Free lunch for patients! Why not?

A story appeared recently in the New York Times about the pharmaceutical industry practice of providing free lunches to physicians and their staffs (see "Drug Makers Pay for Lunch as They Pitch" NYT, 7/28/2006).

This issue has been covered here in Pharma Marketing Blog and in Pharma Marketing News before (see "Gifts That Keep on Giving," "Free Gifts to Physicians: What's the Big Deal?," "What Pharma Companies Spend on Gifts to Docs," and "Pharma Marketing Survey: Gifts to Physicians"), so I won't bother to go over the same ground again.

However, I am perturbed about one aspect of pharma-sponsored free lunches for physicians: often the trays of food are wheeled into the doctor's office right past patients sitting "patiently" in the waiting room. This scenario was mentioned in passing in the article:

"A deliveryman carrying trays of gourmet sandwiches sashayed past patients at Advanced Internal Medicine. The bill showed that Takeda Pharmaceuticals was picking up the bill. The doctors in the group must have liked the sandwiches. The next day, the exact same delivery came in, paid for by Cephalon."

A lunch order arrives at North Shore Diabetes in New Hyde Park, N.Y. A pharmaceutical company paid for the food. [This guy is going to walk past an office full of patients? Many New Yorkers I know (not me or my immediate family) complain about the sloppy dress code of people who live in the "burbs". Not that they ever said it of people from New Hyde Park, but this guy obviously is no exception to the rule!]

Unless physician offices are being fitted with service entrances, there's no other way to reach the staff with food except by "sashaying" past patients in the waiting room. I've witnessed this myself several times. It happened once when I had to wait 45 minutes past my appointment time to see my physician, who happens to have a weight problem. I envisioned her gorging on the food and being pitched to by the sales rep while I was waiting to "gain access," a term frequently used by drug marketers to describe the main goal of the physician free lunch program.

[Some critics of physician free lunches claim that the practice influences physician prescribing habits (see, for example, the Required Reading list over at the No Free Lunch Web site).

The free lunch, however, is just the initial aerial bombardment before the ground campaign begins -- it allows your ground forces (ie, sales reps) to get across the border (ie, office gatekeeper) and wipe out the opposition (ie, the idea planted in the physician's head that your competitor's product is better than yours). It's not the gun that kills people, it's the person using the gun. OK, I guess you get my point by now.

Scott M. Lassman, senior assistant general counsel for the Pharmaceutical Research and Manufacturers of America (PhRMA), supports my point: "It's our feeling that a modest meal is not the type of thing that is going to interfere with the independence of a health care practitioner. It's really a recognition that these folks are extremely busy. They don't have time to talk. Perhaps the only time they do have time to talk is over lunch or dinner. So we thought it was appropriate for the sales rep to pay for that."

The meal does not "interfere;" that's the job of the sales rep.]

What about us patients?
Forget the argument about whether or not free lunches influence physician prescribing habits. What about us patients? We're hungry too!

Maybe if patients paid for physicians' lunches once in a while they'd also get better and faster access instead of sweltering in cramped waiting rooms with sickos!

Think of pharma paying only for physician lunches from a PR perspective. For every physician free meal tray wheeled through a waiting room, perhaps 5 to 10 patients potentially feel "left out" like I did when it happened to me. If there are 90,000 reps and each has a $2,000 free lunch monthly budget (a number quoted in the New York Times article) and each lunch costs $250, then that is 720,000 lunches per year wheeled past as many as 7 million patients!

[OK, maybe $2,000 per month is on the high end. Lilly admits to a $500-$750 per month per rep.]

A pharmaceutical company would love to have 2-7 million patients visit any of its product Web sites in a given year!

So, here's what I suggest:

Free lunch for patients!

Think about it!

• There are no guidelines, ethical or otherwise, about free lunches for patients that I know of.
• Each free patient lunch can come with product logos emblazoned on the napkins or sandwich wrappers (I already reserved the Web address www.RxLogoNap.com and am prepared to offer that service to pharma clients). This will help drive prescriptions because, unlike physicians, patients are influenced by such advertising -- why else would there be so much DTC advertising?
• Add free trial coupons to the patient lunch box as a value-added surprise!
• Not only will free patient lunches give pharma companies an opportunity to get their product logo in front of patients at the point of care, they will ensure that patients support pharma free lunches in general, including free lunches for physicians. That way, negative articles like the one in the New York Times will have much less effect on the public who will say "Leave those poor pharmaceutical companies be! No free lunch can 'interfere with the independence' of me or my physician."
• When the weather is nice, invite the whole office -- physicians, staff, and patients -- outside for a picnic! Sales reps can then easily work the crowd and enhance the patient-physician relationship!

But, you may ask, where's the money going to come from?

By some estimates (mentioned in the NYT article), the pharma industry spends about $1 billion per year on free lunches for physicians. That's a drop in the overall physician marketing budget. However, where would $1 billion come from for patient lunches? IMHO it should come out of the $4-5 billion spent on DTC advertising. Here's why:

• First, forget the "gourmet" sandwiches. Patients, who are less jaded than most physicians, would appreciate equally as much Subway sandwiches or even McDonald's lunches. That could shave about $500 million right off the top! (Jeffrey B. Kindler, Pfizer's new CEO, who used to head up a division at McDonald's and who may still own McD stock should be on board with this idea; "Prior to joining Pfizer, Mr. Kindler served as chairman and chief executive officer of Boston Market Corporation, owned by McDonald's, and president of Partner Brands, also owned by McDonald's." See press release here.).
• Use some of the savings to do the logo-emblazoned napkins or to include free gifts via Hollywood tie-in deals such as tiny Caribbean treasure chests full of your pills (free samples? Or fake. Whatever!) emblazoned with the product logo.
• DTC advertising is very scattershot -- it reaches all consumers and not specifically patients. You want to reach patients because they may be taking your competitors' products or may not be compliant when taking your product.
• DTC ads are very visible and even politicians can see them on TV and in magazines. Free lunches, however, are delivered behind closed doors and not readily visible to politicians who go to high-end physicians. These celebrity physicians can afford their own lunches and even may have buffets set up for their patients (you can't compete with that).

In summary, the main benefits I see of the free lunch for patients program are:

1. great PR,
2. enhanced patient-physician relationships,
3. great way to distribute free trial coupons at the point of care, and
4. increased patient compliance.

A "quadfecta" for the drug industry, which claims that these are very important goals.

So, how about it? Is this a good idea or what? Mr. Kindler, give me a call. Pfizer should be first to try this!