Wednesday, February 21, 2007

Who's Easier to Buy? A Physician or a Politician?

Merck's lobbying efforts to get states to pass laws requiring that preteen girls be vaccinated against cervical cancer has backfired and Merck's has said it will stop doing it (see "Merck Quits Lobbying for Mandatory Gardasil Vaccination").

It would be interesting to know how much money Merck spent in its efforts. At least one of my blogger colleagues suggested that the money Merck saves from not lobbying could be used to lower the cost of the vaccine, which he claims is the "most expensive vaccine ever" (see "Merck - Gardasil: are we still in Kansas, Toto?").

It's time to engage the left side of our brains and do some math.

First, how much is or was Merck paying for lobbying?

Let's see... Texas Governor Perry is said to have received $6,000. In Kansas, sponsors of a mandatory vaccination bill there have taken in a total of $2,400 (see "Merck's pitiful Gardasil Lobbying Budget -- in Kansas, At Least").

$2,000 here, $6,000 there... pretty soon we are talking... thousands! Not exactly a treasure chest.

Buying a Governor may not be representative of what Merck tried to do in every state -- the model is more like what it did in Kansas. I know, most of us are not in Kansas, so let's say the average Merck spent -- or intended to spend before pulling the plug -- in ALL fifty states was say $5,000 per state or $250,000 in total.

I've always argued that PR is a cheaper form of marketing and this proves it. Look at all the press Gardasil has gotten for that $250,000! You couldn't buy a cheap cable TV commercial spot for that pitiful sum!

Oh, I forgot! The publicity was all negative!

But does it matter? I bet there are many more parents right now talking to their doctors about Gardasil than before all hell broke out over this mandatory vaccination controversy.

But I digress from my little math exercise, which is designed to show how much the price of the vaccine could be reduced IF Merck had decided to give the lobbying money to consumers/voters (by way of rebates) rather than to politicians.

Look, forget the math! It would amount to practically nothing! Spread $250,000 over how many doses/patients? There has got to be a zillion preteen girls in the US! It wouldn't even come to $1 off of the $360 price of the vaccine.

So, there's goes that idea!

But it's interesting how cheap it is to buy a politician. For $6,000 you can get a Governor to stick his neck out and make a controversial decision, bypassing any discussion in his/her state legislature! Wow!

I think it's cheaper to buy a politician than a doctor! I know that a lot of people think doctors are paid off with cheap pens and mugs worth considerably less than $6,000. But these trinkets are for the rank-and-file insignificant docs. The big guns -- ie, key opinion leaders, "consultants", and post-marketing study leaders -- are given an order of magnitude more money than Perry got!

All this leads me to wonder what other issues affecting the pharmaceutical industry are being influenced by lobbying? I know the pharmaceutical industry spends a lot of money on lobbying, but I am too lazy to look up the amount.

It all goes to show how one little mis-step -- involving a minuscule amount of money -- can shine a bad light on the whole industry.

Merck -- slap along side of head -- what were you thinking! PhRMA should have a stupidity fine for any of its members who, due to their stupid actions, further drag the industry's name in the mud.


  1. John, I'm less inclind to see anything sinister in Merck's lobbying effort than most people seem to be just now.

    And while I'm generally supportive (though not without criticism) of the industry, it's my former employment in public health, not my present in pharma marketing that really drives this assessment.

    General immunization against HPV (for both women and men) is an altogether sensible public health move --one that can significantly reduce the burden of cervical cancer (and of over-use of Pap smears, with their attendant high false-positive rate) to society and which deserves the support of public policymakers.

    Ten years ago, when the industry wasn't automatically under suspicion for its every action, Merck's policy advocacy would be the kind of thing cited by Forbes in rating it America's most admired company -- civic-minded, public-health oriented, and underaken in the face of opposition (which it would have received even back then) from the religious right and the anti-vaccination cultists.

    Today, the climate of opinion is so hostile that whatever the industry does looks sinister to perhaps a majority of people across the political spectrum.

    (I sometimes think if the pharmaceutical industry invented a cure for death, the headlines would read "Greedy Drug Companies Profit from Runaway Population Explosion.")

    Here, I think the specter of impairing Merck's access to policymakers on a host of much larger policy issues (price controls, reimportation, physician data access, state consumer fraud prosecution, etc., etc.) led them to cut their losses and fold this relatively low-intensity (and, as you point out, low-spending) effort on behalf of one brand.

    Shame, really, since a guaranteed market for the vaccine would not only have made lowering the price here in the US more economically feasible, but would have made low- or no-cost distribution in the developing world (where HPV and cervical cancer are rampant) more attractive.

    O tempore, o mores...

  2. I too am in favour of the vaccine.

    And I appreciate the math lesson, John. :-)

    Put my rhetoric down to a bit of artistic license.

  3. Bruce,

    I never said Merck's lobbying effort was sinister -- I said it was stupid. There's a difference, so please don't put my criticism in the sunister camp.

    My goal is to help pharmaceutical marketers stop shooting themselves in the foot, to be smarter, and less motivated by greed than doing good.

    I don't think pharmaceutical companies are sinister -- if I did have that opinion, then I couldn't expect anyone to listen to me.

    But I think many people agree with me that smart people can sometimes do stupid things in pursuit of righteous goals and still be redeemable.

    I do not believe that the means justify the ends. So even though I applaud the end result -- getting as many young girls vaccinated with Gardasil -- I do approve the means employed Merck -- specifically, paying to influence legislators to pass mandatory vaccination laws.

    Truly sinister people, on the other hand, cannot be redeemed in my view and are condemned to Hell! They are beyond my help. Seek redemption with Jerry Falwell!

  4. Correction: "I do NOT approve the means employed..."


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