Brigham Buhler
speaker
1,533 appearances
6 recordings
5 series
first heard Oct 2024
last heard 27 Feb
Brigham Buhler’s voice in public audio — every appearance, attributed to the second.
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Appearances
And so we, the American people, are paying the bill for these innovations multiple times. We funded the original legwork to get this molecule to a point it could be patented. Then the NIH turns it over to Big Pharma. Then Big Pharma patents it and we got to pay for it again.
And then Big Pharma says, well, we got to charge you more because you're fitting the bill for the rest of the world's innovation. But yet we're one of the most chronically ill societies for a first world country, which is crazy.
Yeah, it's the National Institute for Health, and they are a taxpayer dollar funded entity that is trying to help drive chronic disease and create cures. But it's really less about cures and more about creating compounds that treat symptomology. And that's because it's guided by big insurance and big pharma. And I know you and I met through our Senate testimonies.
And I and the gist of it is in my main point that I try to make as coming from a background of a little bit about me is like I started out as a drug rep right out of college. And so I got the experience of being a drug rep and I only did it for a few years. But I learned so much about how that system works.
Well, so all the folks that trained and taught me were on the payroll for the pharmaceutical company, right? And so when we launch a compound into a marketplace, I had every doctor in a geographic region, what they were prescribing, where I was supposed to go for the day. They tailored my schedule to focus on heavy prescribers, people who prescribed a certain demographic of medication.
You fish where the big fish are.
Correct. And I would know what they prescribed the day before. And so let's just say, as an example, you're selling an ADHD medication. You would prioritize your schedule to go call on the clinicians that prescribe the most Adderall. And then your job is to go convert them or grow the patient population.
And the conversion's one thing, because that's trying to sell and place your product in a way and argue the medical necessity and benefits of that compound. But to grow a market is a whole nother thing, because think about it. This is where it gets really gray and jaded with these pharmaceutical companies.
They'll have you sign these contracts as a 20-year-old kid saying, I'm not going to off-label promote. I agree. I've been trained that I'm not going to talk about something that this drug isn't indicated for. Then they send you to dinners with thought leaders in your field that tell you all the areas they're using these drugs that aren't on the label. which would be off-label promotion.
And then you're tasked with growing a market share and immense pressures put on you to grow market share. And you're out at a dinner with one of your doctors and you go, well, man, do I bring up what that doctor told me about using this? And let me give you an example. Like there was a antipsychotic, a very niche drug, right? Antipsychotics are not meant to just be handed out like candy, right?
They would literally train the sales reps to go in and instead of focusing on this very niche patient population, you would try to grow it to a more average patient population. So example would be, you've talked about the mother that comes in, she's stressed, she's anxious, she's having a hard time sleeping.
That mom that maybe wakes up in the middle of the night and just starts cleaning the house because she can't sleep. Mm-hmm. that might be a manic patient. That might be a patient that this compound could help. But that is not a manic.
This is what the drug companies would try to teach a clinician and get a clinician to essentially over-prescribe a drug and prescribe it in patient demographics that don't make sense. We talk often about the opioid crisis. The opioid crisis was preceded by the Valium crisis, which was the same family, the Sacklers. And this is what's wild.
The Sacklers in the 60s, I think, and 70s began to promote Valium for women who had headaches. And they tried to target housewives.
Oh, it's an opioid. So it's addictive. It's abusive. You become dependent on it. Mood swings.
I think that was one that they called mom. I can't remember. They were saying, don't just take a martini, pop a Valium. And I think it's the one that they called mama's little helper.
Yeah, it was marketed towards housewives that were stressed and anxious and overwhelmed, you know, and then they marketed to husbands about and this is the 60s and 70s. But it's like if your wife's on edge, tell her to pop a volume. And they created and perpetuated a crisis where Congress had to step in and go after the Sackler family to shut down this volume crisis.
Yeah, yeah. They had created a crisis already once.
Yeah.
So. Again, and I try to portray it. It's not that reps are all good or bad. Humanity's a duality, right? We all have good or bad. But show me the incentives and I'll show you the outcomes. If everything becomes about quarterly earnings, quarterly profits, commission plans, hitting your incentives, hitting your milestones, you create this ultra competitive environment.
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