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A timeless classic comes to an end

November 2008

Published in the November 2008 issue of Today’s Hospitalist

Certain traditions will probably never go away: Cracker Jack at baseball games, popcorn at movies, lemonade at summer picnics. But every now and then, a deathless classic comes to an end. I’m talking, of course, about the free drug-company pen. According to new industry guidelines, drug reps won’t be passing those out, beginning next year. I submit that this is no insignificant event.

Drug pens couldn’t be more ubiquitous or achieve better “market penetration.” They are everywhere, from the Viagra pen my dry cleaner uses to the Norvasc pen wielded by New Jersey gas station attendants. And, of course, they’re everywhere at the hospital, as was revealed by an informal survey that I conducted just the other day by surreptitiously recording who used what pen. By my count, eight out of 10 health care professionals prefer drug-company sponsored writing utensils to non-brand pens.

Becoming a human billboard?
Not me. Holier than thou I am not, but I do recall the moment during my second year of clinical practice when I decided I was not into the free-branding business. To be sure, I have consumed and still partake of plenty of free lunches while patiently (or not so patiently) listening to a drug representative’s pitch.

But a drug company pen provides not free information but free advertising for that company, and I found the idea of providing said advertising a bit disconcerting. I’m certainly not the first to note the potential conflict of interest that exists if one writes for Diovan with a Diovan pen. Perhaps I would sing a different tune if the reps offered a Mercedes Benz instead of a piece of cheap plastic emblazoned with a Cozaar logo. But when it comes to a 49-cent pen, I choose to keep my integrity intact.

My point is this: I believe the voluntary banning of drug pens to be a good thing because I see no upside to being a human billboard for Big Pharma. We physicians are highly paid professionals, and a pen worth mere pennies is not worth the baggage. Granted, I have never heard of a patient asking his or her doctor if the Plavix pen he’s using has influenced the decision to write a prescription for the drug. But if so queried, what would we say? “No, just a free pen, never noticed it said ‘Plavix’ before.”

A question of influence
“Bull malarkey,” I say to the physician who states that he or she cannot be biased, even if unknowingly, by Big Pharma’s marketing techniques. This is Big Pharma, people, arguably the most successful business in the history of, well, business. Big Pharma knows what it is doing, and it would not spend millions of dollars on marketing if those tactics didn’t lead to billions of dollars in profit.

As to the argument that eliminating pens “as well as notepads, sticky notes, surgical caps, stress release balls, penlights, calculators, stethoscope name-tags, clipboards, refrigerator magnets, travel clocks, umbrellas and stuffed animals, just to name a few drug-rep goodies “will have no global impact on Big Pharma’s ability to influence us, I say “perhaps.” The industry might not have so readily ceded the use of these marketing tools without a close analysis of the financial impact.

Although they still spend plenty on us, drug companies are increasingly shifting to direct-to-consumer advertising. That is abundantly clear every time one tunes into the 6 o’clock news, only to suffer through the world of pharmaceutical commercials that feature flower-filled meadows, puppies and beaming middle agers. I’ll conclude with this bold call to arms: Unshackle yourself now! Open up your Web browser and go to discountpens.com.

Pull out that credit card and drop $20 on your favorite mega-pack. I can all but guarantee that you will feel liberated the first time you make your mark with a non-sponsored pen. And with electronic medical records for everyone just around the corner, that first 40-pack of pens you buy just might be your last.

Erik DeLue, MD, is medical director of the hospitalist program at Virtua Memorial Hospital in Mt. Holly, N.J. Check out Dr. DeLue’s blog and others on the Today’s Hospitalist Web site.