Pharmaceutical sales representatives (formerly detailmen) are salespeople employed by pharmaceutical companies to persuade doctors to prescribe their drugs to patients. Drug companies in the United States spend ~$5 billion annually sending representatives to doctors, to provide product information, answer questions on product use, and deliver product samples. These interactions are governed according to limits established by the Code on Interactions with Health Care Professionals, created by the Pharmaceutical Research and Manufacturers of America (PhRMA). This code came into practice in 2002 and has since been updated to help define ethical interactions between health care professionals and the pharmaceutical companies Companies maintain this provides an educational service by keeping doctors updated on the latest changes in medical science. Critics point to a systematic use of gifts and personal information to befriend doctors to influence their drug prescriptions. In the United Kingdom representatives are governed by a strict code of conduct from the Association of British Pharmaceutical Industries (ABPI). No gifts are allowed. Companies are fined and held in breach if they use the tactics described in this description. Methods Doctors can receive small gifts, such as free dinners, event or travel tickets, clocks, free drug samples and swag like pens, paper pads, and office toys with company logos. Controversial inducements include jobs offers for the drug company, consulting / speaking fees, and all-expense-paid travel to resorts and exotic locations where attendance is limited or not mandatory. Pharmaceutical Representative is a trade journal featuring common sales tactics such as how to close a tough sale by flattering a stubborn doctor. Along with flattery, the attractiveness of sales reps has been noted, with a trend of former cheerleaders entering the field. Researchers stated that "seduction appeared to be a deliberate industry strategy", and in informal survey by a doctor found that 12 out of 13 women sales reps said they had been sexually harassed by doctors. Me-too drugs Sales reps push new "follow on" or "me-too" drugs with free samples that are more expensive than existing generic drugs, such as Nexium which costs three times as much as its predecessor Prilosec, with no evidence of improved efficacy. With beta-blockers and statins, me-too drugs have improved results, and increased competition while lowering prices. As me-too drugs are similar but new, their side effects can be unknown and not well understood. Pharmaceutical marketing / reps assert a me-too drug may work better than another, but