Have you ever gone to the doctor and noticed that the pen you used to sign in for your appointment sported the logo of a drug company? Or maybe your appointment was delayed because the staff was busy enjoying bagels from a pharmaceutical representative. Everyone knows that doctors and the pharmaceutical industry enjoy a rather cozy relationship. But you might be surprised by just how cozy. Standard marketing practices in the pharmaceutical industry include lavish payments to doctors for food, travel, speaking and research fees. Eli Lilly, for example, indicated it spent $216.5 million on payments and gifts to physicians in 2011. And in 2013, a federal lawsuit against Swiss pharmaceutical firm Novartis alleged that one payment among many included a nearly $10,000 dinner for three at the restaurant Nobu, to induce doctors to prescribe its drugs. Drug-makers claim that this type of spending is standard promotional practice in the industry, meant to educate physicians on how to use the company's medicines. The Obama Administrations healthcare reform legislation included the Physician Payment Sunshine Act, which will require pharmaceutical firms to report things of value that they have given to doctors, hospitals, and health care workers. The information should be available on a public website, without judgment attached about appropriateness, allowing consumers to make better-informed choices. And there are legitimate arguments on either side of this issue:

Against promotional "gifts" to healthcare industry:

Analysis by theNew York Timesfound that doctors who take money from drug makers often practice medicine differently from those who do not and that they are more willing to prescribe drugs in risky and unapproved ways, such as prescribing powerful antipsychotic medicines for children.

Patients deserve to get treatment based on medical evidence, not an opulent meal or some other financial relationship.

In favor of promotional "gifts" to healthcare industry:

According to a key industry trade group, meals featuring educational talks are good for patients because they give doctors one more tool in understanding medicines.

One doctorclaimsthat she is paid to take online classes by each company she speaks for as a way to learn about new drugs, and then is paid to give talks at free dinners. Usually, but not always, she speaks about new drugs on the market.

To minimize conflicts of interest, the American Medical Association has ethical guidelines that allow modest meals and pay as long as a service is rendered. The guidelines do not approve gifts or payments that expect anything in return.

Answer the following questions:

A. Do you believe that the relationship between the pharmaceutical industry and the healthcare industry is too cozy? What level of relationship do you believe would be most appropriate and ethical? Why?

1.What are the four different kinds of utility that marketers can provide? Give an example (not from the book) of a product that delivers each type of utility.

2.What are the key categories of nontraditional marketing? Do you expect these areas to grow over the next decade? Why or why not?

3.How has marketing evolved over time? How have current events, economics, and culture influenced thinking about marketing?