Obviously marketing works, and sales reps can help physicians by pushing research and information at the as part of their outreach -- just like any other relationship based salesperson.<p>The other equation missing is the impact of pharma sales practices with respect to the gatekeeper pharmacy managers. Who is taking the CVS&#x2F;Caremark guy out for steak dinner and what is the rebate or consideration that the insurance company gets for choosing one drug over another.<p>In my case, my insurance company standardized on a drug in a broader class of medications that wasn&#x27;t as effective for me -- I had some minor side effects and the metrics changed for the worse.<p>So my doctor switched me back to a non-preferred drug. His mousepad was provided by that drug maker. Is that an ethical issue?