So as I indicated in my statement, I think the pluralism of sources of information for the practicing physician is good. Can they be expanded? Yes. And we are doing what we can to see to it that all we know about our products from the scientific and clinical point of view is contained in the materials which we disseminate. Mr. GILMAN. Is the advertising that you utilize in professional journals geared toward encouraging the physician to utilize your product? I assume that is the premise by which you embark on your advertising campaigns. Mr. LERNER. Yes; that is the basic premise. We seek to persuade by presenting the merits, the features, the benefits, and the drawbacks of the individual product. Mr. GILMAN. Then I would assume you are dependent to some extent on the journal advertising to sway the opinion of the attending physician with regard to the utilization of your product. Mr. LERNER. If I can just parase that somewhat differently, we do depend on journal advertising to present information vis-a-vis our products. Now, it should be recognized that in the very same setting in which the journal advertisements of Roche Laboratories appear, appear an entire array of advertisements from other companies for products that are often directly competitive as well as in other therapeutic areas. And quite often within the same pages of those journals in which we advertise there are scientific or clinical articles which can speak to our drugs or the drugs of our competitors in an entirely different way than we do, again giving the physician a chance to balance, to assess, and to test against his own knowledge and clinical experience. Mr. GILMAN. Mr. Lerner, you are the head of the marketing division of the Roche Co? Mr. LERNER. Yes. Mr. GILMAN. How much did you expend on journal advertising last year in professional journals? Mr. LERNER. Are you interested, Mr. Chairman, in the figures for psychotropic drugs? For all drugs? Mr. GILMAN. For all drugs. Mr. LERNER. For all drugs of Roche Laboratories? Mr. GILMAN. Yes. Mr. LERNER. Give me a minute to dig it out here because I did prepare it. Let me categorize advertising to include journals, mail, and sales promotional materials. As a rule in Roche Laboratories, we invest about 60 percent of the advertising dollars in journals, roughly 40 percent in mail and sales promotion materials, just to give you a perspective on that. So the figure for all prescription medicines of our Roche Laboratories Division for 1977 was approximately $40 million. Mr. GILMAN. What percentage of gross sales did that represent? Mr. LERNER. The percentage of the gross sales of that divisionbecause this advertising to which I have referred applies only to the Roche Laboratories Division-would be somewhere between 8 and 10 percent. Mr. GILMAN. And what proportion of those sales were devoted to advertising for Valium? Mr. LERNER. The Valium portion of the journals, mail, and sales promotion would be about $9 million. Mr. GILMAN. And what percentage of your advertising budgetMr. LERNER. Well, 9 on 40 Mr. GILMAN. About one-quarter? Mr. LERNER. Roughly, yes. Mr. GILMAN. And as I recall, Valium represented the major propor tion of the sales of your company; is that correct? Mr. LERNER. Valium does represent the major portion of the sales of Roche Laboratories, that is right. Mr. GILMAN. Approximately $400 million of $600 million, is that what we are talking about? Mr. LERNER. Would that, if that were so, but it's not quite that large. Mr. GILMAN. Can you tell us roughly what it is? Mr. LERNER. Sales for Valium in 1977 approximated $250 million. Mr. GILMAN. Out of total gross sales of Mr. LERNER. Total gross sales of about $470 million, so it's roughly 50 to 60 percent, somewhere in there. Mr. GILMAN. You eleborated a bit on the training that you give your detailmen when they come into the company. What are the qualifications for your detailmen? Mr. LERNER. To be hired? Mr. GILMAN. For hiring. Mr. LERNER. Basically we have been attracting in the past people from virtually all walks of life, who share in common a high level of interpersonal skills, and who desire a sales career in this industry. Mr. GILMAN. Any minimum requirements? Education? Training? Mr. LERNER. Well, not in a stated way. Generally most of the people have at least a high school education. Most of them have a college education. Quite a few have degrees in one of the sciences. I would point out that of late, taking the outlook toward the future of more complex drugs, we are modifying our recruiting practices to try to attract more people with scientific backgrounds, particularly, for example, for pharmacy schools. Mr. GILMAN. But it isn't a requirement? Mr. LERNER. It has not been a requirement. Mr. GILMAN. And some are detailing who have just a high school education? Mr. LERNER. I would imagine very few. The great majority would undoubtedly have college educations. Mr. GILMAN. And those who have college educations are not particularly required to have any pharmacology background; is that correct? Mr. LERNER. That is right, although a large percentage of them do. Mr. GILMAN. What specifically is the nature of your pharmacological training courses for your drug salesmen? First of all, how long a period of time in training do they spend on pharmacology? Mr. LERNER. Well, it is very difficult for me to segment out any one section of the overall training program. You see each product is approached on an earned right basis. And as I indicated a few minutes ago, one salesperson must become what we call qualified on the individual product. Mr. GILMAN. But they spend about 2 weeks in training, do they not? Mr. LERNER. No; I didn't say that. Mr. GILMAN. I guess it was your detailman this morning who mentioned that. Roughly how much time in training do they spend-the average salesmen? Mr. LERNER. Let me put it in the sense of being qualified on the full product line that our salespeople are expected to deal with in the field. It takes about a year. Mr. GILMAN. They spend a full year in training? Mr. LERNER. In the training process. Mr. GILMAN. How much time actually in training? Mr. LERNER. I consider them to be in training for most of this period of time. Mr. GILMAN. When you bring a recruit in and put him in a training program, how much time do they spend in that training program? Mr. LERNER. It is difficult to quantify in terms of days or weeks. They spend as much time as is necessary to get them to qualify. That may run with a product a couple of months, it may run 3 months, it may run a couple of weeks. Mr. GILMAN. You would say your average new recruit spends 3 months in training before going out on the road? Mr. LERNER. I would say it would take that much time to become qualified in at least one product. Mr. GILMAN. How much of that time is spent in a pharmacological training program? Mr. LERNER. I would call the pure scientific background on the product itself difficult to put a quantifiable number on. Mr. GILMAN. Try to approximate it. Mr. LERNER. Let's say 25 percent of that time. Mr. GILMAN. So he is spending about 2 or 3 weeks in pharmacological training. Mr. LERNER. On a particular product such as Valium. Mr. GILMAN. Who trains him in that type of program? Mr. LERNER. It is a combination approach of the immediate supervisor in the field, plus a career development associate who works in our career development facility as part of the home office. Mr. GILMAN. Are those then selling and advertising people? Mr. LERNER. Well, I would consider the people in career development to be training people. Mr. GILMAN. Well, do you have any pharmacologists? Do you have any medical people who are training your recruits? Mr. LERNER. There is a great deal of interaction between our medical staff and these new and more mature salespeople as they move through our career development center. Mr. GILMAN. How much time is given to training your recruits by professional people or pharmacologists? Mr. LERNER. If I might just have a moment, I'd like to check that with one of my associates. [Discussion off the record.] Mr. LERNER. Again, it sounds evasive and I don't mean to be- Mr. LERNER. But I am not trying to be, I assure you. It depends on the individual needs for education in this area. Some learn at a faster rate than others. Mr. GILMAN. We are only asking you for an average amount of time. Mr. LERNER. It is awfully difficult to give you averages in that sense. Mr. GILMAN. How many recruits do you have in a year? Mr. LERNER. Let's say the turnover in our sales organization, which I am happy to say is, from our knowledge, about half that of most of the other companies in the industry, is about 10 percent. Mr. GILMAN. How many detailmen do you have? Mr. LERNER. We have about 700 detail people, men and women. Mr. LERNER. Seventy new people. We have a continuing Mr. GILMAN. What is the average amount of time? Mr. LERNER. In contact with scientific and medical people? Mr. GILMAN. Yes. Mr. LERNER. It is very difficult to give you a number. Mr. GILMAN. Can you give us an approximation? Mr. LERNER. I would say the bulk of the 25 percent of the time they spend dealing with the pharmacologic and scientific background of the product is spent in the direct presence of medical people. Mr. GILMAN. And what is that in days or weeks that they are spending? Mr. LERNER. I can't give you a number in days and weeks, Mr. Chairman. Mr. GILMAN. Can you estimate it for us? Mr. LERNER. I can't even estimate it. Mr. GILMAN. Is it more than a week or less than a week? Mr. LERNER. It could be more. It probably always is more. Mr. GILMAN. As part of your training staff do you have any physicians? Mr. LERNER. Yes. Mr. GILMAN. How much do you have? Mr. LERNER. We have our entire professional services department staff of physicians who interact with our training program on a very regular basis. Mr. GILMAN. Do they instruct recruits? Mr. LERNER. Yes. Mr. GILMAN. And do you have any pharmacists? Mr. LERNER. Yes. Mr. GILMAN. How many of those instruct? Mr. LERNER. As many as are necessary. Mr. GILMAN. Approximately how many? Mr. LERNER. Well, many of the people who are in our career department training facility are themselves pharmacists by background and training. In addition, in our professional services department we have a number of staff people who are pharmacists and interact with people in career development much the same way the physicians do. So there is a high level of contact with either pharmacists or physicians on our staff on a regular basis for everyone going through the career development process. Mr: GILMAN. Let me put it this way: Does a recruit take any direct instruction from any of your physicians or any of your pharmacists? Mr. LERNER. Yes. Mr. GILMAN. How many hours? Mr. LERNER. It is very difficult for me to give you hours because I just don't have a quantifiable number to give you. Mr. GILMAN. Can you give us an example of something of that nature? Mr. LERNER. Let's say the subject of a particular day on Valium happens to be its pharmacokinetic background, its metabolic rate, and subjects of that complexity. Obviously that subject matter would be handled by the medical and pharmacy staff. They would stay with these people until they have demonstrated sufficient skills with this subject matter to qualify on that aspect of the training program in what I have labeled our qualification programs. Mr. GILMAN. Is that done by a pharmacist or physician? Mr. LERNER. It may be done by a combination. Mr. GILMAN. Or it may be done by someone other than a physician or pharmacist? Mr. LERNER. The assessment of the knowledge level may be; yes. Mr. GILMAN. What about the instruction? Mr. LERNER. The instruction is generally done by a scientifically trained person. Mr. GILMAN. What is the amount of time it takes to train those people by that kind of professional person? Take your last recruit, for example, the one you most recently are knowledgeable about. Mr. LERNER. Again, I have asked my colleagues if we can assign a a specific number of hours. Mr. GILMAN. Mr. Lerner, could you provide this committee with that information? Mr. LERNER. Thank you. I'd be very happy to do that. Mr. GILMAN. Without objection, we will make that part of the com. mittee record at this point in the record. [The information referred to follows:] Hon. LESTER WOLFF, HOFFMANN-LA ROCHE INC., Chairman, House Select Committee on Narcotics Abuse and Control, U.S. House of Representatives, Washington, D.C. DEAR CONGRESSMAN WOLFF: During my testimony at the hearing before this Committee on August 10, the Committee requested that I supply further information concerning training of sales representatives by Hoffmann-La Roche Inc., and research expenditures. Specifically, I was asked the approximate number of hours sales representatives spent under the instruction of physicians and pharmacists; and the extent to which Roche research expenditures in 1977 were directed toward research into currently marketed Roche psychotropics, and toward overcoming side effects of Roche products. There follows information pertinent to these matters. TRAINING OF SALES REPRESENTATIVES Preparation of the Roche representative to assume the responsibilities of communication with health care providers is an encompasing task whose basis is firmly rooted in the health sciences. Beginning with the initial day of hire, salespeople are launched on a comprehensive educational experience which will ultimately lead them to an understanding of the complexities of health |