'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!

'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!

'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.

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."

Black Kitty Loves Us Alpha Dogs and Vice Versa

BK, author of the blog "The Black Kitty - All Things Health Care Related" sent the following message of love and peace to us "alpha dogs" of the Pharma Blogosphere^TM in a comment to a recent post on this blog. I thought it deserved more prominence!

As an outsider closely observing your alpha dog PHARMA blogger WARS, I can say, that in my very HUMBLE and RESPECTFUL opinion, you all should really stop focusing so much on the negatives in each others work product and use your positive intentions to build up all bloggers who share, lets say 50% or more common information or linkages to your sites.

Its a big cluster f*&*( to those who peak in for the first time). YOU ALL link so intensely to each other, I actually thought you were all one person. You don't sound even write all that differently in style. Except, Dr. Rost and Pharma Giles who are both unique, very informative, timely, and funny as hell at times.

Even little tic unread blogs like mine, Black Kitty at gcic. blogspot.com love getting recognition from you big dog health care bloggers.

There are several exceptionally good blogs trying to break in to get to your levels of popularity (e.g., clinical psych, furious seasons, pharma-analyst, WSP).

I believe that YOU as a community are committed to getting other men into your ALPHA DOG network of top health care blogers. You all are doing a good job of helping SOME of them.

I received PRICELESS help from Dr. Rost. Just mentioning my blog on his, gets me 100 hits in a few hours. That IS BIG TIME FOR ME. It makes me and my family really happy to see the increasing bang on analytics.. totally provided courtesy of Dr. Rost.

Thank you, TO ALL OF YOU. I LOVE reading and commenting and being a general pain in the ass.

I AM a very good statistican, and if you want to talk data analysis of your blogger survey or more objective measurement(for free) let me know.

Love and Peace,

Dr. BK

Black Kitty sounds like someone we should get to know better, even though she does seem a bit enamored of Peter Rost!