Health Care Renewal discusses a disheartening development in the debate over the Massachusetts' law to ban drug companies from giving bribes--I mean, "gifts"-- to physicians. In the past, I wrote this rambling post about the issue, including links to several letters and editorials printed in the Boston papers. The latest article, published in the Boston Herald, quotes the head of GlaxoSmithKline's operation in the U.S. as implying that if the full legislature passes the ban (the State Senate has already done so), GSK will take their money out of Massachusetts and head to other states that do not "demonize" the pharmaceutical industry.Yawwwwn. It's a threat we've heard before but it's actually quite embarrassing for GSK. Why does the company believe it needs to give pens and pizzas to doctors in order to get them to prescribe their drugs? Are their products so ineffective that bribery is the key incentive for their use? Read this excellent letter in rebuttal, written by Marco Cornelio, a medical student at Tufts. Cornelio writes, in part, "Instead of spending their money on such bribes, pharmaceutical companies ought to be using it for research to produce truly innovative, effective and safe medications."
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6 comments:
If you, as a physician, really want to make a statement to Big Pharma, stop or don't write further for their "me too" drugs, like this pathetic Pristiq example out now.
After all, they can monitor your prescribing habits, so when lots of zeros show up in their ledgers, panic may ensue.
In the end, though, if you can't or won't stop meeting with the leeches who try to drain you of your ethics and morals, just sign and say thank you for the samples needed for uninsured patients. As a physician, if you can't put out 5 to 7 bucks for a lunch, then I guess you should consider these honorariums? Not the dinners, but the internet things they allegedly pay you for in participating in "information" as a provider.
Personally, I never participate, but if you're hurting for a $5 meal, at least you're avoiding the reciprocity exchange issue. That way you could buy lunch for the office and they'll thank you and not be beholden to someone who has little to no interest in how the patient is doing.
Just an idea.
By the way, I was surprised it wasn't Lilly who was making a fuss. They are one of the worst offenders of blackmail and projection I have come across in my travels.
Efficacy should be the gold standard for writing prescriptions, but since when did efficacy count for much with the general public? Look at the horrible case of Airbourne, which entered the public consciousness simply because a teacher thought of it. This is "story-based medicine."
The pen and pizza problem is similar--we should be demanding evidence of efficacy, but we are instead settling for poorly-designed clinical trials and trinkets.
If GSK pulls out of Massachusetts, they will lose credibility with whatever state they end up with--if they can pull up stakes in one state, what would stop them from doing it in another state?
The pens, pads and pizzas are such a small drop in the bucket when you look at how much money pharma spends. R&D should be a top priority, but it seems the U.S. is experiencing a brain drain to Asia, and not only that, but I think pharma has gotten lazy: why spend millions to get a molecule or compound all the way to the FDA to be told "no" - go back to the drawing board? Better to stay safe with a cheesy enantiomer that I can make a few million vs. several million down the drain!
Just another way to think about it.
Are you serious !!!! Which doctor will get sold just on pens and pizzas? Making big deal about nothing is specialty of politicians. They need to focus on malpractice, drug cost and so on for making any meaningful change in healthcare cost. Just because I got a pen from a pharmaceutical does not change my prescription writing. It just saves me a trip to the store to get one.
Psychiatrists who claim that gift-giving has no effect on their behavior should be ashamed. We are supposedly schooled in the behavioral sciences including operant conditioning. I believe there are data out there to support the powerful effect of relatively small gifts. Is it possible that our Pharma colleagues understand behavioral modification better than we do?
Most of you have probably seen this already, but if not, check out "How Drug Reps Make Friends and Influence Doctors" (on PLOS). it is a potent reminder of just how skillfull the drug reps are in using gifts to manipulate physcians without the doc even realizing it.
Yes, the reps have magically "hypnotized" me with drinks and pizza.
Why don't I hear any outrage about congressman who decide the fate of our very country taking thousands of dolalrs apiece, MILLIONS OF DOLLARS together, from lobbyists who influence laws and budgets for personal gain.
And you weirdos are obsessed with pizzas. It's this very disconnect from so-called healthcare "experts' that gives doctors a bad reputation, when WE are getting fleeced daily by insurance companies.
But go ahead. Waste time bitching about how a pen made me write for Lyrica. You guys are another part of the problem.
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