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Several large health maintenance organizations have announced that they are dropping out of the Medicare+Choice program, citing inadequate funding and overregulation. Humana Inc., Louisville, KY; Aetna U.S. Healthcare, Hartford, CT; Foundation Health Systems Inc., Woodland Hills, CA; and UnitedHealth Group Inc., Minnetonka, MN, among the largest plans, have announced that, as of Jan. 1, 2001, they will no longer be offering the supplemental insurance in many states and counties. Plan members in those areas will need to switch to higher-cost, traditional fee-for-service Medicare, which lacks a prescription drug benefit.

But prescription drug plan could be a hard pill to swallow.

When asked to rate pharmaceutical companies, physicians most value three attributes: commitment to research and development, credibility and educational orientation, according to Newtown, PA-based Scott-Levin's Pharmaceutical Company Image 2000 study. According to the report, doctors overall ranked Pfizer Inc., New York; Merck & Co. Inc., Whitehouse Station, NJ; and Glaxo Wellcome Inc., Research Triangle Park, NC, as having the strongest commitment to research and development. For the study, Scott-Levin surveyed physicians in 27 specialties, nurse practitioners, physician assistants, HMO medical directors and pharmacists.

For Michael Dorfman, a pediatric sales specialist with Wilmington, MA-based Ascent Pediatrics Inc., the most rewarding part of his job is watching his professional relationships grow. "I enjoy the rapport with the doctors and the staff and seeing how, as the relationship develops, your sales increase as well," said Dorfman, who has been in pharmaceutical sales for over six years and spent the last three with Ascent.

New York-based Standard & Poor's ratings outlook for the health insurance and managed care industries in 2000 is stable. However, according to the company problems persist in certain regions of the country, particularly New England, Texas and Florida.

According to "The Strategic Advantage: A Competitive View of Managed Care Sales Forces," a new survey released by Newtown, PA-based Scott-Levin, managed care decision-makers have named the managed care sales forces of SmithKline Beecham, Philadelphia, and Forest Laboratories, Inc., New York, the "most empowered."

Compensation is the top driver of job satisfaction among pharmaceutical sales representatives, according to "Sales Force Productivity & Effectiveness 2000," a study conducted by Newtown, PA-based Scott-Levin. But money isn't everything. An overwhelming majority - 95% of more than 700 reps surveyed - said the quality of their company's products is either very important or extremely important to both their motivation and their ability to succeed in the marketplace.

The Food and Drug Administration may consider restrictions on how the abortion drug mifepristone may be administered if it is approved, a move that could have an effect on the number of doctors who are willing to prescribe it.

The U. S. Supreme Court decided unanimously that health maintenance organizations cannot be sued for providing physicians with financial incentives to keep costs down. The case, Herdrich v. Pegram, involved a woman who complained of abdominal pain only to be told that she would have to wait eight days for an ultrasound. Her appendix subsequently ruptured, causing peritonitis. Upon recovery, she sued her HMO in state court, claiming that they had violated their fiduciary duty under the Employee Retirement Income Security Act.

The House Committee on Commerce conducted a Commerce Oversight and Investigations Subcommittee hearing on counterfeit bulk drugs to inquire into the Food and Drug Administration's oversight into foreign drug imports.

In an analysis of 22 pharmaceutical companies that merged between 1988 and 1999, Boston-based CenterWatch found that clinical research spending and productivity declined sharply in the three years following a merger.

The Department of Health and Human Services has announced that it is taking new steps to strengthen federal oversight and increase the accountability of researchers conducting clinical trials with human subjects in order to protect the safety of individuals participating in all clinical trials.

The quality of our voice can say more about us then the words we speak.

The traditional boss-employee relationship has been replaced by a model in which the partnerships between managers and their employees - as well as those among managers across the organization - are a vital tool for enhancing performance.

How the job has changed over the years.

Independent Maine governor Angus King signed into law a bill that would allow the state of Maine to collectively bargain for pharmaceutical prices. The bill that passed is different from a bill previously rejected by King in that it does not use Canadian prices as a yardstick. The new bill requires pharmaceutical companies to voluntarily bring prices down to levels the federal government pays, which is currently discounted up to 15.1% from retail prices. The state will implement a mandatory pricing reduction to mirror the government's discount. These mandatory discounts could be put into place as early as July 1, 2003.

Pfizer, Merck and Bristol-Myers Squibb top the list of companies with the most effective sales forces according to a new study profiling pharmaceutical sales representatives and the factors that motivate them.

The top 10 things reps can do to irritate physicians.

The Department of Health and Human Services added the cancer-fighting drug tamoxifen to the ninth edition of its report on carcinogens. The report, which is prepared every two years by the National Toxicology Program at the National Institute of Environmental Health Sciences, Washington, identifies substances, such as metals, pesticides, drugs and natural and synthetic chemicals, and mixtures and exposure circumstances that are known or are reasonably anticipated to cause cancer and to which a significant number of Americans are exposed.

Tips for successful speaker programs.

Whether browsing through magazines or watching television, one doesn't have to look long in order to find a direct-to-consumer advertisement for a prescription medication.

Advice for those new to pharmaceutical sales.

The Prescription Drug Fairness Act, a bill that would eliminate price discrimination by American drug companies that sell drugs developed and manufactured in the United States to foreign countries at a dramatically lower price, was introduced in the Senate by Senator Slade Gorton (R-WA).

For Lorraine Simpson, a Chicago-based sales representative with Professional Detailing Inc., there are no downsides to working for a contract sales organization. "I'm telling you, it's wonderful!" she said. "But the perception is that in contractual work, you don't work as hard and you're not on the same level. In my opinion, we work just as hard."

The patent entitles the University of Rochester to royalties on the sale of all COX-2 inhibitors. Shortly after the patent was awarded, attorneys representing the University of Rochester filed an infringement suit in federal court against Searle, Chicago, and Pfizer Inc., New York, which jointly market Celebrex.

The Pharmaceutical Research and Manufacturers of America, the Washington-based pharmaceutical industry lobbying organization, has formed a Paperless Labeling Task Force to look into the use of new technologies as a means to assure timely distribution of full prescribing information to pharmacists.

President Clinton released the results of a Department of Health and Human Services study showing that seniors without drug coverage lack insurance against high costs and lack access to discounts and rebates that insured people receive.

Newtown, PA-based healthcare consulting firm Scott-Levin released its "Year in Review 1999," an analysis of pharmaceutical industry trends.

The Federal Trade Commission charged two drug makers, Hoechst Marion Roussel (now Aventis) and Andrx Corp., with engaging in anticompetitive practices, alleging that Hoechst, the maker of Cardizem CD,® a widely prescribed drug for treatment of hypertension and angina, agreed to pay Andrx millions of dollars to delay bringing its competitive generic product to market. The commission also announced a proposed settlement with two other drug makers, Abbott Laboratories, Abbott Park, IL, and Geneva Pharmaceuticals, Inc., resolving charges that the companies entered into a similar anticompetitive agreement in which Abbott paid Geneva substantial sums to delay bringing to market a generic alternative to Abbott's brand-name hypertension and prostate drug, Hytrin.®

In its monthly Drug Monitor, Westport, CT-based IMS Health reported overall 10% growth in retail drug sales, to $209.7 billion, for twelve strategic global markets in the twelve-month period from March 1999 to February 2000. North America is the global leader in pharmaceutical sales growth, at 15% and $92.3 billion in sales during this period. The average sales growth for the top five European markets was 8%, for a combined total sales value of $53.7 billion in Europe.