Pharmaceutical marketing-greater than the sum of its parts?

Pharmaceutical industry use of key opinion leaders to market prescription opioids: A review of internal industry documents

Objective

Prescription opioid-related deaths increased by 200 % from 2000 to 2014. There has been limited research regarding channels used by pharmaceutical companies to market prescription opioids. In this study, we investigated pharmaceutical industry use of key opinion leaders (KOLs).

Methods

We conducted a retrospective qualitative review of the first 503 opioid industry documents publicly released, which are held at the University of California, San Francisco Opioid Industry Document Archive (OIDA). We reviewed documents including legal rulings, correspondences, witness statements, clinical studies, and corporate communications for relevance and coded them by themes.

Results

Between 2001 and 2019, pharmaceutical companies including Janssen, Purdue Pharma, and Cephalon identified, recruited and developed individuals they referred to as "Key Opinion Leaders," (KOLs) that they recognized could reach strategic audiences to influence prescriber behaviors. Pharmaceutical companies identified KOLs through a variety of sources ranging from partnerships with PR firms to social media analysis and congressional and regulatory sources. Companies recruited KOLs through various methods including surveys to identify common names identified by physicians, internal rankings based on friendliness, and opioid prescribing behaviors. Companies employed KOLs as speakers at conferences for branded opioid products, authors of research articles in support of prescription opioids, and consultants regarding marketing strategies.

Conclusions

KOLs were employed by the pharmaceutical industry to leverage their reputations in the service of encouraging healthcare providers to prescribe more opioids. It is critical to ensure that researchers and leaders in the medical field are aware and critical of pharmaceutical corporate profit-led biases and are free from conflicts of interest to avoid inappropriate prescribing and minimize adverse outcomes for patients.

Drug company payments to General Practices in England: Cross-sectional and social network analysis

Although there has been extensive research on pharmaceutical industry payments to healthcare professionals, healthcare organisations with key roles in health systems have received little attention. We seek to contribute to addressing this gap in research by examining drug company payments to General Practices in England in 2015. We combine a publicly available payments database managed by the pharmaceutical industry with datasets covering key practice characteristics. We find that practices were an important target of company payments, receiving £2,726,018, equivalent to 6.5% of the value of payments to all healthcare organisations in England. Payments to practices were highly concentrated and specific companies were also highly dominant. The top 10 donors and the top 10 recipients amassed 87.9% and 13.6% of the value of payments, respectively. Practices with more patients, a greater proportion of elderly patients, and those in more affluent areas received significantly more payments on average. However, the patterns of payments were similar across England's regions. We also found that company networks-established by making payments to the same practices-were largely dominated by a single company, which was also by far the biggest donor. Greater policy attention is required to the risk of financial dependency and conflicts of interests that might arise from payments to practices and to organisational conflicts of interests more broadly. Our research also demonstrates that the comprehensiveness and quality of payment data disclosed via industry self-regulatory arrangements needs improvement. More interconnectivity between payment data and other datasets is needed to capture company marketing strategies systematically.