The Pill Pushers

Pharmaceutical giants employ "detailers" who specialize in persuading physicians to prescribe their companies' drugs

By Alex Roslin
September 4, 2008
The Georgia Straight

[This story won the Canadian Association of Journalists award for best investigative journalism in a magazine and was a finalist for the investigative journalism prize of the National Magazine Awards for 2008.]

When Shahram Ahari went to work at pharmaceutical giant Eli Lilly straight out of college in New Jersey, he was hired to do a job that few people know exists. Even the job title would be a mystery to most people. Ahari was going to be a “detailer”.

His job was to schmooze with doctors in order to get them to prescribe Lilly’s drugs. He was really a salesman, but he was also much more. His tools included everything from free drugs to offers of lucrative speaking engagements, even trips. He’d bring medical residents pizza for lunch or invite a doctor to dinner at an exclusive restaurant. He’d do anything to improve sales in his New York City district, which meant a bigger bonus.

The first hint of the strange world Ahari had entered came when he was brought to Indianapolis for Lilly’s intensive, six-week boot camp for detailers. There, he met his fellow trainees. They were hundreds of fellow college grads, mostly in their mid-20s, perhaps two-thirds of them women, the vast majority beautiful.

“They were 200 or 300 of the most attractive people I had ever seen,” he said in a phone interview. “The physical appeal was only part of it. They were vivacious, well-coiffured, well-dressed, engaging people.”

Ahari soon learned that charisma was more important in his new job than, say, medical or scientific knowledge. He was the only one in his class of 22 trainees with a science degree, he said.

The training was part CIA, part Freud. He learned to immediately spot items in a doctor’s office that could be used to strike up a personal conversation and, ultimately, friendship: golf paraphernalia, photos of trips or kids, religious items. The information would later be entered into the company’s file on the doctor and analyzed for future approaches.

“It was analogous to training in spy agencies,” said Ahari, who ended up working for Lilly for a year and a half in New York City. “You instantly suss up the person’s personality and look for points of entry. You capitalize on sexual appeal. My more attractive colleagues would say, ‘I’m going to wear my short skirt today,’ or ‘I’m going to wear my low-cleavage top. He [the doctor] seems to get a kick out of that.’ ”

The practice of detailing has come under growing scrutiny in B.C. Two-thirds of doctors in the province say drug reps visit them at least once a month, according to a 2006 survey by the B.C. Medical Association. Forty-two percent of general practitioners are visited several times a week. ...

Read the rest of the story at The Georgia Straight's website here. Also surf to these follow-up stories: "Pharmacies sell prescription info to drug makers" and "B.C. Health Minister won't prevent gifts going to doctors."