Drug companies pile on perks for doctors

[Guest guest]

, " lobrien "

<lobrien@a...> wrote:

>

>

>

> Drug companies pile on perks for doctors

> Is it unethical for physicians to accept?

>

> By Robert Bazell, Correspondent, NBC News

> April 21, 2005

>

>

> Dr. Arnold Kassanoff says the best gift he ever got from a drug

company was a trip to Monaco for him and his wife in 1982.

>

> " We were told in advance that there would be, you know, everything

was covered except gambling, " says Kassanoff. " All your meals. No

tipping allowed. Nothing. And just enjoy yourself. "

>

> What did he think they wanted from him in exchange for the trip?

>

> " Well, I knew that they had come up with a breakthrough drug, "

says Kassanoff. And it was a drug that the company wanted him to

prescribe to his patients.

>

> Kassanoff says the gifts from drug companies - usually small items

such as bags, pens and meals - start in medical school. " From that

point on you are indoctrinated, " he says.

>

> In recent years, the American Medical Association and U.S. drug

manufacturers have agreed to cut back on the big trips offered to

doctors, although Kassanoff says he can still get a free dinner

almost any night for listening to a sales pitch.

>

> " If you look hard enough you might get a trip to Hawaii, " he says.

>

> The gifts have never been illegal, but Kassanoff wonders about the

long-term effect on his practice.

>

> " When you pick up your prescription pad, you write something

out. . It has to do with psychology and the whole marketing

business, " he says.

>

> Today there are 88,000 drug salespeople for the 600,000 practicing

doctors in the United States. Six or seven visit Kassanoff's small

practice every week, offering souvenirs and free lunch for the staff.

>

> " Very, very bright, attractive people who've got good people

skills, " says Kassanoff.

>

> Dr. Jerome Kasserir, former editor of the New England Journal of

Medicine and author of a new book on drug companies, says the sales

people drive up health care costs.

>

> " They're always marketing the newest drugs and the most expensive

drugs and the idea is to get the doctors to use these more expensive

drugs instead of the drugs that may be just as good but are not as

expensive, " says Kasserir.

>

> Pharmaceutical manufacturers say the sales efforts are critical to

educate doctors, but after practicing medicine for 40 years,

Kassanoff is worried about the education they provide.

 

 

 

 

The new Editor at the BMJ (British medical journal) Is awesome! I

wish we had her in America!

 

 

Say no to the free lunch

 

Are you a pig or a weasel? Or do you consider yourself above all

that? When the BMJ published a special issue on the links between

doctors and drug companies in 2003, the cover showed pigs in white

coats lunching and golfing with weasel drug reps. At the time this

seemed strong stuff even to those involved in editing the issue. But

little has happened since to suggest that the image was wrong. In

fact, every day new revelations suggest that the reality is worse.

 

The power of drug companies to buy influence over every key group in

health care—doctors, charities, patient groups, journalists,

politicians—has clearly shocked a UK parliamentary committee (p

855). It should shock us all. Can we console ourselves that

companies' lavish spending on research and marketing, which far

outstrips spending on independent research and drug information,

leads to truly innovative treatments? No, says the committee's

report. Can we rely on regulatory bodies to keep the industry in

check? No, again.

 

What we can rely on, says Slattery-Moschkau, a former drug rep and

creator of a hard hitting new film on the industry (p 911), is that

drug reps are " armed and dangerous, " selected for their ability to

seduce and persuade rather than their scientific skills, and armed

with, among other things, details of your prescribing behaviour.

 

All of this might encourage new resolve to step away from the trough

and stand with the good guys. So it's interesting that the American

College of Physicians has refused a booth at its annual meeting to

the not-for-profit group No Free Lunch, which works to reduce

conflicts of interest (p 862). Interesting, too, that the US

National Institutes of Health may be forced to relax its policy on

conflict of interest in response to protests from staff that it is

too restrictive (p 864).

 

The BMJ, like most academic medical journals that carry

pharmaceutical advertising, is perhaps somewhere between a pig and a

weasel. And those of you alert to competing interests will see that

Gauthier (p 857), in line with our policy on disclosure, lists at

the end of his editorial several companies he has received funding

from. We take the pragmatic view that competing interests cannot be

removed altogether, since few clinical experts do not have some

links to industry. But this is a hard balance to keep, and perhaps

we delude ourselves that we have got it right.

 

Ferner (p 855) indicates that " professional self delusion " —doctors'

view that they are not influenced by marketing—may force external

regulation. The committee recommends, for example, requiring

clinicians to register all substantial gifts from industry. It also

recommends limits to promotion aimed at inexperienced prescribers

and more training for medical students about marketing by drug

companies.

 

So when the drug reps call for a chat, or offer to throw a sponsored

lunch, make sure you are armed with cynicism, or information, or

both. Better still—however seductive they are, just say no.

 

Fiona Godlee, editor

 

http://bmj.bmjjournals.com/cgi/content/full/330/7496/0-g?ehom

[Guest guest]

Drug companies pile on perks for doctors

Is it unethical for physicians to accept?

 

By Robert Bazell, Correspondent, NBC News

April 21, 2005

 

 

Dr. Arnold Kassanoff says the best gift he ever got from a drug company was a

trip to Monaco for him and his wife in 1982.

 

" We were told in advance that there would be, you know, everything was covered

except gambling, " says Kassanoff. " All your meals. No tipping allowed. Nothing.

And just enjoy yourself. "

 

What did he think they wanted from him in exchange for the trip?

 

" Well, I knew that they had come up with a breakthrough drug, " says Kassanoff.

And it was a drug that the company wanted him to prescribe to his patients.

 

Kassanoff says the gifts from drug companies - usually small items such as bags,

pens and meals - start in medical school. " From that point on you are

indoctrinated, " he says.

 

In recent years, the American Medical Association and U.S. drug manufacturers

have agreed to cut back on the big trips offered to doctors, although Kassanoff

says he can still get a free dinner almost any night for listening to a sales

pitch.

 

" If you look hard enough you might get a trip to Hawaii, " he says.

 

The gifts have never been illegal, but Kassanoff wonders about the long-term

effect on his practice.

 

" When you pick up your prescription pad, you write something out. . It has to do

with psychology and the whole marketing business, " he says.

 

Today there are 88,000 drug salespeople for the 600,000 practicing doctors in

the United States. Six or seven visit Kassanoff's small practice every week,

offering souvenirs and free lunch for the staff.

 

" Very, very bright, attractive people who've got good people skills, " says

Kassanoff.

 

Dr. Jerome Kasserir, former editor of the New England Journal of Medicine and

author of a new book on drug companies, says the sales people drive up health

care costs.

 

" They're always marketing the newest drugs and the most expensive drugs and the

idea is to get the doctors to use these more expensive drugs instead of the

drugs that may be just as good but are not as expensive, " says Kasserir.

 

Pharmaceutical manufacturers say the sales efforts are critical to educate

doctors, but after practicing medicine for 40 years, Kassanoff is worried about

the education they provide.

 

© 2005 MSNBC Interactive

© 2005 MSNBC.com

URL: http://www.msnbc.msn.com/id/7575967/