Tracing Performance in the Pharmaceutical Industry: Ambivalence, Opacity and the Performativity of Flawed Measures

Abstract

In this paper we explore performance measurement practices in the pharmaceutical industry with particular focus on the inscribing (or ‘tracing’) of pharmaceutical representatives (‘drug reps’) responsible for the promotion of prescription medications to general practitioners and other healthcare professionals. We draw upon Latour’s sociology of translation to explore performance measures in the organizational field of pharmaceutical companies operating in France. Access to sales data is heavily circumscribed by government regulation of the health sector: doctors’ prescriptions that generate sales remain hidden from pharmaceutical companies. We explore how organizational actors build control and address problems of ‘circulating reference’ (Latour, 1999) in this setting. We show how ambivalence, opacity, bricolage, and practical actions enabled by inscription devices strengthen networks of performance measurement. In so doing, we contribute to the sociology of translation by highlighting how weak references can perform and circulate without reversibility in the chains of transformation between matters and forms. We also seek to add to and to depart from the literature on performance measurement focusing on transparency and certainty as key features for ‘successful’ implementation of performance measures.

Keywords: performance measures, actor network theory, circulating reference, opacity, ambivalence, pharmaceutical industry