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Doctors in their Pockets

A nice article from the Washington Post, Probing Doctors’ Ties to Industry, evaluates the recent movement for transparency in the relationships between the pharmaceutical and medical device companies and doctors. We’ve all been to the doctor and have seen pens and pads of paper touting the latest miracle drug, but that is only the tip of the iceberg. The pharmaceutical and medical device industry pays for doctors to attend symposiums (sometimes these are actually just really fancy vacations with a very small lecture component), dinners, and provides them with gifts of all kinds (from pens to much more valuable objects). It is estimated that Big Pharma spends over $20 billion per year pitching their wares to doctors.

What’s the impact? Like the rest of us, marketing influences doctors (if they weren’t, these industries would not be spending the money). So, a doctor is more likely to prescribe Drug A over Drug B if he just got a nice lunch from Drug A’s sales representative. You’d like to think that all doctors will sit in their library and compare the attributes of the drugs, poring over the Physician’s Desk Reference. But time is at a premium, and it’s often easier to listen to the sales reps (who are very rarely medically trained). The question is whether patients receive the proper drug or the properly marketed drug.

Of course, some donations are for the advancement of science. Doctors frequently receive free samples of drugs or devices for research studies they are performing—this helps pharmaceutical companies and medical device companies to determine the safety and efficacy of their products. Those should be reported as well, but they are less likely to influence a doctor’s prescribing habits.
The article includes statements from a number of doctors who admit to being influenced by these marketing strategies. Many states and the federal government are starting to examine whether doctors should be required to report money and gifts. Some even want to make information available on-line. That way, before your appointment, you can see who is paying your doctor. And you can ask your doctor whether other manufacturers’ drugs might not be better. It’s good to know whether the doctor is prescribing a drug, or whether it’s basically coming straight from the industry.