Hey Doc, Let’s Fly to Maui To Talk About Drugs

In 1997, Minnesota became the first of a handful of states to pass a law requiring drug makers to disclose payments made to doctors. Its records reveal that over twenty percent of the state’s physicians have received such payments, generally for giving speeches about drugs to other doctors.

Psychiatrists were the top earners, followed by internal medicine doctors, cardiologists, and endocrinologists. The median payment was $1,000, and more than 100 doctors pulled in more than $100,000 each. A 2002 study found that more than eighty percent of doctors who help write national guidelines about when to use medicines had received money from drug makers.

It’s perfectly legal, and doctors say that their lectures are unbiased and highly educational. Former drug company sales reps, on the other hand, admit that they hired doctors to make speeches in hopes of influencing them. As a former sales rep who left the industry in 2002 said to the New York Times, “I hate to say it out loud, but it all comes down to ways to manipulate the doctors” to prescribe more of the company’s drug.  Another rep, fired in 2005 for writing a book about his experiences, said that the drug makers influence doctors in a variety of ways, starting with all-expense paid trips to vacation spots, ostensibly to learn about the drug. Yet a third retired sales rep commented to the Times, “The hope in all this is that a silent quid pro quo is created.  I’ve done so much for you, the only thing I need from you is that you write more of my products.”

The doctors who make the speeches are aware of the underlying goal of the drug makers, but insist that they are not influenced. Dr. George Realmuto, a psychiatrist from the University of Minnesota, observed to the Times, “[You’re] at a wonderful restaurant, the atmosphere is very conducive to a positive attitude toward the drug, and everyone is having a good time.” Another physician, Dr. Richard Grimm, who earned nearly $800,000 from drug companies between 1997 and 2005, described drug companies as predatory beasts. “For lions, it’s their nature to kill zebras and eat them.  For drug companies, it’s their nature to make money. They’re really not trying to improve anybody’s health except if it makes them money. On your side, you’re making a bit of money, but you’re also trying to educate the doctors. And in my view, the doctors need a lot of educating.”  Apparently so…

Source:  The New York Times, March 21, 2007

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