CFHC in the News: Prescription Payday
November 29, 2007
By Sylvia Perz, ABC7
Pharmaceutical companies create life-saving new drugs. But attempts to sell them may be going too far.
In 2004 the painkiller Vioxx was pulled from the market because of links to heart attacks and stroke. A study later showed 70 percent of patients who were prescribed arthritis drugs such as Vioxx didn’t really need them in the first place.
Some doctors say heavy marketing influenced their prescriptions. And now more physicians are cutting cozy relationships with the drug industry, and they say patients need to know why.
Dr. Robert Goodman usually spends his lunch hour alone. He doesn’t want drug reps to treat him to free meals in exchange for a noontime sales pitch.
“When we receive a gift, even a small gift, we have a very strong need to reciprocate,” he said.
Some argue doctors may be doing just that by choosing your drugs, not on the basis of the best medicine, but the best marketing. According to researchers, pharmaceutical companies spent more than $7 billion last year marketing directly to doctors.
“If you have to know what drug companies are about, you need to know three things: marketing, marketing, marketing,” said David Rothman, Ph.D.
Every day, as many as 100,000 reps, called detailers, fan out across the country. Each one meets with as many as eight doctors a day.
“I was not compensated for helping doctors help patients. I was compensated for getting the doctors in my territory to write more of my particular pills,” said former drug detailer Kathleen Slattery-Moschkau.
They come armed with some very sophisticated info. Using a technique called data-mining, the pharmaceutical companies provide the sales reps with weekly records on exactly what each doctor is prescribing.
Internist Andrew Davis at the University of Chicago Medical Center said he knows all about this practice. Drug reps are not so welcome at this center’s general medicine clinic.
“In part because the messages we tend to get from drug reps is to overestimate the benefits and underplay the side effects of medications,” said Dr. Davis.
But the companies believe they play an educational role for many docs and are a good source of information on new medications.
“We’re busy in our practice. It’s hard to keep up with the most up-to-date literature, so at times it’s helpful,” said Dr. Heather Fullerton, pediatric neurologist, Univ. of Calif., San Francisco.
And what about those free samples? Some claim the samples can help patients who are financially disadvantaged. Family physician Michael Mendoza disagrees.
“I think when that free stuff comes with strings attached, that doesn’t help improve patients’ outcomes in the long run. I think that’s bad medicine,” he said.
Dr. Mendoza says in most cases there is a generic drug that is just as effective and much more affordable over the long run. He urges patients to ask their doctors why they’re recommending a specific medication.
“I think physicians should be held accountable by their patients. I think that would be the best scenario for medicine,” said Mendoza.
At the Chicago Family Health Center, 9119 South Exchange Ave., on the city’s South Side, medical director Carl Toren has the job of balancing both approaches.
Doctor Mendoza will not meet with drug reps; other doctors at the center still do. Dr. Toren cautioned physicians, especially those just starting out, to beware of the potential conflict of interest.
“I think a lot of doctors who accept freebies or see the drug reps participate in the whole activity just become more influenced than they realize,” said Dr. Carl Toren, pediatrician, Chicago Family Health Center.
The drug industry lobby Pharmaceutical Research and Manufacturers of America says members are working to promote ethical relationships. The group has issued guidelines designed to curb sales tactics such as golf outings, lavish meals and expensive gifts. And laws are now pending in Congress and many states that would require public disclosure of the amount and type of any gifts given by drug companies to doctors.
The Prescription Project
30 Winter St.
Boston , MA 02108
617-275-2853
www.theprescriptionproject.org
Institute on Medicine as a Profession
Columbia College of Physicians & Surgeons
630 W. 168th St.
Box 11
NY, NY 10032
212-305-4184
www.imapny.org
Pharmaceutical Research and Manufacturers of America (PhRMA)
www.phrma.org
The Chicago Family Health Center
(773) 768-5000
www.chicagofamilyhealth.org
American Medical Student Association
www.amsa.org
Kaiser Family Foundation
www.kff.org
