LOVE AND OTHER DRUGS Directed by Edward Zwick
Given the power of the pharmaceutical industry, any big-studio feature that explored the marketing tactics of drug companies would be a welcome addition to the debate over the U.S. health-care system. Universal Pictures appeared ready to make that movie five years ago when it bought the rights to Jamie Reidy's memoir Hard Sell: The Evolution of a Viagra Salesman. Reidy's book, chronicling his years in the late 90s as a sales representative for Pfizer, was largely comic, filled with stories about his creative ways of dodging work for happy hour. But it was also a damning look at Big Pharma.
Love and Other Drugs, the fictional film based on Reidy's book, hits theaters this week, with Jake Gyllenhaal as an unscrupulous Pfizer rep and Anne Hathaway as the woman he falls for, who suffers from early-onset Parkinson's. The film was directed and cowritten by Edward Zwick, who's grappled with big social issues in such movies as Glory (1989) and Blood Diamond (2006). In those films the issues were thoroughly integrated into the plot, but that isn't the case in Love and Other Drugs, whose formulaic love story has been invented to make the movie's critique of the pharmaceutical industry more palatable to mainstream moviegoers.
When Hard Sell was published in March 2005, Reidy had left Pfizer and was working as a sales trainer for another drug giant, Eli Lilly. But the book painted him and his profession in such an unflattering light that Lilly fired him. A former army lieutenant, Reidy had likened pharmaceutical sales training to military brainwashing, designed to instill conformity and obedience. Physicians and their staffs were merely "targets" to be bribed with candy, trinkets, free lunches, tickets to sporting events, and trips to tropical resorts. Hard Sell explained how drug companies kept tabs on doctors by purchasing their prescription records from pharmacy chains and revealed that Pfizer had made Viagra tablets diamond-shaped so they wouldn't fit into a typical pill cutter.
Hard Sell was cited in investigative articles in the New York Times and the San Francisco Chronicle, and Reidy appeared on CNBC's Mad Money w/Jim Cramer. Then came his big break: the New Yorker's Malcolm Gladwell recommended Hard Sell to screenwriter Charles Randolph. The book may even have been partly responsible for some industry reform: in the years following its publication, Maine, Vermont, and New Hampshire all passed legislation banning drug company access to prescription records, and the American Medical Association created an opt-out program for doctors who didn't want their prescription data accessed for marketing purposes.
Love and Other Drugs isn't nearly as revealing as Hard Sell, except when it comes to the stars' bodies. There's a lot of sex in this movie: in a stockroom, in a hot tub, in a coffee shop, and, once or twice, even in bed. Zwick presents most of these scenes as fitful encounters, bursts of passion that leave the participants exhausted and empty. Gyllenhaal's character, Jamie Randall, is a fast-talking Casanova who believes he has little to offer the world besides a 100-watt smile and a big package of drug samples. His sexual performance mirrors this shallow self-conception, but when he falls for Hathaway's character, Maggie Murdock, their couplings are tender and heartfelt. This works well enough as character development, but there's something disingenuous about a film that, on the one hand, tweaks Big Pharma for using the promise of sex to sell drugs and, on the other, uses the promise of two attractive stars having sex to sell tickets.
By far the most interesting element of the story is the relationship between doctors and drug reps, and the effects those relationships have on the healthcare system. "Always lead with a pen," Jamie's manager tells him. "It establishes reciprocity." The line brings to mind a 2003 study on pharmaceutical industry gift-giving that revealed gifts, no matter how small, leave the recipient feeling he must return the favor; it refuted physicians' common assertions that company-branded trinkets had no bearing on the prescriptions they wrote.
Jamie's efforts to get Dr. Knight, a general practitioner played by Hank Azaria, to prescribe Zoloft, Pfizer's antidepressant, over Prozac is mostly faithful to the book. When the usual swag proves ineffectual, Jamie offers Knight a "preceptorship," a $1,000 payment that will let Jamie shadow him around the office, ostensibly to learn about his specialty. The constant interaction with Knight brings Jamie closer to his goal, but when he asks Knight about Zoloft again, Knight refuses, explaining that the Prozac rep is his friend. Jamie takes him to a bar, plies him with drinks, and sets him up with a couple of bombshells, which finally seals the deal.
Love and Other Drugs also comments more broadly on the inadequacy of the U.S. health-care system. Invented by the screenwriters, Maggie is an uninsured artist who must pay out of pocket for her numerous doctor visits and prescription drugs, and on top of that she spends her spare time escorting busloads of seniors to Canada to buy U.S.-produced drugs at lower prices. In another scene Knight laments to Jamie that the HMOs are "killing" him, that he must see 50 patients a day just to pay his bills, and that the big law firms watch him like a hawk for any mistakes he might make so they can pounce on him with a malpractice suit.
And then there's "Vitamin V," as the Pfizer reps call it. Pfizer stumbled onto a gold mine when participants in trials for an angina medication cited penile erection as a side effect, releasing Viagra in 1998; eight years later it was still netting the company more than $1 billion annually. Pfizer didn't need to spend as much researching Viagra as it would have a drug it was formulating from scratch, but it's spent loads on marketing, with commercials flooding the airwaves. (A 2008 study found that the U.S. pharmaceutical industry spends almost twice as much on marketing as on research.) By saddling Jamie with a girlfriend who suffers from an incurable condition, Zwick establishes the movie's key argument: wouldn't the money spent marketing drugs for erections be better spent developing new drugs for conditions like Parkinson's?
In a rare sequence that confronts this question squarely—and hints at what the film might have been—Jamie brings Maggie along to a pharmaceutical convention in Chicago (filmed in Pittsburgh). While Jamie schmoozes at the Viagra booth, Maggie sneaks across the street to an "unconvention"—a gathering of Parkinson's patients venting about what it's like to live with the disease. It's the first time Maggie, an iron-willed woman convinced she can face her disease alone, seems to break out of her shell. One elderly woman, trembling terribly, takes the podium and then hushes the crowd. "Do you hear that?" she asks. "Oh, sorry. I thought I heard a cure coming." As heavy-handed as her joke might sound, the scene is a vivid reminder that some people suffer terribly, and that love isn't the drug they need.