Closing the Marketing Strategy-Tactics Gap: An Institutional Theory Analysis of Pharmaceutical Value Chain

Abstract

This chapter identifi es a strategy-tactics gap in most previous studies of pharmaceutical marketing, and addresses it by systematically analyzing the marketing strategies used in practice with the help of a unique dataset of court discovery documents unsealed in a recent litigation. Adopting an institutional theory perspective, we examine the dominant logic that underlies pharmaceutical marketing strategies, and contrast it with the organizing logics of the value chain partners. Four distinct marketing strategies with carefully crafted interdependencies emerge from our analysis: (1) market penetration strategy involving a focus on segmentation and penetration, (2) evidence-based strategy involving production of science, (3) medical education strategy involving development and dissemination of standards of care, and (4) surrogate selling strategy involving leverage of peer-to-peer infl uence among target physicians. Together, the strategies uncovered in our analysis provide coherence to the observed marketing tactics and show that they are largely consistent with the logic of consequences which confl icts with the logic of appropriateness guiding the actions of the value chain partners. The institutional theory analysis shows that: (1) pharmaceutical value chain is characterized by confl icted logics, (2) that are amplifi ed by pharmaceutical marketing strategies thereby, (3) inviting regulatory intervention to constrain and restrict pharmaceutical marketing efforts. We propose an open systems framework that elaborates on value chain interdependencies and compare it with the economic framework that characterizes most current research. We close the chapter with an agenda for future research into the theory and practice of pharmaceutical marketing.

The Role of Social Norms on Direct-to-Physician Pharmaceutical Marketing Payment Acceptance

“…In addition, stakeholders can appoint thought leaders or role models to provide informal sanctions to guide physician behaviors. Thought leaders can exert their social powers to discourage the acceptance of pharmaceutical marketing payments on the basis of an agent’s desire to gain legitimacy and approval (French and Raven 1959; Singh and Jayanti 2014). Because our results suggest that being in a teaching hospital leads physicians to be more susceptible to peer influence, it may be particularly important for appointed thought leaders to instill and promote ethical values to young medical professionals in teaching hospitals (Rothman et al 2009).…”

“…In addition to training, intensive communication and socialization between members reinforce the standards and practices of a field. Professional activities (e.g., conferences, meetings, speakers bureaus, peer-reviewed journal publications, advisory boards) reiterate and reinforce the standards and practices (Singh and Jayanti 2014). In summary, members are likely to imitate others in the same field to gain legitimacy.…”

Ethical drug marketing criteria for the 21st century

“…11 It is important that health professionals and the public are educated about the promotional nature of industry activities, particularly those dressed up as research, education, or covert marketing through surrogates such as patient associations and key opinion leaders. The 1988 document covers a wide range of marketing activities, but many new marketing strategies have since been introduced, including through social media.…”

“…Model of drug promotion activities 11. A company’s strategy directs its choice of actors and tactics…”

Interpreting evidence in general practice: Bias and conflicts of interest

“…The pharmaceutical industry has well-developed strategies to identify sympathetic, high-profile clinicians and give them opportunities to speak favourably about particular medications. 18,19 Industries may release biased media reports, leading to unrealistic patient expectations and requests to GPs for inappropriate medications. 20…”