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Unformatted text preview: PLoS Medicine | www.plosmedicine.org 0621 Policy Forum April 2007 | Volume 4 | Issue 4 | e150 Its my job to fi gure out what a physicians price is. For some its dinner at the fi nest restaurants, for others its enough convincing data to let them prescribe confi dently and for others its my attention and friendship...but at the most basic level, everything is for sale and everything is an exchange. Shahram Ahari You are absolutely buying love. James Reidy  I n 2000, pharmaceutical companies spent more than 15.7 billion dollars on promoting prescription drugs in the United States . More than 4.8 billion dollars was spent on detailing, the one-on-one promotion of drugs to doctors by pharmaceutical sales representatives, commonly called drug reps. The average sales force expenditure for pharmaceutical companies is $875 million annually . Unlike the door-to-door vendors of cosmetics and vacuum cleaners, drug reps do not sell their product directly to buyers. Consumers pay for prescription drugs, but physicians control access. Drug reps increase drug sales by in uencing physicians, and they do so with fi nely titrated doses of friendship. This article, which grew out of conversations between a former drug rep (SA) and a physician who researches pharmaceutical marketing (AFB), reveals the strategies used by reps to manipulate physician prescribing....
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