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Feature Drug marketing

Key opinion leaders: independent experts or drug representatives in disguise?

BMJ 2008; 336 doi: (Published 19 June 2008) Cite this as: BMJ 2008;336:1402
  1. Ray Moynihan, visiting editor, BMJ
  1. 1University of Newcastle, Newcastle, New South Wales, Australia
  1. Ray.moynihan{at}

Ray Moynihan examines the role of the influential experts paid by industry to help “educate” the profession and the public

In the world of medicine, “key opinion leader” is the somewhat Orwellian term used to describe the senior doctors who help drug companies sell drugs.1 These influential doctors are engaged by industry to advise on marketing and help boost sales of new medicines. Across all specialties, in hospitals and universities everywhere, many leading specialists are being paid generous fees to peddle influence on behalf of the world’s biggest drug companies.

Kimberly Elliott, who was a drug company sales representative for almost two decades in the United States, puts it directly. “Key opinion leaders were salespeople for us, and we would routinely measure the return on our investment, by tracking prescriptions before and after their presentations,” she said. “If that speaker didn’t make the impact the company was looking for, then you wouldn’t invite them back.”

View the first of two video clip interviews with Kimberly Elliot

From the age of 23, Ms Elliott worked for several global drug companies, including Westwood Squibb, SmithKline Beecham, and Novartis, leaving the industry 18 years later, only last year. Many times a top national salesperson, part of her job was developing relationships with local and national opinion leaders, also described as “thought leaders.” Ms Elliott says she would pay these respected doctors $2500 (£1280; €1610) for a single lecture, which was largely based on slides supplied by the company. Sometimes the company would pay the fee to an academic centre, which would then pay the doctor. “These people are paid a …

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