A forthcoming movie claims to spill the beans on Big Pharma

[Guest guest]

Confessions of a drug rep

 

 

A forthcoming movie claims to spill the beans on Big Pharma

 

 

Think big. Think money. Think drugs. And then think of all the sly,

silly, ethically impaired things that people will do to sell drugs,

and you'll have a taste of Kathleen Slattery-Moschkau's film, Side

Effects.

 

Slattery-Moschkau (pronounced Moscow, " like the city " ) sold drugs

for a living for Bristol-Myers Squibb and Johnson & Johnson, until

she found it increasingly difficult to " look myself in the mirror, "

and left her job after 10 years in the industry.

 

An aspiring screenwriter since her college years, Slattery-Moschkau,

wrote, directed, and produced Side Effects, a satirical film about

the dilemma of Karly Hert (Katherine Heigl), a drug representative

torn between her conscience and some really good perks. Hert's

company plans to roll out " the biggest drug launch of the 21st

century " for its new antidepressant, Vivexx, which they

enthusiastically promote as " absolutely the most efficacious drug

your patients can use! " while cheerfully predicting that " Vivexx

will make Prozac look like penny candy. "

 

Hert, who suffers pangs of conscience about some of the promotional

techniques encouraged by her managers, launches a campaign of her

own—to tell doctors the truth about drug side effects. She's

surprised when her honesty pays off—with increased sales. With

increased sales comes a meteoric rise on the corporate ladder,

making her even more beholden to her company—a company that is

hiding some dirty secrets about Vivexx.

 

Enter Hert's new boyfriend, Zach Danner (Lucian McAfee), a former

drug representative who challenges Hert about her values. When

corporate shenanigans turn ugly, the action goes from amusing to

savagely funny.

 

 

 

Side Effects: rolling out " the biggest drugs launch of the 21st

century "

 

 

 

In one scene, likely to resonate with doctors who are frequently

presented with wildly conflicting information about drugs, a manager

grills one of his drug reps during a group meeting:

 

" Where is Dr Schmidt in terms of Festril prescriptions? "

 

" He's at 2%. "

 

" Why isn't he on board yet? "

 

" He likes to wait at least one year before prescribing any new

drugs. It's a safety issue and he likes to reserve quinolones for

compromised patients. "

 

" What kind of idiot would reserve the most effective drug on the

market? What's his reason? "

 

" Well, because last year, you know, when we didn't have our own

quinolones to sell, we were calling him an idiot for using such a

big gun when it wasn't absolutely necessary. "

 

" Oh, it looks like you did your job a little too well last year.

Have you invited him out to corporate yet? "

 

" No, but... "

 

" OK. I want him flown out to corporate. Also make sure he is signed

up for the upcoming webcast with Dr Sing. I want you in his office

twice a week for the next three. Got it? "

 

Slattery-Moschkau told the BMJ that when sales reps went into

doctors' offices, they were " armed and dangerous " with prescribing

information on each doctor. " They know what percentage of Prozac or

Paxil a doctor prescribes, " she said. " The doctor often doesn't know

this and it gives [reps] an incredible advantage over the doctor. "

 

When doctors do find out that every single drug they prescribe has

been tracked and sold " for millions of dollars " to drug companies,

they can " go ballistic, " said one drug company insider who asked to

remain anonymous. Telling a doctor about the existence of these

prescription tracking lists, he said, was " not a good career move. "

 

" This story is actually my story, " said Slattery-Moschkau, adding

that the tactics employed by the industry in its " dangerous pursuit "

of profits sometimes came " at the expense of patients' lives. "

 

One widespread corporate tactic is hiring reps who are undeniably

alluring and always charming. And when it comes to experience,

sales, rather than science, is the hands-down winner. Slattery-

Moschkau, like her alter ego Hert, was stunned when she found that

her experience selling cellphones and her political science degree

from the University of Wisconsin-Madison were all she needed to get

started in an exciting career of " educating doctors. " Her science

background? A course in geology.

 

 

 

Slattery-Moschkau: industry tactics sometimes come " at the expense

of people's lives "

 

 

 

Jeff Trewhitt, spokesperson for the Pharmaceutical Research and

Manufacturers of America, was quoted in USA Today on 15 March saying

that Slattery-Moschkau's film " really does sound like fiction

considering that all sales representatives undergo extensive

technical training and are prepared to answer questions about new

medicines and their characteristics. " Mr Trewhitt also said that

drug companies often hired nurses and pharmacists for their sales

force, according to the article.

 

But Slattery-Moschkau told the BMJ, " Most of the people I worked

with majored in history or drama or music. " She added, " Drug reps

are pawns. They are encouraged to believe they are doing the right

thing. But there are clues and when it gets a little dangerous, it's

made clear to them that you toe the line. "

 

The rewards for " toeing the line " can be substantial. Slattery-

Moschkau was pulling in $100 000 (£53 000; 77 000) annually when she

left her job, her company car, and expense account behind.

 

Side Effects premiered at the Cinequest Film festival in San Jose,

California, in March and Slattery-Moschkau expects the film to be in

cinemas by early summer.

 

She decided to produce the film herself after a Hollywood agent

wanted to " water down " the script to be more appealing to the

studios. So she raised $190 000 and shot the film over 18 days last

summer.

 

Since the film's debut, the writer has been contacted by other drug

representatives whose response, she said, had largely been, " Amen,

sister. "

 

 

http://bmj.bmjjournals.com/cgi/content/full/330/7496/911?ehom