Drug Marketing and the Tea Baggers

Print PDF

Pharmaceutical Execs are worried.

According to PharmExec.com relations between the pharmaceutical industry and physicians in the United States reached a “tipping point”.

It seems that doctors in the US have traditionally been considered strong allies of the drug industry.  In 2009, this was no longer true.

According to a survey by TNS Healthcare the number of “rebel” doctors has increased dramatically from 12% in 2008 to 19% in 2009.

Negative WOM

What is a “rebel” doctor?  “Those deeply dissatisfied with the pharmaceutical industry and actively generating negative word of mouth (WOM)” (TNS Healthcare acronym).

Why is a jump from 12% to 19% considered a “tipping point”?  According to Andrew Brana, Senior Global Consultant, Sales Performance Optimization for TNS Healthcare, a “rebel” percentage above 15% makes it increasingly difficult to overcome the negative buzz and promote the industry message successfully.

In fact, there is a metric for this.  It is called the Market Resistance Index.  This MRI (my acronym) measures the number of rebels and the number of “apostles” – active advocates.  It takes three apostles to overcome the negativity of one rebel.

That’s why 2009 was a critical year.  For the first time, the apostle to rebel ratio in the United States dropped below 3 to 2.  TNS converts this ratio into the Market Resistance Index.  An MRI of 1 or less is optimal.  The MRI moved from 1.0 in 2008 to 1.62 in 2009.  According to Brana:

For the first time, US companies are facing a truly negative market environment. We call that apostle-to-rebel ratio the Market Resistance Index-and it is basically the headwind working against you. The stronger the headwind, the harder it is to make progress with your customer base.

The pharmaceutical industry is accustomed to this “negative headwind” in European countries, where resistance to the drug industry marketing has a much longer tradition.  The Market Resistance Index ranges from 3.75 in the United Kingdom to 1.38 in Italy.

Why the negative WOM?

What the survey is measuring is physician reaction to “detailing”.  Pharmaceutical firms have always “detailed” marketing representatives to physician offices to promote their products.  It is these detailers who provide physicians with free samples and information about new products.

TNS Healthcare offers little explanation for this dramatic reversal of pharma’s perception among physicians.  But ParmaExec.com points to the reductions in industry sales forces to explain this downturn.  The switch to “alternate channels” such as the Internet have not compensated for this switch.

Curiously, they add “The decline may also be a reaction to some of the new promotional guidelines that have prohibited more traditional ‘services,’ such as theater tickets, free lunches for office staff, golf balls, and other non-medically relevant gifts.”

Is negativity deserved?

The American Medical News offers some additional insight into this phenomenon.

Drug company profits per marketing rep dropped 23% in 2009.   For every 100 physician office reps by drug company marketing reps, only 37 result in products placed in the physician sample cabinet and only 20 were able to meet with a physician.

Time and physician revenue was one explanation.  One in four doctors work in practices that refuse to see drug company detailers and 40% of doctors who do see drug reps, require appointments.  But another factor just may be justifiable negative buzz.

Controversies over the drugs marketed as Vioxx (rofecoxib), Avandia (rosiglitazone) and Vytorin (ezetimbe and simvastatin) appear to be making doctors more skeptical of drugmakers as an information source, said Jerome L. Avorn, MD, professor of medicine at Harvard Medical School in Massachusetts.

And the Tea Baggers?

So what does this have to do with the Tea Bagger Movement?

Did they know about this apostle to rebel ratio?  Did they deliberately develop a rebel strategy knowing that it would take at least three apostles to overcome the negative buzz of their message? Did they count on the mainstream media amplifying their buzz into a roar?

That may give them more credit than they deserve.  But the  parallels are uncanny.