BOOKS/Jake Whitney

Big Pharma's Hard Sell

"I don't think the R in R&D stands for Rock 'N Roll," Jamie Reidy said, smiling and leaning back in his chair at a midtown Manhattan restaurant. A former pharmaceutical sales representative, Reidy just finished telling a story about his most recent employer, Eli Lilly, paying $400,000 to the rock band Train to perform at a drug launch party. (A spokeswoman for Eli Lilly, after saying she would look into the matter, did not return calls.)

Reidy was illustrating his point, made by many critics in recent years, that drug prices are a lot higher than they ought to be. It is also the underlying, if unintentional, theme of his recent book, Hard Sell: The Evolution of a Viagra Salesman, about his days peddling drugs for Pfizer in the late 1990s.

Reidy, 35, has pale blue eyes, an easy laugh and a chatty, personable manner. Dressed in a crisp dark suit, it was easy to imagine him a successful salesman. He didn't resemble the feckless party animal portrayed in his book.

Hard Sell is an anomaly. On the one hand a comedic how-I-screwed-the-system-and-got-away-with-it yarn, on the other it is anything but laughable. Beneath Reidy's tales of scamming the Pfizer brass and his efforts in ditching work lies an exposé of drug industry greed and the conflicts of interest in the doctor/drug representative relationship.

A 2001 study published in the European Journal of Pharmacology found that increased interaction with drug representatives led physicians to prescribe against their patients' best interests. Reidy shows us why. "There's no question that bias is involved," he said of the drug information sales reps provide to physicians. "For every negative trial someone could show me about one of my drugs, or a positive one for a competitor, I could show the opposite."

One of Reidy's more startling assertions in Hard Sell is that Pfizer made Viagra tablets diamond-shaped so they wouldn't fit into the typical pill cutter. This was not done for any medical reasons but simply so the pills would be harder to split and patients would be forced to buy more of them. When physicians inquired into the matter, Reidy and his colleagues responded with half-truths and outright lies. Perhaps the most ludicrous was that the active ingredient was found in only one half of the pill, and it was impossible to tell which half.

The most damaging shots in Hard Sell, though, come when Reidy isn't even aiming. They come in stories of how he would play on the friendships he made with physicians, and on their competitiveness, to get them to do what he wanted; and in the way he bribed them -- with lunches, movies, Christmas trees, M&Ms and drug samples -- into writing prescriptions for his drugs.

There's the story of a urologist in Modesto, Cal., for example, who prescribed "a ton" of Cardura for four years primarily because an attractive female rep asked him to. Reidy later befriended this physician and then would lean on their friendship to boost sales. Once, when Reidy thought his friend was underprescribing the Pfizer antibiotic Trovan, Reidy confronted him, to which the urologist answered: "You're right. I've been f**king up."

"I walked out of there and actually felt pretty terrible," Reidy said of the encounter. "I didn't want to insult my friend like that." But, Reidy added, "from that point on, he was rockin' with my drug." (Just four months later, incidentally, Trovan was pulled from pharmacy shelves after it was found to have caused 140 cases of liver damage, resulting in six deaths.)

Daniel Watts, a Pfizer spokesman, replied to questions about Reidy's book in an email, saying: "Most who read Mr. Reidy's book will see it as a reflection of his work habits, and thus, there is nothing more that needs to be said." Nowhere has Pfizer specifically disputed any of Reidy's assertions. Which would strike one as odd if they weren't true.

Hard Sell comes not only in the wake of the Vioxx and Bextra recalls, but also on the heels of three jeremiads by respected members of the medical community. Dr. John Abramson, a primary care physician on the staff of Harvard Medical School, Dr. Jerome Kassirer, who edited the New England Journal of Medicine from 1991 to 1999, and Dr. Marcia Angell, who succeeded Kassirer at the Journal, all released books last year critical of Big Pharma.

Jake Whitney is a freelance writer.

From The Progressive Populist, Oct. 1, 2005

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