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The Dark Side

Some Sales Force

If you want to see the real underbelly of pharmaceutical sales and promotion, here it is. Insys Therapeutics makes a sublingual spray formulation of fentanyl called Subsys, and has been doing very well with it. But that seems to be, to a good extent, the product of, well, let’s just call them extremely aggressive sales tactics. There are repeated accusations of off-label promotions and of widespread kickbacks to physicians, and various investigations are underway.
But here’s a look at what makes Insys run:

Let’s start with sales. There’s no way around it: Insys’s sales force is very different from its competitors in the pharmaceutical industry. One reason is that a pharmaceutical sales background or even college science coursework isn’t required. Another is that if you appear to be driven and aggressive, the company will look past things that your local Starbucks might not. Scrolling through the LinkedIn profiles of Insys sales reps lends some credence to one of the assertions from an amended class action lawsuit filed against the company in October and which settled within the past week without disclosing terms: per three confidential witnesses, “most of Insys’s sales representatives were extremely attractive women.” (To be fair, Merck and other leading pharmaceutical companies have long drawn attention for constructing sales forces with a large percentage of attractive women.)
Take the sales head of the New York region, Jeff Pearlman. Before becoming what his peers say is a highly productive salesmen of Class II opioids, he appears to have installed aquariums. Prior to that, he ran a ticket sales agency called Sitting Pretty Seating Services which, in 2004, attracted the ire of the New Jersey Division of Consumer Affairs. Shortly after, records indicate that the company’s registration was revoked for not filing an annual report for two consecutive years. . .
. . .Before she joined the company in August 2012, (recently departed Western sales head Sunrise Lee) ran an adult-entertainment business of a sort called Sensuous Entertainment. Prior to that, she was a dancer at Rachel’s, a West Palm Beach strip club . . .It’s not clear what she did before adult entertainment.

I hope that this sort of thing stands out. The opioid market is a weird one, because there’s a lot of legitimate unmet need for pain medication, and the only things that work as well as opioid ligands are. . .other opioid ligands. And that means that there’s a lot of less legitimate prescribing going on, what with the risk of addiction and the street value of unused prescriptions. (People have tried for decades to come up with really effective pain medications that are non-addicting, with brutal lack of success). The whole area is a regulatory tangle because of this (which makes the financial results that Insys has achieved look even more strange).
So it’s a strange part of the business. But what this article details only differs in degree, not in kind, from the excesses of sales forces in other parts of the industry. And every time news like this breaks out, the reputation of, and the prospects for, the drug industry as a whole decrease.

32 comments on “Some Sales Force”

  1. Anonymous says:

    Pretty sure there was a How I Met Your Mother episode about overly attractive women being pharmaceutical sales reps.

  2. Idi Amine says:

    Personally I have an instant negative gut feeling about any vendor who sends attractive female sales representatives to our company to showcase their products.

  3. Anonymous says:

    After reading this I realize the only problem here is the stupid people that fall for such tricks. Good on Darwin.

  4. Sam Adams the Dog says:

    @3: The stupid people who fall for such tricks are the doctors, but the victims are their patients. Darwin is a step removed.
    Is anyone else out there old enough to remember when the expo at ACS meetings was dominated by industrial chemical companies whose booths were manned (womaned?) by “booth babes”?
    And when the back-cover ad of C&EN typically depicted such a babe in hot pants or minidress perched on top of a 55-gallon drum of some industrial chemical?

  5. UICAlchemist says:

    Lets not be naive here. Sex sells- regardless of the market

  6. biotechtoreador says:

    Does anyone think MRK or PFE hire ugly salespeople?

  7. anomalous canard says:

    Qualifications?
    What are the qualifications you’d actually need to sell a slightly different way of delivering an existing drug, from a common family that’s been well understood forever, to trained physicians?
    I would think that the ability to write down an order neatly would be enough.
    Kickbacks and whatnot are a problem. If doctors are writing prescriptions because they want to see that hot rep again, that’s a problem. But that doesn’t seem to be what you’re focusing on.
    Seriously, how much do these people really need to know?

  8. GreyMouser says:

    Oh, the bitterness in these comments. As a dazzlingly attractive, fit, and charismatic genius, I have had to live with so many hasty assumptions and dismissals.
    But, OK – yes, perhaps these reps, and maybe a few others elsewhere are bending the wills of pliable physicians and providers. But don’t dismiss the hardworking, beautiful, folk out of hand.
    And as regards Darwin, fancy tailfeathers and nice teeth are reproductive advantages. Over time, the best and the brightest may also be the bold and the beautiful.

  9. FarmHand says:

    @9
    As the father of a “dazzlingly attractive, fit, and charismatic genius” with a PhD, I would hope that you would come down hard on places like Insys Therapeutics who apparently hire women whose only qualification is that they are “dazzlingly attractive.” They make it harder for people like you and my daughter to be taken seriously. Don’t defend them. Condemn them. As for fine feathers, as the folks at “HAIR” taught us, they generally belong to the male of the species while the females are less flashy but do all the important work.

  10. Magrinhopalido says:

    Sunrise Lee. Love that name. I guess she got sick of the ‘crack of Dawn’ jokes.

  11. greymouser says:

    @9
    Farmhand! C’mon. I do, in fact, condemn the exploitative use of women to push inappropriate solutions:
    “yes, perhaps these reps, and maybe a few others elsewhere are bending the wills of pliable physicians and providers”, though perhaps not as strongly or overtly as you would like. But I largely agree.
    I was targeting a somewhat sheepish response to #2, who stated: “Personally I have an instant negative gut feeling about any vendor who sends attractive female sales representatives to our company to showcase their products” I don’t want anyone prejudging your daughter, before she has the chance to bury them, intellectually.

  12. luysii says:

    My secretary invariably announced that one was in the outer office by saying “Another homely detail rep (what the pharmaceutical sales force was called back them) to see you.” There might have been one or two homely ones over the decades.
    They weren’t at all sleazy, and usually quite intelligent as they had to master a fairly technical presentation and be able to respond to any and all questions about the product.
    Interestingly, the same held true in China a few months ago, as I sat with my daughter in law waiting for her appointment.

  13. Anonymous says:

    Why not chuck in a free BJ with every sale, just to make sure the doctors make the best decisions for their patients?

  14. Nick K says:

    #14: Do you really think a free copy of the Biochemical Journal will make the sale?

  15. oldnuke says:

    #16: Maybe they meant a free Bubble Jet printer with every order? 🙂

  16. LeeH says:

    Good-looking pharmaceutical reps? Who’da thunk it?
    (By the way, if you look closely on LinkedIn you’ll discover that they’re not THAT hot.)

  17. fajensen says:

    Meh – Sometimes people have to search for their talent.
    I had two school friends who were both modelling and occasionally doing weird things for Money* – and they were really intelligent, smart, funny and nice people.
    I am quite sure that both could have become excellent technical sales people, except, that they are probably busy running things wherever they are now.
    *) Back then, there was no “Social” Media to keep a detailed record of everything you once did so the filth in HR can back-stab you decades later.

  18. passionlessDrone says:

    A friend of my wife was/is a pharma sales rep. She was pretty good looking in her day. She’s also a goddamned idiot that doesn’t know shit about biology, or anything else, except buying lunches for doctor offices and drinks or whatever.
    We live in a medium sized city (~ 300K people), and she had a *quarterly* quota of 15K to spend on things like catered lunches, happy hours, t shirts, whatever, as long as the scripts kept coming. Once I got free drinks at Bonefish because she saw a doctor she knew at the bar, shouted something about ‘XXX is a good drug’, and then everyone’s tab was golden. The system works!
    I don’t know what company she represents or what drugs she hawks; it doesn’t really matter.

  19. Anonymous says:

    I’ve heard some stories about pharma sales reps in the 1970’s doing things that would be considered wildly inappropriate today, like sleeping with doctors and stuff like that. Can anyone who was in the industry back then confirm or deny?

  20. Andrew says:

    Sounds like they’ve been implementing the latest series of Big Bang Theory!!

  21. Andrew says:

    Sounds like they’ve been implementing the latest season of Big Bang Theory!!

  22. Ann O'Nymous says:

    Before we all start hating on Sunrise, working in adult entertainment doesn’t automatically mean that you are stupid and should never be allowed to do anything else. I thought the tone of that section of the article was condescending.
    More depressing is that a doctor who might hold your life in their hand one day is distracted by hot women. Remind me to ask for ugly nurses in the OR for my hip replacement.

  23. ab says:

    Oh come on, quit taking yourselves so seriously. All other things equal, I’d rather converse with an attractive person than an unattractive person. So would everyone else, ever.
    Sales jobs are (or used to be, pre-internet) about engaging customers personally. Looks helped. Not attractive? Don’t go into sales. (Don’t have a nice voice? Don’t be a radio host. Don’t have good hands? Don’t be a surgeon. Etc. etc. etc.) People try to make “pretty” a bad word, like “money.” Both efforts are silly and misguided.
    And yeah, spare me the shock and horror at the prospect that someone working in “adult entertainment” might try and parlay some of those skills into another career. As if 99.9% of you wouldn’t give your left ovary/nut to have such a person to share a bench with. You know, once you got past your prudish snobbery, the Monday morning conversation might actually be more interesting than, “How was your weekend?” “Good, how was yours?” “Good.” BORING.

  24. NMH says:

    Starring in porn and selling marginally useful pharmaceuticals seem equally sleazy to me.

  25. Anonymous says:

    @3: The Darwinism can apply to the society as a whole. The society that bases medical decisions on attractive salespeople has to compete with the society that bases such decisions on, say, trial data.
    @9: Self-identification as “dazzlingly attractive, fit, and charismatic genius” may not be as charismatic as you think.

  26. Idi Amine says:

    #25: It all depends on the context, doesn’t it? If I am watching models glide down a ramp then looks are fine. But if it takes models to sell a bonafide pharmaceutical product, then there’s nothing wrong in asking whether there might be something iffy about the product. It’s not about being prudish by any means, it’s about being able to judge the value of a product. If the product is looks then looks are all important, if the product is something else then looks should be seen as a ploy.

  27. metaphysician says:

    #26-
    Honestly, using dubious methods to sell unneeded drugs strikes me as *considerably* more sleazy than starring in porn.

  28. aairfccha says:

    There is an extremely simple way of dealing with a lot of the
    “less legitimate prescribing going on, what with the risk of addiction and the street value of unused prescriptions”.
    Throw the prohibitionist moralizers out of power (and ideally in prison, just the needless suffering of pain patients should give some legal leverage) and ditch their legalistic madness.
    40+ years of War on Drugs
    40+ years of failure
    40+ years of misery and missed opportunities
    Time for drug legalization.

  29. KissTheChemist says:

    For information….Sunrise Lee is being sued for breach of contract by Insys….porn, drugs, lawyers….there’s enough sleaze for a straight to DVD movie in there somewhere!

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