues disappear. If anything, big pharma will only appear more defensive, and confirm impressions that critics say is all too real." (See "SiCKO Debuts At Cannes On Saturday").

Ed got some decidedly nasty comments, including this one, which brought the Holocaust into play:

"Occam's Beard says:

Sorry, don't mean to become a gadfly here, but I can't let this pass either without examining the logic.

Or has industry made it easy for him - and other critics - to pull out the long knives? This requires a gamut of people ...to look in the mirror and ask why their industry is increasingly villified.

So unpopularity necessarily has a just basis that the unpopular would do well to reflect on and change their ways?

Perhaps that should be pointed out to German Jews, if you can find any. Demonizing the unpopular is child's play."

I am not sure this qualifies as a direct comparison of Moore's anticipated treatment of Pharma to German Nazi's' demonizing of jews, but there you have it! Occam must not be a proponent of the First Amendment!

Other bloggers in the Pharma Blogosphere^TM posted reports about SiCKO, but had nothing new to add.

Meanwhile, the brouhaha over the Cupcake Caper (see "'Round the Sphere With Christiane Truelove") has morphed to a brouhaha about pharma free lunches to physicians and patients in general.

When Black Kitty first raised the issue of appropriate food to give to patients -- cupcakes didn't seem to meet BK's criteria of appropriate -- I thought this was worthy to follow up with some general guidelines of pharma's nascent free lunch for patients program (see "Guidelines for Gifts to Patients"). I had written on free lunch for patients before (see "Free lunch for patients! Why not?") and thought this was an appropriate topic to add on to.

But that story is history.

Pharma's Free Lunch for Physicians Program
What really hit a nerve is when I revisited pharma's practice of free lunch for PHYSICIANS and reported that 62% of respondents to a poll agreed that this practice should ceaase (see "Blog Readers' Opinions on Physician Marketing & Education Practices").

Sarah Palmer, Cafe Pharma webmaster, reminded me that such a poll is not statistically significant. I'm not questioning that -- Sarah and I are on good speaking terms now and I don't wish to reopen old issues. But I will say that in this new age of Web 2.0 and "The Wisdom of Crowds," online polls, rating score and opinions from readers, regardless of the statistical significance, will have an increasing impact on the pharmaceutical industry.

Some industry experts, like Bob Ehrlich, Chairman of DTC Perspectives, have even suggested that Blogs may some day rival DTC (direct to consumer) advertising in influencing consumers (see "Blogs vs. DTC: What's Best for Consumers?").

I think that's what he said. But you don't have to be satisfied with my interpretation. Mr. Ehrlich will be my guest on an upcoming Pharma Marketing Talk podcast on Thursday, May 24, 2007, 1 PM Eastern US time. You can access this podcast here.

Regarding my post about the poll that called for an end to pharma free lunch to physicians, I received a comment from an anonymous physician who said:

"I would just like to say that as a former intern and resident working 100-hour weeks while making less than $30K a year, a free lunch now and then was a godsend and brightened up otherwise long and dreary days."

"Seriously, though, I do understand why institutions are moving toward these 'No Free Lunch' things, but really, cut the scut workers a break every now and then. If you've been there, you know how it sucked and how a free lunch was like having recess."

Of course, I took him/her at his/her word and went on to post a little spoof about free lunch being more than just lunch (see "When is a Free Lunch More Than Just Lunch?").

The guy took all this too seriously: "Like I've said, I don't deny that there are issues, but in the world of pharma and medicine, this is such piddling nothing, I have a hard time understanding your obsession with it."

Chill out, dude. You need a Valium, not pizza! You are so full of yourself that YOU cannot recognize when someone else makes comments "with considerable tongue-in-cheek"!

But, you have to wonder, if free lunch was such a "piddling nothing," why does the drug industry spend so much on its "free lunch for physician" program (which I once estimated cost about $1.65 billion per year; see "Free Lunch Redux") and why do physicians like this get so worked up about criticism of the program? It obviously means a lot to them -- like a free entitlement that they will fight tooth and nail to maintain!

Of course, it's not just lunch; it's the golden key that gets reps in the physician's door (see chart above), which is closing to more and more drug reps. The industry itself recognizes it has only itself to blame -- Pfizer, for example, recently cut back the practice of "rep pods" by which a number of reps hit the same doctor with the same message until the doc caves in!

That's it for now. Go forth and explore the sphere!

Whistle Blower Blowout

It's Whistle-Blower week in Washington DC (see "Washington Whistleblower Week") and Peter Rost is steaming along with more whistle blowers coming out on his blog. For the latest see "Pfizer Finance Executive Blows the Whistle - Part One."

Is it just me that feels overloaded with whistle blowers?

I kind of fell asleep halfway through this latest revelation about the sale of some Pfizer plant in India. I don't think I'll be tuning in to part two of this story.

These financial shenanigans are never likely to rise to the level of the simple (now legendary) "buckets of cash" story that Peter broke some time ago. Corruption regarding the sale of a plant in India has very little relevance to "me", which is what is really important. Maybe that's why not many other blogs are picking up on this latest whistle blower story.

Welcome to Cafepharma's Detailpiece

Cafepharma has started a new blog called Cafepharma' Detailpiece. Here's their welcome message:

Cafepharma staff will be blogging pharma from the unique viewpoint of the pharmaceutical sales community. We will be opening discussions on various topics in pharma news, pulling relevant discussions from the cafepharma message boards and more. Please feel free to join in the discussion by posting comments to any posts.

I have no doubt that this will be an interesting blog, worthy of inclusion immediately into the Inner Planets of the Pharma Blogosphere^TM.

Us other bloggers will no longer be able to scoop up and co-opt Cafepharma message board discussions -- Cafepharma's Detailpiece will alwasy beat us to the punch!

Pharma Gospel

Faith-based Unbranded Marketing
How to Educate, Engage and Empower members of the African American Community

Guest: Jay Bolling, President of Roska Healthcare Advertising

Guest: David D. Comey, Managing Partner at Healthy National Network

Live Podcast Date: Tuesday, May 15, 2007, 1 PM Eastern US time

Duration: Approx. 35 minutes

Go to the Pharma Marketing Talk Channel Page to listen live and for call in instructions (only if you want to ask a question during the live broadcast). You can also have a reminder message sent to you by e-mail.

Background
The African American experience in America has left many of them mistrustful of mainstream institutions/providers who are members of the dominant culture. While studies show that this community is receptive to DTC advertising, there are gaps in the healthcare delivery system and many at-risk patients never receive treatment.

This suggests that a distinct need exists for an alternate, targeted program that can help motivate African Americans toward self-healthcare awareness and caregiving.

To address this problem, Roska Healthcare Advertising, in partnership with Healthy National Network (HNN) and Impact Health, recently formed the "Multi-cultural Outreach Initiative" to improve the disease awareness of African Americans and other minorities. This targeted program involves a unique 'push/pull' strategy that brings together key physician opinion leaders, faith-based organizations and targeted media to improve the health of minorities in their communities, and the pharmaceutical manufacturers who are partnering in this important initiative.

Jay Bolling
Jay Bolling is president of Roska Healthcare, where he is responsible for directing the agency's overall highly targeted professional and DTC/DTP campaigns for their clients. Having spent 20+ years overseeing programs in the pharmaceutical and healthcare markets, Jay is a recognized thought leader in consumer, physician, managed care, and retail pharmacy channels. His strategic vision and expertise in targeted communications easily place him at the forefront of today's pharmaceutical marketers.

David Comey
David Comey has over 30 years experience in healthcare leadership. Immediately prior to founding Healthy National Network, Mr. Comey created Impact Health; Inc. which included proprietary technology for point-of-care screenings and clinical testing, healthcare and pharmaceutical data management tools, and product marketing applications for specific disease states. In his current capacity. Mr. Comey leads HNN as an organization that connects "healthy messages" with targeted populations with channels that include: African American Healthy Network, Latino Healthy Network, and the Cardiology Healthy Network (general market).

Some topics to be discussed:

• How do you target the right population?
• How do you enlist physicians and ministers to work together?
• What are the organizations and skills brought together in this initiative?
• What are you doing to get pharmaceutical companies involved?

Another Pharma "Friend" Leaves the Pharma Blogosphere

Pharma Gazette's Gloria Gamat is leaving the Pharma Blogosphere^TM -- at least for now. Was it something I said? I don't think so, but here's what she says:

The last 14 months of blogging here at Pharmagazette had been rewarding in more ways than one and I want to take this opportunity to thank the whole Know More Media team for believing in me.

However, some things must end and after this post I will no longer be blogging for Pharmagazette.

(I will still be blogging about health and science though, but outside the Know More Media network of business blogs.)

While blogging about pharmaceutical business taught me huge stuff than I could ever learn somewhere else, it is something that I cannot do anymore.

Thank you so much for frequenting this blog. I hope you still find time to visit when Know More Media finds a new resident blogger.

And as for me, I will still be present in the blogosphere...so I hope you find me there some time soon.

So long and best of luck and regards to Know More Media and its team of excellent professionals and wonderful people.

I wish her luck in whatever her new endeavor may be and I hope she keeps us informed about her new blog about health and science by submitting a comment here.

Friend of Foe?
BTW, I am not at all sure that Gloria can be characterized as a "friend" of pharma. In the First Ever Pharma Blogosphere Reader Survey (download summary here), Pharma Gazette was rated "supportive" of the industry -- but not by as wide a margin as several other blogs. Only about 20% of respondents rated the blog as "very" or "somewhat" supportive of the industry, whereas 40% said the same of In the Pipeline, which I don't view as super-pharma friendly (Lowe often criticizes the industry).

In fact, I don't like characterizing people as "Friends" or "Foes" or as Jim Edwards at BrandweekNRX says, "Enemies" (see "More of Pharma's Enemies Join the Blogosphere"; Jeeez Jim! Can you get rid of that Neilsen NetRatings pop-up? I don't want to take your survey and it takes soooo long to dispose of that window that I sometimes quit your blog in frustration!).

Jim was commenting on the entry of the Prescription Access Litigation (PAL) Blog to the Pharma Blogosphere (see "New Pharma Blog Planet Discovered!"). Frankly, I don't think PAL is an industry supporter, but "enemy" may be too strong a word.

Anyway, it's a free blogosphere and bloggers like Jim can call anyone anything, even "turd." But that's another story about another pharma blogger who has fizzled out of the sphere.

'Round the Sphere With Christiane Truelove

PharmaLive's e-newsletter "Pharma Blogs: Week in Review" edited by Christiane Truelove offers a roundup of what bloggers in the Pharma Blogosphere^TM are writing about recently. To read it, you need to subscribe here.

Topics covered this week include:

• The two Peters (Pitts and Rost) on the issue of drug re-importation.

Pitts is the anti-Peter, whereas Rost if the pro-Peter, viz-a-viz allowing re-importation. You may recall that this was the issue that first brought Rost to worldwide attention via his 60 minutes interview. Back then Peter did not have a blog and would send out email missives. "Get a Blog already," I said (see "Rost to Roost in Blogosphere"). The rest, as they say, is history. Pitts, on the other hand, used to work for the FDA. Funny how many former FDAers now lobby, do PR, or otherwise consult for the drug industry.

• Jim Edwards (Brandweek) on the failed DTC moratorium provision

Truelove says "In response to comments made by Democratic Iowa Senator Tom Harkin in the Star-Ledger, Mr. Edwards says, 'We've had 10 years of DTC. Either it's fine the way it is or it needs to be reined in. If it needed reining in, then this was the chance to do it. And you balked. No one believes that Congress will ever again take serious action to change DTC rules.'" (see "Senate to Big Pharma on DTC: 'Never Mind!'")

Of course, some people, like Robert Corn-Revere, think Congress has the right to limit DTC only by eliminating the first amendment (see this screed from the Media Institute).

• Derek Lowe (In the Pipeline) on more power to the FDA to monitor drug safety

"We know just as much about toxicology as we did yesterday -- a lot, from one perspective, but not nearly enough, from another," Dr. Lowe says.

No legislation will correct the FDA's blind eye, which was turned towards years and years of Purdue's perfidy re: off-label promotion of OxyContin. According to an article in the New York Times, "when the painkiller was first approved, F.D.A. officials allowed Purdue Pharma to state that the time-release of a narcotic like OxyContin 'is believed to reduce' its potential to be abused." Where was the FDA when Purdue Pharma went further? They can have all the power in the world, but it doesn't mean they will use it. After all, there are post-FDA career decisions to consider.

Frosting occurs over pink cupcakes
Of course, Truelove mentions the Pink Cupcake Caper and the "kitty fight" that briefly pitted her against Black Kitty. I'm not going to get into that here, but Truelove handles the whole thing very professionally and distills from it the lesson I promulgated: pharmaceutical sales reps need to have some guidance about what is and what is not appropriate food to be handing out to patients in waiting rooms (see my Guidelines for Gifts to Patients).

Truelove then relates her own personal story about an inappropriate gift from a pharma rep that she still cherishes -- a chocolate bar wrapped in a drug logo-emblazoned wrapper (you'll have to read the newsletter to find out what drug and what pharma company -- hint: it ends with "zeneca"). It must be way moldy by now! Yewwww!

There's more, but I've got to get on with making a living. I suppose you should too!

Ed Silverman Rips Giuliani A New One!

My mother-in-law would freak if she read Ed Silverman's Pharmalot Blog piece "OxyContin And...Our Next President?" connecting the OxyContin/Purdue Pharma criminals to presidential candidate Rudy Giuliani, who some people equate with The Saviour or at least with the One Who Can Do No Wrong.

What's the connection? You'll have to read Ed's piece for the details.

This is not the first time, however, that Giuliani has been connected with questionable drug industry practices.

More on that can be found under the posting Giuliani, OxyContin, Big Pharma, and Terrorism.

New Pharma Blog Planet Discovered!

This observer of the Pharma Blogosphere^TM wishes to register this new sighting among the "Outer Sphere" of influence: Prescription Access Litigation (PAL to their friends) Blog!

Launched just today, and not yet formally announced, here's PAL Blog's opening statement:

This blog will feature updates on activities of Prescription Access Litigation (PAL) and its members, including class action lawsuits, amicus curiae (Friend of the Court”) briefs, regulatory and legislative testimony and public education campaigns. We will also feature commentary on major developments and news stories on the pharmaceutical industry.

The PAL blog will not be updated daily, but rather as we have news to report. There are a number of daily pharmaceutical blogs that do a great job of covering the industry every day. See our blogroll on the left.

The universe of pharmaceutical blogs has grown rapidly over the past few months, as ably documented by John Mack over at PharmaBlogosphere. Some of its luminaries include industry critics and gadflies, such as Peter Rost and the pseudonymous Jack Friday (aka “Insider”). But as far as we have been able to ascertain, there are no other blogs critical of the industry that are written strictly from a consumer perspective. We hope to help partially fill that void.

So tune in, and stay tuned… We welcome your comments and suggestions.

I hope that PAL Blog does take a strictly consumer-centric viewpoint and does not just report on PAL litigation issues, which might wear thin after awhile. Anyway, that's my advice.

BTW, PAL Director and blogger Alex Sugerman-Brozan, was a guest not too long ago on a Pharma Marketing Talk podcast dedicated to disease mongering. Access and listen to the audio archive here.

More Dirt on the Co-optation of Rx Daily Dose Blog by Pfizer

Earlier today, we learned that Rx Daily Dose blogger and Boston Herald op-ed columnist Virginia Buckingham rocketed out of the Pharma Blogosphere^TM and landed a job as a Pfizer lobbyist (see "Is a Pharma PR Job In Your Future?"). i picked this up from PharmaGossip.

Ed Silverman over at Pharmalot picked up and added to the story:

"Until recently, Ginny [Ed and Ms. Buckingham must be buddies if he can get away with using this familiar form of her name] also managed the content of Rx Daily Dose, a blog that may be familiar to some of you. This is how the blog describes itself: 'On a daily basis, RxDailyDose will correct the record, expose the biases and clarify the cost to patients of misguided policies, off-base attacks and hypocritical politicians targeting an industry whose constant discovery of new and better medicines has improved health and extended lives.'

"Not sure if the blog exists anymore [Nope, it doesn't. Seriously, Ed you got to visit here more frequently. It doesn't look good for a journalist to admit to not knowing something!]. But it was begun as a project of the Institute For Liberty, a conservative group. The organization's president, Jason Wright, was previously a vp at Frontiers of Freedom Institute, another conservative group that was founded by Malcolm Wallop, a former republican senator from Wyoming. His group receives backing from oil and tobacco companies, according to SourceWatch."

This is the closest connection I can find between the drug, oil, and tobacco industries, other than they all are way down in the cellar of public opinion ... THEY HIRE MOUTHPIECES FROM THE SAME REPUBLICAN THINK TANKS! How cozy!

Is a Pharma PR Job In Your Future?

First, pharmaceutical companies invite "prominent" bloggers to the dinner table for an "informal get-together" (see "Should Bloggers Dine at Pharma's Table?"). Then, they start hiring bloggers!

According to a post by "Insider" Jack Friday on PharmaGossip:

Rx Daily Dose blogger joins Pfizer

Rx Daily Dose blogger and Boston Herald op-ed columnist Virginia Buckingham is to to work for drugmaker Pfizer as a lobbyist focusing on New England.

The blog has already been consigned to history!

She served as deputy editorial page editor of the Herald from January 2003 to July 2005 when she began writing a regular column, which focused mainly on state and national politics.

As assistant director of government relations, Buckingham will work for New York-based Pfizer’s Worldwide Public Affairs and Policy Division.

Insider wishes Virginia all the best.

When you sup with the devil, use a long spoon!

Maybe Pfizer first invited Virginia to dinner and was so impressed that it hired her. Or maybe it was posts like this (sorry, I only have the feed summary; the blog, as Jack notes, is gone):

"Enormous" Pharma's challenge
Pfizer CEO Jeff Kindler likens it to "changing the tires on a moving vehicle." This insightful article in The Economist is the most comprehensive look at the coming transformation of pharma's business model I've seen anywhere. From "personalized medicine" to the $1 billion pill to the rise of "drug hunters", there's a mountain the size of Everest to climb to overcome all the obstacles. But nothing is more important to healthy lives than a healthy drug industry.

Question: What will the government do to help, not hurt?

A little sympathy goes a long way! Maybe that's why I didn't get the job after turning Kindler's remarks into an April Fool's joke (see "Kindler's Refreshing View of Pharma's Problems and His Job").

I wonder if any of the guys meeting with J&J at that recent dinner party have been approached about employment in J&J's PR department -- especially those journalist, PR, and physician bloggers that attended?

Inquiring minds want to know!

Stats: I'll Show You Mine; Will You Show Me Yours?

The mission of Pharma Blogosphere^TM, believe it or not, is to promote the rising luminaries of our little sphere of influence. By writing about and linking to blogs in this sphere, I believe I have helped bring attention to our little world and increase the number of readers for each and every one of us.

I think I have some evidence to back that statement. The evidence resides in site statistics; namely number of visitors and page views.

This is a very touchy subject because often metrics are a closely-held asset, especially that "etc." stuff (IP addresses of site visitors, referring pages, etc.). As far as personally-identifiable metrics like IP addresses, a few bloggers -- notably Peter Rost -- are open about their privacy policies. Others, myself included, have not gotten around to making those policies public. It's not that we are hiding anything, we've just been lazy or, more likely, blogging is so new that we've never thought about some of these things. A few of us don't even collect the sort of information for which policies are necessary. So don't take this as a personal condemnation. Just a wake up call.

But I really want to talk about de-identified or aggregate visitor data, specifically number of visitors and page views.

Bloggers use a number of different applications to measure these metrics, which means there is no clear standard and it is not possible to compare one blog's metrics with another's; no statistically accurate way, that is. So, anything I say here is not meant to accurately compare one blog with another (despite the provocative title of this post, which was meant to grab your attention more than to challenge you).

Rather, I'd like to reveal some metrics in the realm of pharma blogging to see how we compare to other blogging topic areas, or to measure our progress over time. I have had a few people ask me if the numbers they are getting are average for a blog in this sphere or maybe above or below average. Of course, I have no way of knowing, but by revealing what I know about my blog (Pharma Marketing Blog) and what's public from other blogs in this sphere, I hope newbies can better measure their progress and popularity.

I will look at the metrics of three different blogs in the Pharma Blogosphere: Pharma Marketing Blog, The Health Care Blog (THCB) and Eye On FDA.

Visitors
Mark Senak at Eye On FDA uses a service called eXTReMe Tracking. From what I can see by clicking on the stats logo on the blog, Eye On FDA averages 3,228 unique visitors per month, or 5,412 visitors in April, which compares to THCB's 30,000 and Pharma Marketing Blog's 18,000 unique visits per month.

The latter two blogs use Site Meter, which defines a "visit" as a series of page views by one person with no more than 30 minutes in between page views. I am not sure how eXTReMe defines unique visitor and how this relates to Site Meter's unique visits.

Page Views
Last month (April 2007), THCB logged approximately 52,000 page views, whereas Pharma Marketing Blog logged about 31,000 page views. I can't figure out how to get Eye on FDA page view data from the publicly available stats link provided.

I have always compared my stats to THCB's stats because this is a great blog in a field much larger than pharmaceutical marketing, which is what I focus on. Last year, I was happy that Pharma Marketing Blog registered one-third (33%) the number of visitors that THCB was getting at the time. Today, that figure is closer to 60%!

I attribute this to the phenomenon of "a rising tide floats all ships" -- that is, as the number of bloggers in the Pharma Blogosphere sea has increased, and as we link to one another and get tracked by other sites like Cafe Pharma and PharmaCentral PageFlakes, that sea level will continue to rise and float all of us even higher! At least I hope so.

Stats For Pharma Marketing Blog
Let's get back to the evidence. The following chart was captured directly from the Site Meter stats page for Pharma Marketing Blog. It shows visits (yellow) and page views (red) per month for the last 12 months. The arrow indicates when I started the Pharma Blogosphere blog. Looks like the rising tide floated my boat! Did it float yours too?

# of Posts
But rising visitor stats is not just due to the fact that more attention is being paid these days to pharma bloggers. I have also made more posts per month than I did last year as the following chart shows.


I now average about 21 posts per month, which is more than many other pharma blogs but much less than others, especially Pharmalot, PharmaGossip, etc. However, my postings tend to be lengthier and more in-depth than others -- I average about 800 words per post! At that rate, I estimate that I am writing over 200,000 words per year or over 300 pages! That's a book!

# of Comments
One of the distinguishing feature of blogging is the comments that people can make and thereby participate in the discussion. That discussion is very important to me. I learn from other people's comments and that helps me create a more useful blog and newsletter for my subscribers.

Between January and April of this year, I have received approximately 3,200 comments. That's about 2-3 comments per post! Perhaps not a lot by general blog standards, but pretty good for this small sphere of influence.

OK, I've showed you my stats and I used a verifiable 3rd-party chart or data that anyone can collect from my blog. So, no smoke and mirrors. I'd be interested in learning how other blogs in this space are doing stat-wise.

Inquiring minds want to know.

'Round the Sphere: The Pink Cupcake Caper, Dollars for Docs, BIO Queen Noir, and Other Insults

Peter Rost keeps milking that AZ newsletter, bringing to the fore two new issues for us Pharma Blogosphere^TM denizens to mash up.

First up is the "Pink Cupcake Caper," which led to some comments published by Christiane Truelove, which raised fur on Black Kitty (BK), which sounded like a "Kitty Fight" to me, who lost more face over the resulting brouhaha.

Lesson: No one should speak for patients as to what is or is not appropriate gifts. It also raises the question that I posed over at Pharma Marketing Blog: should the drug industry develop guidelines for gifts to patients similar to guidelines for gifts to physicians? (see "Guidelines for Gifts to Patients").

However, I was glad to raise the issue of sexism amongst a few of us male bloggers in this arena, which I hope the women focus on rather than my provocative "Kitty Fight" blog post, which is a red herring.

BTW, have you voted in the "most sexist male blogger" poll yet? Voter turnout is light so far, but I see that Peter Rost leads with 27% of the votes, Jack Friday follows with 18%, and I trail with 9%. Of course, a plurality (45%) think we should grow up already! See the poll in the sidebar on the right.

Doctor Bags of Money
Peter, of course, brought us the "Buckets of Money" that sales reps can dip their hands into when calling on doctors. But did you know that many docs reap "Bags of Money" as paid drug industry consultants?

Peter exposes one such doctor that may have been paid as much as $204,000 in 2006 by Astrazeneca (see the Dr. Freedland Fee Fest post by Peter here).

My take on this: Hey! Pharma! Are you going to report these fees now that you are beginning to be more transparent about educational grants? Should these fees be reported? Let me know what you think by taking the poll here.

Queen Noir
Oh well, if sexism doesn't get your blood roiling, how about a Jordanian queen barring the press from her BIO keynote speech. This angered -- and rightly so -- Ed Silverman over at Pharmalot who wondered if BIO was taking place in the Middle East or America (see "BIO: Is This Boston, Or The Mideast?").

It is a BIO PR faux pas -- Americans are dying every day supposedly to make the Middle East more democratic, while our freedoms are being whittled away here at home. I say bullshit to that and throw the Queen Noir out-a-here! (as in the great NYC sense of the term "Throw da bum out!").

P.S. Now that the French have elected a conservative leader, I feel it is now politically correct to pepper my post with French phrases.

Snore! Is Everyone at BIO or What?

Although Ted Kennedy blew off presenting at the prestigious BIO conference in Boston (see Pharmalot: "Where's Ted? Not At BIO") and Queen "Noir" of Jordan pulled the Hijab over her presentation (see "BIO: Is This Boston, Or The Mideast?"), quite a few pharma people must be up there and not reading blogs today.

Traffic has been slow, in other words. Even with all the "kitty" kidding around that Rost and I are engaged in (see "AstraZeneca's pink cupcakes cause cat fight. According to John Mack").

BTW, did you read the little "love" note I received from BK?

"John, I *love* you. You have been patient and kind with me. I love this discussion. Thanks for *even* listening to me... purrrr....

I will respond thoughtfully tonite.."

MeeeeeOW! If my wife (I would never refer to my wife as "Mrs. Mack" -- that was my mom) ever saw that, I'd get a much worse beating than I got in this little kitty fight!

How About a Little Poll to Liven Things Up?
Speaking of sexism, please let it be known that I kid Peter and Jack (PharmaGossip) -- although they do post a lot of images of women in suggestive poses! Peter was proud to post a video of a Brazilian model having sex on the beach -- and she wasn't drinking! Jack also suggested what the bikini-clad sales rep looked like (see here).

So, who's the most sexist (male) blogger in the Pharma Blogosphere^TM (NOT the sexist!)? Inquiring minds want to know:

Who's the most sexist male blogger in the Pharma Blogosphere?
	Jack Friday (Pharma Gossip)
	John Mack (Pharma Marketing Blog)
	Peter Rost (Question Authority)
	None of the above
	Oh, grow up already!

Love it, Truly!

Chris Truelove has man handled me over in the comments to my Pharma Marketing News post "Guidelines for Gifts to Patients" and suggested that my "casting the verbal disagreement between Dr. Black Kitty and me as a 'Kitty fight,' you've implied a bimbo-tastic tone that's hard for folks to get past and take us seriously. It's an attitude that is satired in this classic Harry Enfield piece:"



Yes, that husband could be me! It happens every time my wife and I attend a dinner party! If only I had seen this a long time ago, I'm sure I'd be more happily married.

In my defense:

At least I refrained from posting any R-rated images of women, which is becomming more common amongst pharma bloggers, especially those who emulate Peter Rost and PharmaGossip! Speaking of whom, did you see the image PharmaGossip used to illustrate Truelove's story about a sales rep who stripped down to her bikini in a doc's office?

In defense of my male colleagues (ie, Peter Rost and Jack Friday), if you put meat in front of lions, you've got to expect them to feast! In other words, Truelove could have chosen not to describe the bikini rep incident, since it is anecdotal anyway and does no good for the image of women reps.

Hey Guys! A Kitty Fight!

A "Cupcake Kitty Fight" is in full swing!

You recall that Peter Rost exposed AstraZeneca's plan to have sales reps distribute cupcakes to chemotherapy patients (see "AstraZeneca's Secret Oncology Plans: Sell Cancer Drugs to Patients with Pink Cupcakes").

This issue has generated heat between some members of the Pharma Blogosphere^TM and the pharma trade press, especially "Pharma Blogs: Week in Review," published by Engel Publishing Partners and written by Christiane Truelove, editor of MedAdNews.

Black Kitty -- a rare women blogger member of the Pharma Blogosphere (see "It's Raining Men in the Pharma Blogosphere!") -- in particular has taken exception to Truelove's view that there is nothing wrong with giving cancer chemotherapy patients cupcakes (see "SIN = MedAdNews 'Pharma Blogs: Week in Review'").

Black Kitty (BK) claims not to be shouting, but her all CAPs comments say otherwise:

"DO YOUR RESEARCH!!! THIS BLACK KITTY HAS HER EARS BACK AND IS SPRINGING INTO ATTACK. ALSO SEE YOUR BLOGGERS FOR MORE WOMEN, BUT LOOK AT "DEPRESSION INTROSPECTION" FOR A GREAT WOMAN'S POINT OF VIEW ON PHARMA. ALSO LOOK AT THE KAISER WHISTLE BLOWER, AND OF COURSE, YOURS TRULY!"

YIKES, BATMAN!

Seems that BK is railing more against us guys than Truelove. But BK does lash into Truelove's "I would be very happy to have them" comment:

MAYBE YOU WOULD, BUT WHEN IF I WAS LEAVING CHEMO, I BELIEVE I WOULD FIND THE DISPLAY DISTASTEFUL FOR SO MANY REASONS. IF YOU ASK, I WILL BE GLAD TO LIST THEM.

Why not list them, Black Kitty?

BK goes on to discuss the link between sugar and cancer, by which time I have tuned out. Not that I don't believe there MAY be a link, but BK shifted her fight from Truelove to pharmaceutical marketers, which raises my fur:

DO THE MARKETERS REALLY THINK THE CONSUMERS ARE THIS STUPID? I HAVE YET TO MEET ANYONE, OF ANY LEVEL OF EDUCATION, WHO THINKS POSITIVELY OF THE RECENT MARKETING OF THE MAJOR PHARMACEUTICAL COMPANIES. THE BLUE PILL, THE GAS, THE DEPRESSION, THE PAIN, THE GIBBERISH ADS, THE ALLERGY ADS, AND MOST OF THE DTC MARKETING IS GOING TO BACKFIRE, I PROMISE. I TALK TO HUNDREDS OF PEOPLE, AND MOST PEOPLE IN CANADA THINK THE ADS ARE MISLEADING AND PEDANTIC, AND APPEAL TO THE MOST VULNERABLE INDIVIDUALS, WHO ARE DESPARATELY LOOKING FOR HELP FOR WHAT AILS THEM. TAKING ADVANTAGE LIKE THIS... WELL... IF U ARE GONNA SIN... DO IT IN A BIG WAY...

A ha! BK is Canadian, eh? I did not know that! That shapes the discussion for me in a whole new light! Me thinks the Canadians BK is speaking to are watching way too much American TV to be so critical of DTC! Don't they have anything better to do up there where DTC advertising is illegal?

BTW, if you are going to give gifts to patients, I think BK raises some important points about nutritional appropriateness. I have taken this a few steps further and suggested that pharma come up with "Guidelines for Gifts to Patients."

'Round the Sphere: Not-as-black-as-you-think-you-are and Blog Schmog Point-Counterpoint

Jim Edwards over at BrandweekNRX wonders whether "not-as-black-as-you-think-you-are" genes are responsible for lackluster sales of BiDil -- the first drug approved specifically for "self identified" African Americans. Jim posits that maybe this group is not as black as they think they are and casts doubt on "race-based medicine" (see "BiDil Falters, Casting Doubts on Race-Based Medicine").

John Mack, over at Pharma Marketing Blog, believes this is a bogus argument and places BiDil's problems squarely in marketing's court (see "BiDil Sales Disappoint: Blame Genes or Marketing?"). As usual, I don't just criticize, I offer an innovative solution to the problem of marketing to minorities.

Meanwhile, Agnes Shanley over at On Pharma is casting some doubt of her own and questions the utility of blogs: "Zube-gate aside, rumors of your power to change the world have been greatly exaggerated," says Shanley (see "Blog, Schmlog: Tales from the Dark Side of Web 2.0").

"I Beg to Differ!," says Fard Johnmar over at HealthcareVOX. "To say that blogs are not significantly influencing health and healthcare is far from correct," says Fard (see "Agnes Shanley Says 'Blog Schmog'; I Beg To Differ").

Agnes has been posting some very interesting things on her blog lately and seems to have picked up some pointers from the rest of the pack, especially heating things up with some controversial postings.

Don't worry about lack of comments, Agnes. Keep up the good work and I am sure the comments will follow. It's not the quantity of comments you receive, but the quality and whether or not they move the discussion forward and teach us a thing or two.

Speaking of moving the discussion forward: don't bother making any comments here if all you are doing is pointing out my shortcomings! I am fully briefed on that subject. Just stick to the subject at hand and I am glad to pass your comments on. Otherwise, hasta la vista, baby!

'Round the Sphere: Zee French Have Zee Multi Drug

Where did the new brand name for Acomplia come from?

An anonymous commenter to a Pharma Marketing Blog gave this enlightening and thoroughly plausible explanation:

I think Zimulti came from a twisted English language branding workshop with only Dehecq and LeFur in the room. When considering that rimonabant is being tested for MULTIple indications, they both exclaimed at the same time about its uniqueness and appeal "Eet ees Zi-Multi drogue" (it is the multi-drug). If you've ever heard Dehecq speak English you know his accent is pretty thick and this is completely plausible. I participated in the original branding workshop for the drug and I suggested "Butt-Off" since it applies for both smoking cessation and weight control. Nobody in the room got the joke. Maybe that's why I no longer work there, ha ha.

And you thought the guys at WSJ had a lock on "Zimulti Humor" with their "We'd like the Zimulti with clams, please."

It also beats my "Yummi! It's Zimulti Italian Pastry" joke.

Any other "Zimulti" jokes out there? It's been a long time since we've had a brand name with so much joke potential!

P.S. I just noticed that Ed Silverman over at Pharmalot also got in on the joke and made a comment that Zimulti sounded more like a dessert to him. Glad to see that great minds think alike, but how about a hat tip to me for the Italian dessert reference, Ed?

BTW, it's Zimulti, not Zumulti; otherwise the French origin joke wouldn't work (Zu is more German than French, n'est pas?).

Pointing Fingers

There's been some interest in the First Ever Pharma Blogosphere Reader Survey from bloggers in the Pharma Blogosphere^TM.

Recently, Rich Meyer, author of World of DTC Marketing (rated as one of the TOP 5 "useful" blogs by survey respondents) suggested that people who have not worked in the pharmaceutical industry should not "point fingers."

Rich was disturbed to learn that according to the survey, "BLOGS critical of the pharmaceutical industry are viewed more credible than BLOGS supportive of the industry. ...unless you have worked in the pharma industry there is no way that you can sit on the fence and point fingers at people inside the house." (See "Unless you have been there don't point fingers".)

The blogs that Rich says in "no way" should point fingers at pharma include:

• Pharmalot
• PharmaGossip
• Pharma Marketing Blog
• BrandweekNRX

Of these, only PharmaGossip meets Rich's criteria for the right to point fingers. PharmaGossip is supposedly written by an industry insider. However, the author is anonymous and there is no way to confirm that he/she is an authentic "insider." But I take the Insider (aka "Jack Friday") at his word.

I think it's incredible for Rich to make this kind of statement. First, any one has a right to point fingers and some of the best finger pointing may be done by "outsiders," such as Democrats in Congress pointing fingers at the Bush administration.

The press (of which we have freedom of here in the USA) is another good example of outsiders pointing in. Pharmalot and BrandweekNRX are two "critical" blogs written by reporters and they are doing a wonderful and critically acclaimed job of pointing fingers.

Of course, the "finger pointer uber alis" is Peter Rost of Question Authority. Rost used to be on the inside but now he is on the outside, so I guess he's OK in Meyer's book.

Meyer plays the "pharma is unique card": "Working in the pharma industry is unique and unless you have spent time on the inside I don't believe that you can understand the environment in which we work."

OK, let's have some sympathy for the environment in which these guys work. But that is no excuse for premeditated abuse of laws, regulations, guidelines, and ethical marketing practices, which are plain for anyone to see, inside or out.

P.S. Meyer relates he has seen a lot of wrong committed inside the tent by fellow pharma people. His blog is a good example of how someone on the inside can take a critical look at this situation and I applaud him for doing it. I also applaud his company, which Meyer doesn't name, for not terminating or muzzling him.

Mack Quoted in Boston Globe Story About Pharma's Empathy Pitch to Physicians

While in Las Vegas I received a voicemail from Stephen Heuser, a staff reporter at the Boston Globe. He was doing a story on an exhibit at the American Academy of Neurology meeting that "claimed it could create, in a perfectly healthy person, the disorienting symptoms of multiple sclerosis."

I called him back and we discussed what seemed to him to be a new technique employed by pharmaceutical companies to market to physicians.

Today, Heuser's article -- "MS drug makers try a new pitch: empathy" -- appeared in the Boston Globe. The article includes a few words of wisdom from moi. I'll have more to say on this topic later on Pharma Marketing Blog, but here are a few of my pearls quoted in the article:

"They're always looking for something new," said John Mack , publisher of Pharma Marketing News and author of a watchdog blog on drug company marketing excess. He was not at the Hynes this week, but is familiar with the heart-failure simulator. "Doctors are very gadget-oriented, and they like this sort of thing," Mack said. "It's also very medically oriented."

The marketing theory behind the simulator is that a more empathetic doctor is more likely to treat patients aggressively, which means prescribing more drugs. O'Leary said one survey showed that the strategy seems to work: Doctors emerged from the anemia simulator measurably more interested in treating patients' symptoms.

"The whole thing was not to push the drug, it was to push the importance of treating the disease," said O'Leary.

Mack, the marketing specialist, is skeptical. A cardiologist with a lot of experience treating congestive heart failure "probably knows all there is to know about being empathetic," he said.

He does, however, believe simulators and other high-tech educational tools can fill important gaps in medical education, even if they are funded by companies that stand to profit from increased drug sales.

"Obviously, pharma companies have a vested interest, but medical schools are just starting to teach doctors about bedside manner and having empathy for the patients," he said.