Mother of God! Forest Labs Had Marketing Plan for Lexapro!
And gambling occurs in casinos.
Yesterday Gardinar Harris of the NYT revealed that Forest Laboratories, the maker of the antidepressant escitalopram (Lexapro), had a 2004 marketing plan for the drug. Harris's article,* which is made possible by government access to a previously confidential document from Forest, seems intended to generate a considerable amount of righteous indignation. But a review of the abridged plan, which is made available here, reveals nothing more than the usual strategies and tactics by pharma to achieve or maintain a drug's market share—objectives that are, in fact, a company's responsibility to its shareholders. Frankly if Forest's marketing team, circa 2003, is to be publicly chided, it should be for lack of originality.
The not-so-surprising subtext of the marketing document, which contains the expected SWOT analysis (or a version of it), is to obtain the best-of-all-possible fiscal worlds for Lexapro and Forest. One strategy or tactic for doing so (depending on how you define each term) was to "increase med ed efforts," including more sponsorships of continuing medical education (CME).** Proposed CME efforts included plans to sponsor various professional-meeting symposia, summaries of these symposia, and scientific sessions. Nothing outside of the ordinary or, more important, in violation of standards for commercial support of CME (either then or now).
The description of the proposed goal and purpose of CME is similarly banal:
[To] Sponsor the development of continuing medical education activities that will educate physicians and other healthcare providers and assist them in acquiring the most current knowledge in the diagnosis and treatment of depression and other related disorders.
Perhaps the only proposed CME tactic to raise an eyebrow is the use of reporters "from publications like CNS News [probably CNS Spectrums], Psych Times, and the Journal of Clinical Psychiatry...to cover key Lexapro data presented at important medical meetings." The report would then be included in the journal as a CME supplement.
Overt (non-CME) marketing methods in the Forest document included the use of bylined medical articles from thought leaders, some of which could be ghostwritten; the typical speakers' bureau; and drug rep-presented "Lunch and Learn" programs for doctors.
Whether any or all of Forest's 2003 marketing plan for Lexapro came to fruition is not addressed by Harris. It is presumed that at least some of it was realized; but what was and what wasn't funded is probably only known to Forest personnel—at least at present.
* One of Harris's points is to show how Forest promoted (or intended to promote) escitalopram as superior to its other antidepressant citalopram or Celexa, which was going off patent--despite the fact that Lexapro is merely an enantiomer (or chemical mirror image) of Celexa. The tactic of creating an enantiomer of a successful, but soon-to-expire, drug to maintain pharma revenue is nothing new: think omeprazole (Prilosec) and esomeprazole (Nexium), both from AstraZeneca.
** The fact that Forest included CME in its marketing plan 6 years ago may be shocking to some, but it shouldn't be. In the current climate of scrutiny, however, major pharma companies separate their proposed CME and marketing efforts.
0 TrackBacks
Listed below are links to blogs that reference this entry: Mother of God! Forest Labs Had Marketing Plan for Lexapro!.
TrackBack URL for this entry: http://bmartinmd.com/cgi-bin/mt/mt-tb.cgi/608
I have worked as a medical professional since 1970 until my profession took a new direction in 1999 and I began working in medical communications. Managed care and medical insurance companies initially wanted to possess a nice slice of the medical industry's profits and sometime in the 1970's they began an all-out effort to gain control of the entire pie. Please think of managed care and insurance companies as part and parcel of the global banking industry because they are under its huge umbrella. These groups have worked to 'corporatize' medical centers and are in the process of hijacking continuing medical education from a secondary industry, the medical education communication companies. As a medical director on teams that supported various pharmaceuticals, imaging equipment and medical imaging agents, I can tell you that no matter the company, we always developed educational content that was without bias and fair balanced. Yes, I realize that the media has highlighted some poor examples of CME out there, but considering the sheer volume of CME programs, the exception is bound to occur. Outliers will happen, evidenced by the mathematical truth and reliability of a statistical Bell curve.
Pharmaceutical companies are for a for-profit industry, it is true. but the new model of non profits, like the Macy Foundation or IHI, are merely wolves wearing the clothing of sheep. Behind these innocuous sounding nonprofits are the parade of Frist/Dodd/Grassley/HCA/Banking Industry support mechanisms: banking industry lobbies, special interest groups, foreign interests, and profiteering agendas. The big difference between the current model and the new 'ethical' model being hawked by the money-hungry wolves is that currently the pharma industry is providing the grant money and soon managed care and medical insurance companies will be providing the grant money. And how is that different? The insurance/managed care groups will be providing the grant money back into their own pockets through non-profit arms. It is really quite an impressive scheme. Right now CME creates an economy indirectly for the pharmaceutical industry and directly for individual faculty, and medical education communication companies. With the new model, the only economy that will be fed will be the banking industry.
I say tell it like it is. I'd rather have the pharma for-profit industry be 'upfront' about what they are doing in their efforts to help educate physicians versus have non profits be a 'front' for the banking industry's coffers. The foreign interest financiers don't care if they further ruin the American economy as long as their bottom line remains black. We, as American citizens, are the ultimate losers. Two major economic industries will be trashed and insurance companies will further dictate ( beyond therapeutic drug selection) the practice of medicine in this country, which as we already know, has proven to be a disaster. Wake up and contact your government representatives today to say "NO" to the banking industry's hijacking of continuing medical education, health care in general, and to the ruination of two prosperous American economic industries: the pharmaceutical industry and the continuing medical education and communications industry.
A provocative post, to say the least. An example that names names and provides a linear relationship from bank to insurance company to nonprofit to CME would help illustrate your point.
BTW, for readers:
HCA = Hospital Corporation of America; IHI = Institute for Healthcare Improvement.