Lexapro is an antidepressant medication that is pretty much the equivalent to the now-generic version, Celexa. It is primarily prescribed to treat depression by primary care physicians and psychiatrists. It is a popular antidepressant.

And it’s also a big money maker for its manufacturer, Forest Laboratories.

So you have to wonder, how do drug companies “educate” docs about the greatness of their products? How does one get an antidepressant to become “popular.”

Embarrassing documents released through an investigation by the Senate’s Special Committee on Aging into the drug manufacturer’s marketing practices describes the process in grueling detail:

Under “Lunch and Learns,” the company intended to spend $36 million providing lunch to doctors in their offices. “Providing lunch for a physician creates an extended amount of selling time for representatives,” the document states.

Who ever said there ain’t no such thing as a free lunch? If you were a doctor practicing for the past two or three decades, you know exactly how many free lunches there were. Many. Subtle, clever marketing? Not really, but effective nonetheless.

An entire section of the marketing plan, titled “Continuing Medical Education,” outlines how the company intended to use educational seminars for doctors to teach them about Lexapro. The Senate’s Special Committee on Aging held a hearing in July on whether industry funding of medical education classes leads to tainted talks.

Yes, there’s nothing better than attending a seminar designed so that all paths led to “understanding” that Lexapro was a great choice for your depressed patients.

The 88 pages released and circulating demonstrate how important it is for pharmaceutical companies to market directly to doctors to try and persuade them to prescribe the “latest and greatest” antidepressant. Despite the fact that Lexapro is basically no different than Celexa. Oh, there is one important difference — Lexapro is covered by a patent (and is therefore 5 to 8 times more expensive), and Celexa is not.

Dr. Carlat’s take on the document, from the continuing medical education perspective:

In other words, rather than waiting for doctors to decide to write their own articles singing the praises of Lexapro, Forest decided to hire reporters from journals to cover the CME symposia they already paid for. Based on the reporting, ghostwriters would then scribble the articles, and plant some psychiatrists’ names as authors. The articles would be packaged as “CME supplements” with the journals.

It’s so much more… efficient this way!

The scary part is to consider what pharmaceutical companies are going to do, now that their past marketing practices are seeing the light of day. As many states are banning doctor gifts (or severely limiting them) such as free lunches, and journals and universities are cracking down on their conflict of interest disclosures, and the continuing medical education needed to keep doctor’s licenses up-to-date are becoming disentangled from their past enmeshment with pharma funding, how will pharmaceutical companies continue to guarantee future profitable quarters? If the spotlight is shining brightly on these mostly-past practices, what new practices are they devising to keep their prescription rates high?

I suppose we’ll find out in another 5 years’ time. After all, that’s how old the current Forest Laboratories’ Lexapro marketing documents are.

Here’s a novel thought for pharmaceutical companies to consider — let doctors decide for themselves which drugs to prescribe to their patients. Without fake educational courses, free lunches, or ghost-written journal articles.

Read the New York Times Magazine article: A Peek at How Forest Laboratories Pushed Lexapro

Read Dr. Carlat’s take: Forest’s Promotional Objective: Use CME to Sell Lexapro



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    Last reviewed: By John M. Grohol, Psy.D. on 2 Sep 2009
    Published on PsychCentral.com. All rights reserved.

APA Reference
Grohol, J. (2009). A How-To Guide to Getting Doctors to Prescribe Your Drug. Psych Central. Retrieved on January 26, 2015, from http://psychcentral.com/blog/archives/2009/09/02/a-how-to-guide-to-getting-doctors-to-prescribe-your-drug/


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