Pharmaceuticals is one of the most profitable industries in North America. But do the drugs industry's sales and marketing strategies go too far?
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AA few months ago Kim Schaefer, sales representative of a major global pharmaceutical company, walked into a medical center in New York to bring information and free samples of her company's latest products. That day she was lucky - a doctor was available to see her. 'The last rep offered me a trip to Florida. What do you have?' the physician asked. He was only half joking.
医药业是北美洲盈利丰厚的行业之一。然而，医药业的销售和营销策略是否做得有点过舟了?
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BWhat was on offer that day was a pair of tickets for a New York musical. But on any given day, what Schaefer can offer is typical for today's drugs rep - a car trunk full of promotional gifts and gadgets, a budget that could buy lunches and dinners for a small country, hundreds of free drug samples and the freedom to give a physician $200 to prescribe her new product to the next six patients who fit the drug's profile. And she also has a few $1,000 honoraria to offer in exchange for doctors' attendance at her company's next educational lecture.
A 几个月前，某全球性大制药公司的销售代表Kim Schaefer走进了纽约的一家医疗中心，并随身带来了公司最新药品的信息和免费样品。那天，Kim算是比较走运，因为有位内科医生有空接待了她，并且仅仅是半开玩笑地说；“上次的医药代表送给我一次佛罗里达之旅，你今天会送来什么?”
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CSelling pharmaceuticals is a daily exercise in ethical judgement. Salespeople like Schaefer walk the line between the common practice of buying a prospect's time with a free meal, and bribing doctors to prescribe their drugs. They work in an industry highly criticized for its sales and marketing practices, but find themselves in the middle of the age-old chicken-or-egg question - businesses won't use strategies that don't work, so are doctors to blame for the escalating extravagance of pharmaceutical marketing? Or is it the industry's responsibility to decide the boundaries?
B 那天，Schaefer送给医生的礼物是两张纽约音乐会的门票。但是在任何特定一天， Schaefer能够送给医生的礼物对于当今医药代表们来说，是极为典型的东西——满满一后备箱的促销礼品和小玩意儿，预算足已支付一个小国家的午餐和晚餐，几百件免费赠送的药物样品和赠送每位医生200美元现金的特权——只要这位医生将她的药品开给六位适用此药的病人。此外，她还会提供价值1 000美元的酬金，用以换取医生参加公司下次的教育讲座。
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DThe explosion in the sheer number of salespeople in the field - and the amount of funding used to promote their causes - forces close examination of the pressures, influences and relationships between drug reps and doctors. Salespeople provide much-needed information and education to physicians. In many cases the glossy brochures, article reprints and prescriptions they deliver are primary sources of drug education for healthcare givers. With the huge investment the industry has placed in face-to-face selling, salespeople have essentially become specialists in one drug or group of drugs - a tremendous advantage in getting the attention of busy doctors in need of quick information.
C 推销药品每天要进行道德判断。像Schaefer这样的推销员行走在两种行为的边界上——一个是正常做法：用请客吃饭来购买潜在客户时间；一个是贿赂行为，从而让医生采用自己公司的药品。他们从事的行业因为其销售和促销做法而受到极大的谴责。但是销售代表发现自己挣扎在一个古老的。鸡和蛋”的抉择里——公司不会采纳不起作用的战略。所以说，针对药品营销急速加剧的奢侈，是医生应当受到谴责，还是应当由医药行业自己来确定行为界限?
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EBut the sales push rarely stops in the office. The flashy brochures and pamphlets left by the sales reps are often followed up with meals at expensive restaurants, meetings in warm and sunny places, and an inundation of promotional gadgets. Rarely do patients watch a doctor write with a pen that isn't emblazoned with a drug's name, or see a nurse use a tablet not bearing a pharmaceutical company's logo. Millions of dollars are spent by pharmaceutical companies on promotional products like coffee mugs, shirts, umbrellas, and golf balls. Money well spent? It's hard to tell. 'I've been the recipient of golf balls from one company and I use them, but it doesn't make me prescribe their medicine,' says one doctor. 'I tend to think I'm not influenced by what they give me.'
D 在医疗行业中，仅仅医药代表数量上的膨胀，加之促销所用资金的增加，足以促使我们深人研究医药代表与医生之间的压力、相互影响和相互关系。销售人员为医生提供了他们急需的信息和培训。在很多情况下，销售员送来的精美的手册、翻版文章和用药指导。是医务人员获取药品培训的主要来源。鉴于医药行业在由对由促销方面的巨大投资，销售员已经基本上成为某种药品和某一组药品的专家——实际上，这对吸引繁忙的医生的注意力来说是一个巨大的优势，因为他们需要快捷的信息。
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FFree samples of new and expensive drugs might be the single most effective way of getting doctors and patients to become loyal to a product. Salespeople hand out hundreds of dollars' worth of samples each week- $7.2 billion worth of them in one year. Though few comprehensive studies have been conducted, one by the University of Washington investigated how drug sample availability affected what physicians prescribe. A total of 131 doctors self-reported their prescribing patterns - the conclusion was that the availability of samples led them to dispense and prescribe drugs that differed from their preferred drug choice.
E 但是办公室里的促销活动极少停止步伐。医药代表把绚丽多彩的宣传手册和小册子留在了医生办公室，紧跟着送给医生的是昂贵餐厅的大餐、在温暖并沐浴着阳光的场所召开的会议、如洪水般涌入的促销礼品。很少有病人看到某位医生使用未印有药品名字的钢笔写字，或哪位护士使用没有制药公司标志的便笺簿。医药公司在诸如咖啡杯、衬衫、雨伞和高尔夫球等推销礼品上的投资高达儿百万美元，但是资金投入明智与否，也很难讲。“我接受井使用一家医药公司送我的高尔夫球，但是这不能使我开他们的药。”一位医生说，“我认为我不太可能受他们所赠礼物的影响。”
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GThe bottom line is that pharmaceutical companies as a whole invest more in marketing than they do in research and development. And patients are the ones who pay - in the form of sky-rocketing prescription prices - for every pen that's handed out, every free theatre ticket, and every steak dinner eaten. In the end the fact remains that pharmaceutical companies have every right to make a profit and will continue to find new ways to increase sales. But as the medical world continues to grapple with what's acceptable and what's not, it is clear that companies must continue to be heavily scrutinized for their sales and marketing strategies.
F 昂贵新药品的免费样品可能是把医生和病人变成此药品忠实用户的唯一最有效的手段。销售人员每周会分发价值几百美元的样品——一年下来价值高达72亿美元。尽管人们没有做过广泛的研究，华盛顿大学的一项研究调查了获取药物样品对医生开处方的影响。总共有131位医生自己汇报了开处方的方式——结论是获取药物样品导致他们分发和开出了不同干最初偏好选择的药物。