How Drug Companies Brainwash Doctors so Doctors Brainwash You with Drugs
by www.SixWise.com
If you've ever received a free sample of a prescription drug
from your doctor, chances are you were happy to get it. It
saved you money and the time of going to a pharmacy, at least
for the short-term.
But did you ever wonder why your doctor had a free sample
to give you in the first place? Was it truly the best option
available?
That free prescription drug sample is just the tip of the
iceberg. Drug companies spend $12 billion to $18 billion each
year marketing directly to physicians and residents. And they
start even before students even enter medical school.
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What's influencing your doctor's decision on which
drug to prescribe?
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"This contact with drug companies begins in the weeks
and months after students graduate from college. By the third
year of medical school, they are being saturated with this,"
said Dr. Frederick S. Sierles, a professor of medicine at
Rosalind Franklin University of Medicine and Science, in North
Chicago, Ill, who conducted a study on the topic.
The study, published in the Journal of the American Medical
Association, found that by the third year of medical school,
students get, on average, one gift or attend one activity
sponsored by a drug company each week. It also found, via
a survey sent out to 1,143 third-year medical students at
eight medical schools, that:
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93.2 percent of the students were asked or required
by a physician to attend at least one lunch sponsored
by a drug company.
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68.8 percent of the students did not think the gifts
would influence their practices.
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57.7 percent believed the gifts would not affect colleagues'
practices.
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Students tended to feel that their peers were more
likely to be influenced than they were.
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80.3 percent of the students believed they were entitled
to gifts.
"Basically, we have medical students exposed to marketing.
We know the marketing is biased in favor of the products.
We know the students don't think they are being influenced.
So they're being set up to be influenced without knowing it,
and to prescribe in a way that is going to be bad for their
patients," Sierles said.
Not Just Free Lunches
Every year, pharmaceutical representatives make 60 million
visits to doctors to inform them about their products.
And, says Dr. Marcia Angell, former editor of the New England
Journal of Medicine and author of "The
Truth About Drug Companies: How They Deceive Us and What to
Do About It," the top U.S. drug makers spend 2.5
times as much on marketing and administration as they do on
research.
So just how do these drug representatives work their magic
to "teach" doctors about the newest and most expensive
drugs on the market? They visit hospitals and private practices,
bringing with them bagels and cream cheese, pens, pads of
paper and other trinkets emblazoned with their company's logo.
They sponsor extravagant lunches and take doctors on all-expenses
paid trips to luxury resorts.
Said one former drug rep, "[Gifts] buy you time with
a doc, time that might change his mind ... Money is the
big resource. The pads and pens are great for access, but
the dinners and what costs money -- CDs, handheld computers,
everything given in the name of research -- this is what's
thrown at docs to get them to change their minds."
But if a free dinner or pad of paper wouldn't change your
mind, maybe a check -- a five- or six-figure one -- would.
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Free lunches, trips, and other gifts may be influencing
which drug you're prescribed.
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According to the New York Times, drug maker Schering-Plough
sent six liver-disease specialists checks for $10,000, along
with a letter explaining the check was for consulting services
that were explained on the attached "Schedule A."
As it turns out, "Schedule A" was nothing more than
a blank sheet of paper with "Schedule A" printed
at the top.
Another doctor also received a $10,000 check from the company,
this one as payment for a consulting agreement that required
only that the doctor commit to prescribing the company's drugs.
Other doctors have reported receiving six-figure checks from
other companies under similar circumstances.
The Gifts Work
The drug companies wouldn't be spending
money on free lunches, computers and trips if it didn't pay
off in the end.
In one study, the prescribing habits of two groups of 10
doctors were tracked before and after they went on a free
luxury vacation from separate drug companies (and attended
several hours of drug seminars each day).
Doctors in the first group, whose trip was sponsored by the
makers of an intravenous antibiotic, prescribed 81 units of
the drug before the trip -- and 272 units afterward.
The trip for the second group of doctors was sponsored by
the makers of an intravenous heart medication. Before the
trip, doctors prescribed an average of 34 units. After the
trip, it rose to 87 units.
What is perhaps most disturbing is that none of the doctors
believed they were influenced. "Maybe I was indirectly
influenced by important scientific information that I might
not otherwise have heard, but nothing else would influence
me," said one.
Clearly, though, doctors are being influenced, often without
their even realizing it.
"They [doctors and residents] are more likely to prescribe
the marketed products than prescribe what they should be prescribing.
That's a big danger," said Sierles.
Protect Yourself
Going back to that free sample from your doctor, it's typically
the newest, most expensive drugs that the drug reps give out.
But, once your free sample runs out, guess who will foot the
bill for those pills, that may be two to three times more
expensive than an older or generic (but just as effective)
drug? You.
So in the long run, those free samples aren't really free.
"We think that big pharma has gotten intricately involved
in every aspect of medical education and clinical practice,"
said Leana Wen, president of the American Medical Student
Association and a medical student at Washington University
in St. Louis. "Medical schools really have a duty to
educate students about the proper ways to interact with drug
companies."
Until that happens, though, it's up to you to protect yourself.
The best way to do this? Rather than just accepting whatever
prescription your doctor gives you (free sample or otherwise),
talk to him or her about all the options available, why this
brand is better than others, and whether there's a less expensive
alternative on the market.
And, says Dr. Angell:
" ... Doctors are too willing to provide drugs for
very minor conditions. Those drugs are too often the very
most expensive, heavily advertised, me-too drugs. I think
that patients have to get a little savvier about that. Instead
of just grabbing that sample and thinking they've gotten
something for free, they ought to think about what it means.
Nearly every drug has side effects. I do think that we are
an overmedicated society."
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Sources
Journal
of the American Medical Association September 2005; 294:1034-1042
Forbes
September 6, 2005
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