Blue Mass Group

Reality-based commentary on politics.

The Selling of Pharmaceuticals

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Hey, maybe not the most exciting reading, but at least I know Charley will read it…

Today’s NYT Magazine has an interesting first-person account by a Newburyport, MA doctor who was recruited to a push a drug for his colleagues to prescribe.  

For those who are aware of this practice, not much new ground is covered, but the level of detail the doctor gives is fascinating and at times quite disturbing.  

Health care wonks go crazy!  

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  1. This was a stunning tidbit:

    …one recent study indicates that at least 25 percent of all doctors in the United States receive drug money for lecturing to physicians or for helping to market drugs in other ways. This meant that I was about to join some 200,000 American physicians who are being paid by companies to promote their drugs.

  2. I agree, major changes to the health care system might remove the negative influences of these sales reps, but what about minor changes?  Short of single payer, what needs to change?

    <

    p>How can the financial influence of pharma be reduced without eliminating legitimate consulting fees and services?

    <

    p>AnnEm?

  3. to a list of common prescription medications compiled by the US Government General Accounting Office about the cost and markup.  The percent markup was in the thousands of percent.

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    p>Ah but that was during my very brief period of “controversial” activism and my foolish attempts to think I could speak to a large audience and like maybe change stuff.

  4. Thanks, Frank, for pointing this out.  

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    p>The article does a good job of describing this process of gifts and payments to doctors to encourage the prescription of drugs, and it definitely conveys the author’s ethical qualms about such a practice.

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    p>But the one thing the article does not do is tell readers how this can be dealt with.  Sure, individual doctors should use their skepticism & judgment, but on a larger level, the government that we pay taxes for can keep track who is getting gifts from the Drug Companies.

    House to offer bill for registry of drug firm gifts to doctors

    Pharmaceutical companies would have to report gifts of $25 or more.

    By Dave Hansen, AMNews staff. Nov. 26, 2007.
    Washington — A U.S. House lawmaker plans to introduce legislation to create a registry in which pharmaceutical manufacturers would have to report any gifts that are given to physicians.

    The measure by Rep. Peter DeFazio (D, Ore.) would be similar to legislation that already was offered in the Senate. But the House bill might apply to companies with less than $100 million in revenues, the threshold set by the Senate bill, said Ed Hill, a legislative assistant for DeFazio. The House and Senate bills would require manufacturers to list both gifts of $25 or more and the physicians who received them.

    As you can read,  the current bill could end up not affecting the biggest companies: In 2006, AmGen made $14 Billion.  Wyeth’s revenue was $5 billion in the FIRST QUARTER of 2007.  

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    p>If my doctor wanted me to take a drug, I might want to know if he had received gifts from the company that made it.  After all, it’s only fair for me to know who donates to my elected representatives.

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    p>So a little citizen input to our Senators and Representatives about the  Physician Payment Sunshine Act could be in order.

    • It’s only fair to know who donates to my elected representatives, and likewise, it should not be a problem for my physicians to be open about any gifts they have received.

        • A few years ago. I was at a public meeting/debate, and the subject of drug companies came up.  A lady stood up and announced that she WORKED in a doctor’s office, and the drug reps. saw that the doctor was given GIFTS and TRIPS, and that she herself was given lunches and cash bonuses, and THAT was why we needed single payer health care!

          <

          p>I took the mike and asked her why, if she felt so strongly about this matter, did she continue to take the cash and free lunches.  Her jaw just dropped, and she was literally speechless.  She had self-rightously told this story many times, and nobody ever asked her that.  The concept that by accepting the cash, she was complict in the practice, was a foreign idea to her.

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          p>I think an OCPF of drugs is a fine idea.

          <

          p>Full disclosure – I have been on medication my entire life, and would not be a functioning member of society, and possibly not alive, without the pharmaseutical industry.

          • Come on, who wouldn’t take the lunches?  She’s doing a service by letting us know about the practice.  You really think it would make a difference if a few people refused the lunches? Or do you just think she should keep her mouth shut, like it was hush money and she broke her promise?

            <

            p>This reminds me of this admission by JK a while back:

            <

            p>Hell, I went to both Becket playoff games thanks to a laboratory we use for soil and groundwater analysis and another lab that is trying to get our air analysis work.

            <

            p>So, it isn’t just drug companies.  It does explain why Boston teams are so embarrassingly well-stocked, it’s because we are fleecing the public.  And JK says we should be happy, our teams are winning.

    • I didn’t carefully read the sentence there–the $100 million in revenue threshold would exempt smaller  drug companies.  But the House version may end up having no threshold at all.

  5. .. of what you conclude.  To be sure, the sales arm of the pharma industry has done some nasty things.  But the industry itself has done some wonderful things.

      • …but I am actually surprised that doctors would nowadays let their patients get hooked on pain killers.

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        p>Twenty five years ago, I was prescribed Percodan when I had a kidney stone.  The feeling when I took a pill was simply euphoric.  The physician carefully monitored my usage; I didn’t know why then, but I do now.

  6. There’s a number of bills pending in the Massachusetts legislature to control pharmaceutical marketing.

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    p>House 2197 (Marzilli) and Senate 1238 (Montigny) contain a number of provisions to put the breaks on these practices. The bills would ban “gifts” by drug companies to prescribers, and require all drug companies to report how much they’re spending on marketing in Massachusetts. The bills also ban “data mining,” where drug companies buy data on every doctor’s prescribing history. This lets the companies target their marketing and reward docs who are prescribing what the company wants.

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    p>The bills also set up a counter-marketing campaign to provide more objective information and educate doctors on the value of generics and non-advertised drugs. In PA, a similar program has more than paid for itself twice over. More info on this is at http://www.RxFacts.org.

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    p>The Senate is about to release its health care cost control bill. People who care about this should contact their state senators.

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    p>This campaign is part of a national effort led by a Boston-based group called the Prescription Project (http://www.prescriptionproject.org). Contact them or Health Care For All to get involved.

  7. Frequently these Pharma companies tout marginal benefits over the existing drug du jour.  And I suppose studies can be framed in a way that leads to those differences.  The price tag of the new drug is often much higher than the alternative and we all experience the higher insurance costs.  When health insurance companies investigate the test results to determine whether to pay for the new drug, they must dodge the glitzy sales pitches and pressure from many of their own customers that have been advertized to directly through TV ads or their doctors.  Yes, drug companies have found medications that have helped the lives of many people, but they are also driven toward profits.  Revolutionizing cures are not easy to come by.  Increasingly expensive options amid highly funded marketing campaigns leads to skyrocketing costs.

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