Tuesday, November 30, 2010

It's a Textbook! It's an Ad! It's Nemeroff/Schatzberg!

Drs. Nemeroff and Schatzberg are back in the limelight, once again dragging the good name of psychiatry through the mud. According to today's New York Times, in 1999 SmithKline Beecham, the maker of Paxil, funded and ghost-wrote a textbook for which this ethically-challenged duo took credit.

What were they thinking?

I imagine the conversation went something like this.

N: "Let's write a textbook for primary care doctors."
S: "Sounds good. But I don't have the the time."
N: "Neither do I."

S: "Hmmm."

N: "Hmmm."

S: "So what do we do?" [N grins.] "Wait, you're not seriously considering--"
N: "Why not? What are you, suddenly Dr. Holier Than Thou?"
S: "All right, don't remind me about Corcept and your 60,000 shares. What's your plan?"

N: "Simple. We know that SmithKline Beecham's Paxil is losing market share to Pfizer's Zoloft. I'll call my friends there, ask them for an 'unrestricted educational grant.'"
[S nudges N. N grins and winks. But then S frowns.]
S: "The money will be nice, but who's going to write it?"

N: "SmithKline will hire a PR firm to do it. All we have to do is review it and make some final tweaks."

S: "But isn't that a little sleazy, even for us? You know they'll play down Paxil's disadvantages--that it causes more sexual side effects, more weight gain, and more drug interactions than Zoloft."

N: "Some studies show that's true, others are more equivocal."

S: [Lightly socks N on the shoulder] "Don't BS me, you sound like you're giving one of your Paxil drug talks to naive country docs."

N: "You know me too well!"
S: "As usual you're very persuasive. I'm in."
N: "I think this is the continuation of a beautiful friendship...."

Thursday, November 4, 2010

Is Your Doctor a "Return on Investment"?

Ever since ProPublica published its disturbing database called Dollars for Docs, there have been many local news stories written about hired gun physicians who take money from drug companies to promote drugs to other doctors. A particularly good one was published yesterday in the SentinelSource by the Chicago Tribune's Judith Graham.

The Tribune interviewed about a dozen physicians who make thousands per year from drug company talks, and, according to Graham, "all said they believe such ties have no effect on their medical practices."

But Graham also interviewed a former drug rep, who provided the unvarnished and rather ugly truth about how these apparently well-meaning doctors are actually being manipulated by their handlers:

"Angie Maher, a former Michigan drug sales representative turned whistle-blower, described training sessions where psychologists and coaches would brief her on how to play on doctors’ vulnerabilities — their desire to feel important, their eagerness to be on the cutting edge — while working to boost sales. Each time a physician would give a talk, Maher would fill out a “return on investment” spreadsheet tracking prescription trends for all the doctors who attended the event. If sales went up, the speaker was asked to give another presentation, she said. If not, further invitations to speak would not be extended."

That says it all. Time for these doctors to wake up and realize that have transformed themselves into ROIs for their sponsoring companies.