by Rita Rubin, USA Today
Virtually all doctors in a national survey of six specialties reported some sort of relationship — from free lunches to payments for consulting and lecturing — with medically related industries such as those for drugs or medical devices, a report says today.
Researchers mailed surveys and a $20 check to a random sample of 3,167 practicing anesthesiologists, cardiologists, family practitioners, general surgeons, internists and pediatricians in late 2003 and early 2004. Slightly more than half responded. Among the findings, reported in The New England Journal of Medicine:
•Cardiologists were more than twice as likely as family practitioners to receive payments from industry.
•On average, family practitioners reported meeting 16 times a month with industry reps — the most of any specialty surveyed.
•Factors significantly linked to higher odds of receiving payments from industry included being male, having a patient population with fewer than a quarter on Medicaid or uninsured, and playing a role in training doctors or developing practice guidelines.
More than a quarter of respondents said they were paid by industry. "That to me is a pretty high percentage," says lead author Eric Campbell, assistant professor of health policy at Harvard Medical School. He says he wasn't surprised that family doctors met most often with industry reps: "They're treating an incredibly wide spectrum of diseases."
Doctors tell him they can't be bought with a free pizza, Campbell says, but social science research shows that even inexpensive gifts can influence behavior.
The Pharmaceutical Research and Manufacturers of America (PhRMA), the main trade group for prescription drug makers, adopted a voluntary Code on Interactions with health care Professionals in April 2002. The guidelines say that only modest meals and gifts (and only those useful in medical practice) should be allowed.
"Marketing is one of several important ways for health care providers to receive the information they need to make sure medicines are used properly and patients are safely and effectively treated," PhRMA senior vice president Ken Johnson said in a statement issued in response to Campbell's paper.
If their goal is to inform, why do sales reps target only high-prescribers? asks Georgetown doctor Adriane Fugh-Berman, director of the publicly funded PharmedOut, which educates doctors about drug companies' influence on prescribing. Fugh-Berman co-authored an article about drug reps' tactics that was posted this week by PloS Medicine, an open-access online journal.
Co-author Shahram Ahari says he worked as a drug rep for nearly two years after earning a bachelor's degree in molecular biology and Asian studies. "I was the only person who had a science education in my (company) training class. The science is really irrelevant to the actual sales. We're there to befriend you and influence you."
I'm afraid this is true. My cousin is medic and she recieves free holidays and travel conferences from some pills companies. It's sad . We cannot trust doctors ,they don't investigate what they prescribe. They just accept it has to be safe otherwise someone would do something, you know the same story everywere.
Mon May 28, 2007 10:27 am
false flag VIP
Joined: 15 Jul 2006 Posts: 445 Location: melbourne, Australia
It is prolific here In Australia. Walk into any doctors consulting room and see all the free merchandise for Pfizer, smithkline and other poison manufacturers adorning the desk and walls. Everything from mouse-mats to pens and then there are the free golf outings and dinners as well.
This is one of the reasons I have completely lost faith in western medicine and now see a Chinese herbalist doctor instead.
Mon May 28, 2007 3:34 pm
Sponsor
madthumbs
Joined: 22 Feb 2006 Posts: 8187 Location: Fingerlakes - NY usa
I didn't realize we didn't have this information here. I've known of it before the site opened. Bars get free stuff from the booze companies too (though most of it's for advertising like coasters, mirrors, neons, etc).
Mon May 28, 2007 3:48 pm
dumby
Joined: 10 Aug 2006 Posts: 237 Location: kalifornia
oh, some of them get much more than free golf trips....
Mon May 28, 2007 4:58 pm
madthumbs
Joined: 22 Feb 2006 Posts: 8187 Location: Fingerlakes - NY usa
Article Tools Sponsored By
By ALEX BERENSON and ANDREW POLLACK
Published: May 9, 2007
Two of the world's largest drug companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses.
There was an article in Sunday's Minneapolis Star Tribune about a similar issue.
State-disciplined Doctors Still on Drug Payroll
More than 100 doctors in Minnesota who had been criticized or disciplined by state medical boards were later paid by drug companies for giving speeches or doing research.
Pharmaceutical companies spend more than $15 billion each year promoting prescription drugs in the United States. One-third of that amount is spent on "detailing" -- an industry term for drug company representatives' one-on-one promotion to doctors. A paper published April 24, 2007 in the Public Library of Science journal Medicine uncovers the tactics which pharmaceutical sales representatives, commonly called "drug reps," are trained to use in promoting drugs to prescribing physicians.
"It's my job to figure out what a physician's price is. For some it's dinner at the finest restaurants, for others it's enough convincing data to let them prescribe confidently and for others it's my attention and friendship... but at the most basic level, everything is for sale and everything is an exchange," stated former Eli Lilly drug rep Shahram Ahari.
Ahari, no longer a drug rep, co-wrote the paper with Adriane Fugh-Berman, associate professor of physiology and biophysics at Georgetown University Medical Center in Washington, D.C. The paper is based on conversations between Ahari and Fugh-Berman, who researches pharmaceutical marketing.
The writers report that drug reps are trained to gather as much personal information as possible about the doctors to whom they are promoting pharmaceuticals -- from birthdays and hobbies to religious affiliation. Drug reps are trained to note any detail that can be used to establish a personal relationship with a doctor. Ahari stated, "During training, I was told, when you're out to dinner with a doctor, 'The physician is eating with a friend. You are eating with a client.'"
Drug reps offer gifts, and not just mugs and pens inscribed with drug names. "The highest prescribers receive better presents," wrote Ahari. Pharmaceutical companies rank doctors according to the number of prescriptions they write -- from 1 at the low end to 10 for high prescribers. According to Ahari, "Some reps said their 10s might receive unrestricted 'educational' grants so loosely restricted that they were the equivalent of a cash gift."
The source of the 1-to-10 ranking data is prescription tracking. So-called "health information organizations" (including IMS Health, Dendrite and Verispan) purchase prescription records from pharmacies. According to the authors, IMS Health buys records of about 70 percent of prescriptions filled by community pharmacies. Pharmaceutical companies purchase the records and use them to identify high-prescribing doctors.
How the AMA earns millions by helping drug companies buy influence
Prescription tracking records do not always identify doctors by name; in some cases they are identified by a state or federal license number or a pharmacy-specific identifier. To establish the identity of the prescribing doctors, pharmaceutical companies rely on the American Medical Association (AMA), which maintains a Physician Masterfile on every U.S. physician. Citing the New England Journal of Medicine, the authors wrote, "In 2005, database product sales, including an unknown amount from licensing Masterfile information, provided more than $44 million to the AMA."
Once the high prescribers are identified, the drugs reps are then directed to reward those doctors with attention and gifts. The highest prescribing doctors are the ones with whom the drug reps work hardest to build relationships. According to Ahari, "The highest prescribers (9s and 10s) are every rep's sugar mommies and daddies." Lower prescribing doctors are hardly ignored, however; Ahari explained that he was taught to "pick a handful out and make them feel special enough" and then associate increased prescribing with personal attention and a reward such as dinner at a fine restaurant.
When doctors express skepticism about a certain drug, reps will take one of several approaches. One tactic is to present the doctors with journal articles that counter the doctor's perceptions. "Armed with the articles and having hopefully scheduled a 20 minute appointment (so the doc can't escape), I play dumb and have the doc explain to me the significance of my article," wrote Ahari. The drug rep then asks the doctor to prescribe the medication based on his or her own explanation (to the sales rep) of the journal articles.
Yet another tactic, reserved for doctors who prefer a competing drug, is described by Ahari: "We force the doctors to constantly explain their prescribing rationale, which is tiresome. Our intent is to engage in discourse but also to wear down the doc until he or she simply agrees to try the product for specific instances."
The pharmaceutical industry employs 100,000 drug reps whose job is, first and foremost, to sell drugs. Their tactics are on par with some of the most clever and potent brainwashing techniques used throughout the world, including those used on political prisoners to convince them to denounce their home nations. Doctors are, in effect, being successfully targeted and influenced through advanced brainwashing campaigns designed to alter prescribing behavior and sell more high-profit drugs. Far from being immune to such techniques, it appears that physicians are remarkably susceptible to them.
Drugging our Children w/ Psychiatry’s Anti psychotic Drugs
Dr. John Breeding has a Ph.D. in psychology. He comments about the recent PBS Frontline Documentary, The Medicated Child. 6 million U.S. Children are taking psychiatric drugs for ADHD, Bipolar and other mental disorders. Good psychiatry, experimentation or kid drugging for profit? Do these medications promote good mental health or do they create a population of people on disability?
