A weekly report showing missed share targets. An internal email announcing a competitor's new launch. A single sentence from a physician who has decided to switch. The moment a pharmaceutical MR senses the first signs of share loss, a defensive emotional state begins to move. That state temporarily overwrites the commitment to honest, accurate information — pulling the person toward a logic that says "if I expose the competitor's weakness, I can protect our product." The Sales Information Provision Monitoring Report for fiscal year 2024 and the Sales Information Provision Survey Report for fiscal year 2025 record that in highly competitive therapeutic areas, multiple healthcare institutions reported similar disparagement incidents, and that "some cases gave the impression of deliberate, organized conduct by the sales organization rather than a problem of individual MR character."
So What / So Why — The Core of This Issue
The core of this issue in one sentence: defensive fear of losing share converts into the offensive act of denigrating a competitor's product. The person believes they are defending; from the outside, it looks like an attack. That asymmetry is the essence of the problem.
So what — what actually happens. An MR who contacts a physician considering a switch mentions the competitor's weaknesses without any comparative data to support the claim. Or they describe an adverse event of unclear causal relationship as an "emergency" and stoke anxiety. Or they phrase a question in a way that leads the physician to voice the disparagement themselves — "Doctor, what is your view on this point?" The form varies, but the motive underneath is the same: a defensive reaction aimed at protecting the product's share.
So why — why this is serious. There are two layers. First, prescribing decisions become distorted. A physician who accepts unsubstantiated criticism of a competitor may steer patients away from a more appropriate option. Organized obstruction of biosimilar switching conflicts directly with the policy goal of reducing medical costs. Second, as the FY2024 Sales Information Provision Monitoring Report explicitly states — "some cases gave the impression of deliberate, organized conduct by the sales organization rather than a problem of individual MR character" — in highly competitive areas, disparagement has escalated from individual deviation to coordinated organizational behavior. Once it reaches that stage, correction and prevention become far harder to achieve.
The Structure of Pressure — Who, Which Deadline, Which Number
Labeling disparagement as a simple failure of ethics makes the structure invisible. It is worth being specific about who is pushing on MRs, what deadlines they face, and which numbers are doing the work.
Who applies the pressure. The immediate line manager — area manager or district manager — is the first source. Share changes are made visible at weekly and monthly sales meetings, and facilities where a competitor has won are called out by name. In an FY2024 incident, a supervisor joined an online meeting and said nothing while a subordinate disparaged two competitor products by name. The report described this as "suggestive of intentional conduct by the sales organization." Pressure flows from senior management as an expectation — "how are you going to defend against this new competitor?" — and field MRs read that expectation and act on it.
Which deadlines matter. The day before the formulary committee decides on a generic or biosimilar switch. The week before the first adoption meeting after a competitor's launch. The last three days of the quarter. As these deadlines approach, options that would normally be off the table start looking viable. The disparagement cases documented in the FY2019 Advertising Activity Monitoring Project report — reported from multiple healthcare institutions that were considering a biosimilar switch — can also be read as deadline-driven actions taken before the switch became irreversible.
Which numbers trigger the response. Management knows the annual revenue loss that follows a one-point share decline. What reaches the MR is something more concrete: "This month, competitor won X cases at Y Hospital." When incentive structures are tied to market share, losing share directly affects an MR's income. The moment "defending the number" takes precedence over "giving the patient accurate information," the first step toward disparagement has already been taken.
The Inner Reconstruction — Beliefs, Emotions, Deep Psychology
The inner world of the person doing this is not visible from outside. But the pattern of actions and statements allows a reasoned inference — not a verdict, but a "this is likely what they felt" account — tracing the flow from belief to emotion to deeper psychological driver.
Beliefs — what they thought was true. Most MRs genuinely believe their product is superior. Years of exposure to scientific literature, internal training, the excitement of a new launch — these form a conviction that "our product helps patients." When an MR who disparaged a biosimilar said "the purification is poor," they may not have been consciously lying. The pharmaceutically valid proposition that "a biosimilar is not chemically identical to the originator" slides into the groundless slur "the purification is poor" — and that slide is a textbook case of motivated reasoning. The conclusion comes first; the data is found afterward.
Emotions — what they felt in the moment. When share is under threat, the emotional mix is indignation and urgency in one. The legitimate concern — "why is this competitor being adopted when it has fewer clinical trials?" "Is this really safe for patients?" — merges with the personal anxiety of "my numbers are going to fall," and the two become indistinguishable. Loss aversion, as behavioral economics describes it — losses of a given size hurt more than equivalent gains feel good — makes the experience of losing share feel disproportionately large. That emotional state lowers the threshold for action. The internal brake — "if I say this, it might count as disparagement" — becomes less effective.
Deep psychology — four drivers at work. In a competitive threat scenario, several drivers operate simultaneously.
- 1. Motivated reasoning. The conclusion — "our product is better" — is already in place. Without data, word-of-mouth fills the gap. The FY2025 "emergency" incident (Sales Information Provision Survey Report) is a case where an adverse event with no confirmed causal link was weaponized, conclusion first.
- 2. Local rationalization. "Just this once, just as a reference." "I only showed a comparison table; the verbal explanation was the physician's own judgment." The FY2023 tactic of asking "Doctor, what is your view on this point?" was deliberately structured so that the MR did not deliver the disparagement — the physician said it themselves. That is motivated reasoning in a refined form.
- 3. The sin of omission. Not mentioning the drawbacks of your own product. In the FY2025 vaccine incident, only the competitor's disadvantage — requiring reconstitution before use — was presented; the company's own disadvantage — a short shelf life — was not mentioned. "I didn't lie" may be the self-perception, but selective silence is judged as disparagement.
- 4. Externalizing responsibility. "My supervisor was there and said nothing, so I assumed it was an approved approach." "The physician asked me, so I answered." "I was just passing along word-of-mouth; it wasn't my own statement." The FY2024 incident with the supervisor present suggests this externalization may have been functioning at an organizational level.
The Underlying Real Incidents
Three documented incidents show that the psychological analysis above is not theoretical. For detailed deviation analysis, see Analysis Series, Vol. 7 — "Disparagement and Defamation of Competitor Products".
Incident 1 — Metabolic Drug: Word-of-Mouth Reframed as an "Emergency" (FY2025)
Channel / Therapeutic area: In-person visit / Metabolic drugs
What happened. An MR visited a healthcare institution and said they had received word-of-mouth information that "two patients in this prefecture who were using Product B (a competitor's product) experienced adverse events requiring surgery," then urged the institution to switch from Product B to the company's Product A on the grounds that "this must be considered an emergency." No causal relationship between Product B and the adverse events had been confirmed.
What was operating internally. The conclusion — "Product B is dangerous" — was already in place (motivated reasoning). Unverified word-of-mouth was used as supporting data for that conclusion. The emotionally charged word "emergency" was a deliberate choice to maximize physician anxiety. Not confirming the causal relationship was the sin of omission; the sense of "I was just passing along what I heard" was externalization of responsibility.
Direct quotation: "Came to inform us that they had received word-of-mouth that two patients in the prefecture who were using Product B (competitor's product) experienced adverse events requiring surgery. Said this must be considered an emergency and requested that we switch adoption to their company's Product A." (FY2025 Sales Information Provision Survey Report)
Incident 2 — Named Disparagement with a Supervisor Present and a Comparison Table (FY2024)
Channel / Therapeutic area: Online meeting (supervisor of company representative also present) / (therapeutic area not specified in report)
What happened. An MR shared a comparison table of three competing products on screen, then — without being asked — stated that "Company N's product requires double the dose at initiation" and "Company O's product causes a lot of constipation," disparaging two competitors by product name and arguing for their own product's superiority. The supervisor was present, and the report noted that this was "suggestive of intentional conduct by the sales organization."
What was operating internally. Preparing a comparison table — framed as "objective data" — functions as local rationalization, making the presentation look evidence-based. The supervisor's presence supported externalization of responsibility: "this is conduct the organization has sanctioned," allowing the MR to feel they were "doing what they were directed to do." This is a clear example of an organizational defensive intent against competitors manifesting as individual MR behavior.
Direct quotation: "Company M's company representative, with their supervisor also present at the briefing session, stated: 'Company N's product requires double the initial dose; Company O's product causes frequent constipation,' disparaging competitor products and arguing for the superiority of their own product." (FY2024 Sales Information Provision Monitoring Report). The report's general conclusion further states: "In recent years, similar inappropriate incidents have been reported by multiple healthcare institutions, particularly for drugs in highly competitive areas, and some cases gave the impression of deliberate, organized conduct by the sales organization rather than a problem of individual MR character." (quoted separately from the summary section)
Incident 3 — Oncology Drug: Leading the Physician to Voice the Disparagement (FY2023)
Channel / Therapeutic area: Online meeting / Oncology drugs
What happened. An MR named a competitor's product and asked the physician: "The clinical trial results for *** (competitor's product) did not reach data of this level, but Doctor, what is your view on this point?" No data or graphs for the competitor's product were presented.
What was operating internally. The structure was deliberately designed so that the MR did not deliver the disparagement — the physician did. This is local rationalization in its most refined form. The groundwork for externalizing responsibility — "I was just conveying an evaluation the physician expressed" — was laid before the statement was even made. The stronger the anxiety about a competitor, the more likely this kind of detour is chosen, caught between "saying it directly would be a problem" and "but I want to get the message across." The report concluded that this leading approach still constitutes disparagement and defamation.
Direct quotation: "The clinical trial results for *** (competitor's product) did not reach this level of data (the company's own figures), but Doctor, what is your view on this point?" (FY2023 Sales Information Provision Monitoring Report)
What all three incidents share is a situation in which switching to a competitor was an immediate, realistic threat. The stronger the defensive emotion, the more sophisticated the means of attack becomes.
Inside the Creator ── The Psychology Behind Deviations ── Map of 10 chapters
- Part 1: A Map of Pressure — How Good Intentions Bend
- Part 2: The Creed Trap — "I Want to Help Patients" as the Entry Point
- Part 3: Conclusion First, Data Second — Motivated Reasoning
- Part 4: "Just One Slide" — Local Rationalization
- Part 5: The Choice Not to Speak — The Sin of Omission
- Part 6: Structures That Let You Blame Someone Else — Externalizing Responsibility
- Part 7: The Gravity of Numbers — Quotas and the Psychology of Incentives
- Part 8 (this chapter): The Anxiety of Competition — How Panic Becomes Disparagement
- Part 9: The Silent Organization — Conformity Pressure, Hollow Audits, and the Self That Won't Disclose
- Part 10: Redesigning Pressure — Individual Psychology and Organizational Systems
- Defensive emotion justifies attack. The motive of "protecting our product" makes unsubstantiated competitor criticism and rumor-driven fear tactics appear to be unavoidable means. But whether those means constitute disparagement is judged independently of motive.
- The sign that disparagement has become organizational is the supervisor's presence. The fact that an MR's supervisor attended the meeting in the FY2024 incident was described by the report as "suggestive of intentional, organized conduct by the sales organization." Once individual ethics become organizational strategy, the cost of correction multiplies.
- Leading the physician to say it is still judged as disparagement. The tactic of asking the physician a question that draws out a negative evaluation — rather than delivering the criticism directly — was explicitly identified in the FY2023 Sales Information Provision Monitoring Report as falling under "disparagement and defamation of competitor products" under the Sales Information Provision Guidelines. A detour does not confer immunity.
- Ministry of Health, Labour and Welfare, "Guidelines on Sales Information Provision Activities for Prescription Drugs" (September 25, 2018, Yakkan-Kansa-Ma-Hatsu-0925 No. 1)
- Ministry of Health, Labour and Welfare, "Report on the Advertising Activity Monitoring Project for Prescription Drugs," FY2019 Edition (published 2019)
- Ministry of Health, Labour and Welfare, "Report on the Sales Information Provision Monitoring Project for Prescription Drugs," FY2023 Edition (published 2023)
- Ministry of Health, Labour and Welfare, "Report on the Sales Information Provision Monitoring Project for Prescription Drugs," FY2024 Edition (published 2024)
- Ministry of Health, Labour and Welfare, "Report on the Sales Information Provision Survey Project for Prescription Drugs," FY2025 Edition (published 2025)
- Ministry of Health, Labour and Welfare, "Act on Securing Quality, Efficacy and Safety of Products Including Pharmaceuticals and Medical Devices," Article 66 (Prohibition of Exaggerated Advertising)
- Ministry of Health, Labour and Welfare, "Standards for Appropriate Advertising of Pharmaceutical Products" (revised September 29, 2017, Yakusei-Hatsu-0929 No. 4)
- Japan Pharmaceutical Manufacturers Association, "Promotion Code" (current edition)
- Daniel Kahneman, Thinking, Fast and Slow, Farrar, Straus and Giroux, 2011 (motivated reasoning; loss aversion bias)
- Amos Tversky & Daniel Kahneman, "Loss Aversion in Riskless Choice: A Reference-Dependent Model," Quarterly Journal of Economics, Vol. 106, No. 4, 1991
- Carol Tavris & Elliot Aronson, Mistakes Were Made (But Not by Me): Why We Justify Foolish Beliefs, Bad Decisions, and Hurtful Acts, Harcourt, 2007 (self-justification and cognitive dissonance)