Critics may play whack-a-mole on pharma's doctor-speakers, but the species lives on

Are drugmakers rethinking their use of physician speakers? The latest round of payment numbers suggests that they might be, with speaking fees down by 40% or more at some Big Pharmas, according to Pro Publica. And GlaxoSmithKline ($GSK) has actually said it's planning to stop paying those fees.

But there's no need for marketing folks to fret--at least not yet. Plenty of companies say they have no plans to follow Glaxo's lead. And the decline in speaking fees in 2012 could have as much to do with the usual marketing give-and-take as it does with worries about financial ties to doctors.

Eli Lilly ($LLY), whose spending on speaking fees plummeted by 55% in 2012, to $21.6 million, blamed the change on patent expirations and a dearth of new products. Lilly has a couple of very promising drugs on the horizon, but over the past few years, its pipeline hasn't yielded much.

Meanwhile, Johnson & Johnson ($JNJ), which has popped out several top prospects over the past few years, boosted its payments to doctors by 17%. And Forest Laboratories ($FRX), among the neediest of drugmakers in the wake of its Lexapro patent loss, has put big money into speaking fees to support the newer products it's counting on for growth.

Plus, with many new drugs targeted to rare diseases and cancer, drugmakers need fewer, more specialized reps to detail specialists, rather than an army of sales folks knocking on primary care doctors' doors.

When Glaxo announced its doc-payment vow in December, an Eli Lilly spokesman said, "Few products in the world are as complex as an innovative medicine," implying that it needs medical professionals to help explain new products. For that and other reasons, the doctor-speaker is a staple of drug marketing. Questions about the ethics of those relationships may have multiplied over the past few years, what with off-label marketing settlements and high-profile scandals at top teaching hospitals. But they show little sign of going away altogether.

- read the Pro Publica story

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