Drug marketing is moving from the GP's doorstep to the desktop,
writes Nicole Manktelow.
Medical Observer Weekly

Most Australian GPs use the Internet everyday to email colleagues, search for information and do their banking. But will they embrace it to order drug samples and participate in online drug information sessions? The pharmaceutical industry hopes they will, as the revolution in drug marketing moves from the GP's doorstep to the desktop.

Earlier this year, Australian online pathology services eClinic released myRep. The website allows pharmaceutical companies to deliver information about pharmaceutical, over-the-counter and complementary medicines direct to practitioners.

"myRep is not just about delivering information� doctors can order samples, access patient support materials, clinical papers and CMI [consumer medical information]," says Saurabh Mishra, joint managing director and co-founder of eClinic (www.eclinic.com.au).

GPs also receive a personalised email each month and incentives to participate. An incentive program is "best practice for an e-business", Mr Mishra says, adding that the question is "how to make it acceptable, ethical and relevant".

myRep offers vouchers for practice supplies for the amounts of $10, $20 and $40. In addition, each quarter it offers five grants of $1000 to reimburse the cost of conference tickets or other industry events, provided the awarded doctor can show a receipt. myRep will tap into the online audience of more than 3500 Australian doctors using eClinic to log in to results from participating pathology outfits - including the Gribbles Group, one of the largest chains. And as with eClinic, there is potential - but no plan - to integrate it with prescribing programs.

myRep will appeal to pharmaceutical companies, which are keen to establish new ways of reaching busy doctors. Many GPs refuse to see reps who pitch and deliver free products in person - a process known as 'detailing' - without appointments; and more GPs are refusing to see reps at all.

The use of technology - such as the Internet, video conferencing and Interactive Voice Response - to replace the rep's visit is an emerging trend, particularly in the United States, where it is promoted as an opportunity to get past the receptionist.

Like many online services, 'e-detailing' or 'electronic detailing' offers efficiencies and convenience to GPs as well as allowing marketers to learn more about their customers.

US research shows how more interactive models, known collectively as 'scripted e-detailing' - in which doctors participate in structured online education sessions in addition to ordering samples and downloading CMI material - have the potential to track prescribing habits and influence prescribing patterns with much greater success than could the traditional rep's visit.

As more Australian services move online, these strategies to target and tempt are destined to enter the relationships between GPs and their suppliers.

"Drug company reps already keep details of doctors and their prescribing habits as they can glean them," AMA vice-president Dr Trevor Mudge says.

And it's already commonplace for websites to ask visitors for information, for personalisation purposes and marketing. It is also common for sites to monitor when, how often and for how long pages are viewed. But the AMA is concerned about how doctors' information is used in the digital age.

"We remain concerned about issues of privacy and improper incentives, or data-mining and the selling of doctor's habits," Dr Mudge says.

"The industry's code of ethics is robust and
flexible enough to cope with new technology"

"Providing information to doctors and patients? That's great.

"But if it also provides information about patients or doctors' prescribing habits, we worry because the supplier has little � control over its usage."

And incentives of any kind create problems, he says.

"Incentives should only be for doctors to do educational courses, not to pay the bills."

The use of new technologies for drug promotion is not a problem as long as online strategies adhere to acceptable marketing standards, Pharmaceutical Benefits Advisory Committee chair Professor Lloyd Samson says.

"We hope that industry regulations have looked at this," Professor Sampson says.

Medicines Australian chief Alan Evans says the industry's code of ethics addresses online marketing.

"The code is robust and flexible enough to cope with new technology," Mr Evans says. "I'm hard put to see that technology � will create a problem because people will observe the code."

The industry is yet to receive any complaints about online marketing, he adds.

myRep adheres to the code of ethics and to Australian privacy legislation, Mr Mishra says.

"The only thing we track is the details for when [GPs] order samples," he says, adding that myRep provides mainly aggregated information to pharmaceutical companies, such as the number of times certain information has been viewed, or the number of requests for samples.

The GP's name, address and preferred time of delivery for samples is the only personally identifiable information received by the companies.

myRep is not meant to be an industry-shaping tool in any way, Mr Mishra says. "This is a measurable, accountable marketing channel."

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