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Agency Confidential interrogated 21 executives at top healthcare agencies to find out the skinny on what is really happening with pharma marketing and advertising at this dire time for the industry. Here is the report.

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At the end of the day you have tribes, some frequently not on the same "brand" page.

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This latest action from the FDA has resulted in confusion, a need for counsel, and conjecture at what might be next.

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When economizing on agency spend, a key question needs to be answered: "Are you getting great value for your promotion?"

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Jennifer Spear Smith may be soft-spoken and petite, but she is loud, clear, and stands tall for one part of industry that she is clearly passionate about: continuing medical education (CME).

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Stefan Platz, Roche

I started off as a pathologist at Boehringer-Ingelheim in Germany.

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My first introductions to medically relevant biology and chemistry began when I worked with Harvard professor Greg Verdine to figure out how enzymes recognized and repaired damaged DNA.

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I started my career as a medical liaison. It was a wonderful opportunity to shape how companies and physicians further scientific understanding of difficult medical problems, focus on key research questions, and address unmet patient needs.

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Joe Mclane, Merck

I joined Merck in 1996 as a customer account representative, processing pharmaceutical and vaccine orders for our direct customers.

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Prior to joining Exelixis, I was an investment banker at Goldman Sachs, focusing on M&A and corporate finance.

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It's hard to believe that Michelle Dipp has been in the industry for only five years considering her significant impact thus far on it.

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FDA slaps down Cheerios and forces pharma companies that use Google to make technical changes no consumer will ever notice. Big whoop.

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I've always loved the life sciences, and have been fortunate to have my career take place during a time of profound advances in biology.

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Even in our crowd of underage overachievers, Luca Santarelli, MD, PhD, is a standout.

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There is increasing importance of differentiation in the pharmaceutical industry, especially given the political, regulatory, and financial challenges we face.

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Joe Shields, Wyeth

People define "work" differently. For some, it's making useful objects that you can see and touch.

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The Primary Care Business Unit at Pfizer has taken some major steps to respond to the needs of our customers.

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I trained as a journalist and worked at news organizations where all the reporters wanted to cover politics and crime.