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Chump change: one dermatologist’s experiences with market research surveys

I practice dermatology in a small New England town. Over the past few years, I have been bombarded with requests to participate in pharmaceutical market research surveys (MRSs). They seem harmless on the surface, but I am cynical about drug marketing and so decided to collect these petitions for a month to learn what they were about. During March 2010, I received 32 e-mail invitations to participate in MRSs. A typical letter read: ‘‘A leading provider of market research services to the professional healthcare community would like to invite you to participate in a market research study. This survey should take just 30 minutes of your time and you will receive a cash honorarium of $80.’’ The surveys I was asked to take concentrated on a narrow range of topics: psoriasis and biologic drugs like Enbrel and Remicade , and facial rejuvenation strategies, such as Botox and its competitors. Overall, 34% of the surveys (11/32) were about psoriasis and the biologics, and 15% (5/32) referred to facial rejuvenation strategies. Had I completed all 32 surveys, my compensation for March would have amounted to US$2067, which extrapolates to US$24,804 for a 12-month period. As it has become more difficult for the pharmaceutical researchers and manufacturers of America (Big PhRMA) to gain access to physician offices, novel strategies to influence the hands that write prescriptions have been devised. The MRS appears to be one of the latest and most subtle. Until recently, the way to get a doctor’s attention was to feed him or her. Continuing education lunches and expensive dinners were enjoyed at fancy restaurants and accompanied by talks delivered by paid key opinion leaders. Such an event was a demeaning show for all who attended, but we were well fed, and the speakers received US$1000–3000 per talk. The drug firm got to ‘‘educate’’ doctors about new, expensive, patentprotected therapies. Free lunches, gourmet dinners, glib speakers, and even pens have been relegated almost to oblivion in the USA. New high-priced drugs must still be marketed. Big PhRMA adapts. The market research survey is born. In my specialty, dermatology, perhaps the most lucrative areas for PhRMA involve the biologics and approaches to cosmetic rejuvenation. Are these really the most pressing issues in dermatology? One would think so from the e-mails we receive from industry. The biologics represent an industry worth US$80 billion per year that is growing by roughly 15% annually. There are presently about 250 biologics on the market and many more in the pipeline. The manufacturers of biologics must reach out to physicians to pitch their products. My one-month study represents just one doctor’s experience. Similar MRSs are directed at thousands of dermatologists and hundreds of thousands of other physicians across the USA and probably in other countries too. They will drive prescriptions for biologics that cost upwards of US$25,000–100,000 per patient per year. Market research surveys represent only the latest ploy in industry’s successful attempt to influence physician behavior. The Physician Payments Sunshine Act and various state ‘‘Sunshine Laws’’ will make the disclosure of PhRMA payments to physicians mandatory. However, payments for completing MRSs do not come from drug manufacturers and are unlikely to be reported or regulated. Many practitioners are naïve as to the hidden goals of these surveys and happily fill them out for chump change. If I, as a dermatologist with a small rural practice, am pursued so aggressively, one can assume that similar requests are spreading virally into medical offices across the USA, Canada, and the European Union, promising cash while indoctrinating prescribers. Do the math and you will see that such market research represents a sector worth hundreds of millions to billions of dollars per year. So far, little attention has been directed to MRSs. PhRMA marketing strategies attempt to stay below the radar until they are well entrenched. If it were clear that the purpose of these studies is to sell drugs, some physicians might be less likely to participate. The goal of PhRMA is business and profit. Now and in the future, patients and society will pay dearly for this novel and cunning activity.