Drug rep creates stir with details on tricks of his trade

The former detailer says he profiled physicians and used friendship to drive sales, but drugmakers and other detailers say that's not how it works.

By Kevin B. O'Reilly, AMNews staff. Sept. 3, 2007.

Drug reps come to physicians' offices bearing not just samples, gifts and meals, but an armamentarium of psychological and sales techniques aimed at changing prescribing habits, says a former Eli Lilly and Co. detailer.

Shahram Ahari, MPH, quit his detailing job in 2000 after a year and a half because of ethical concerns about the work. In an April article in PLoS Medicine, a peer-reviewed, open-access journal, Ahari writes that drug reps are trained to profile physicians by personality type and tailor their detailing approaches accordingly. It's a technique similar to what is done in other industries that involve sales. But other drug reps said Ahari's account distorts the truth, and drugmakers said detailers are professionals whose visits focus on education, not sales.

In an interview, Ahari said many physicians still are unaware of how much information detailers gather about the doctors they visit. Material ranges from up-to-date prescribing data to any personal details physicians might mention. Moreover, he said, drug reps' personality styles are assessed in training so that they can understand how best to form friendships with physicians and use those friendships to change prescribing behavior.

"A lot of physicians feel a sense of invulnerability to the marketing techniques that industry representatives use," said Ahari, a health researcher at the University of California, San Francisco. "That's really a false sense of security and one cultivated by drug reps themselves. They want to lure physicians into thinking they can't possibly influence their prescribing habits, when in the face of the facts -- and the salaries drug reps get paid -- it's clearly the opposite."