Unethical practices - drug industry
J Aldridge
>>>>After all, we are an
>integral part of the medical team and have obligations not just to our
>employees and stockholders, but to patients and all members of the medical
>profession.<<<
>I think pharmacists(with no ties to any one pharmaceutical company)
>should be part of the medical team, and paid an appropriate consultant's
>fee (like other medical professionals)---particularly when there are
>patients that take multiple medications.
I've had pharmacists chae a separate prescription fee but usually it's
included in the mark-up of the drug. Computer programs don't cost that much
and most pharmacies are installing them to attract steady customers. So
easy to answer questions only once and stick with the same drugstore.
Around here we have very professional pharmacists who give quite good
briefings on the drugs and their sides effects, potential hazards, and what
not to mix with them. A druggist has to be careful not to practice medicine
however and isn't able to dispute what a doctor prescribes (with the
patient). They are able to refer the patient back to the doctor or call the
doctor for clarification and that is what they normally do.
Jackie
J Aldridge
>>>>It appears there is some concern on the part of at least one individual
>in
>our group about the abundance of promotional literature in doctors'
>offices. He or she stated that if they enter an office with a lot of
>promotional literature, they leave (not a quote but a paraphrase).<<<
>NO NO NO!!! I said promotional "items" not literature. By items I mean
>computers with the drug company's name plastererd all over it, briefcases,
>etc......items that are given as gifts to docs---with the drug company's
>name and drug in plain view. Literature---particularly brochures that
>outline adverse side effects of drugs and symptoms to be aware of is a
>good idea.....since not all docs or pharmacists tell the patients of
>adverse effects, or why they are even prescribing the drug.
Well, I've not met many doctors who prescribe egregariously. Doctors do
tend to prescribe but by tradename but I don't see a problem with that in
most cases since I can choose to take generic at the pharmacy.
I kind of favor some of the promotional stuff given by companies. If a
doctor knows a patient doesn't have money for medicines very often they can
make up the supply from their closets. And it's a good way to introduce
patients to non-prescriptions drugs they might otherwise not bother to try
out. For example, my gastroenterologist gave me a packet of Fiber-Con a
couple of weeks ago. I wasn't sold on the idea of trying it but since I
didn't have to go out and buy the first one I used it. Now that I like it I
find that it's the only brand on the pharmacy shelves. The pads and pencils
and other small stuff isn't likely to sway most doctors.
Cash kickbacks, vacations, other likely to lead to abuse. I know that as a
heavy database user the database companies send me entry forms for vacation
drawings. As a matter of policy I don't enter. But I don't have qualms
about taking the free time offered for using a new database when they're
introducing it. Otherwise I'd probably not try most of them at all.
This is an area where professional standards can be imposed. Basically, the
medical societies can state where the line is drawn on accepting gifts from
pharmaceutical companies. And the public can dictate to the medical
societies, a letter to their committees might to the trick.
Jackie
Steven B. Harris
James Purcell) writes:
>
>sbha...@ix.netcom.com (Steven B. Harris ) writes:
>
>> Could you post the names of drug companies who give briefcases and
>>computers to doctors? Somehow I've always missed them and got
nothing
>>but the lousy pens.
>
>> Left Out,
>
>> Steve Harris, M.D.
>
>Steve,
>
>Perhaps you are working to hard and not seeing the right sales reps.
Last year
>every pharmacist where I work (abit in Canada) got an Italian Leather
>briefcase from the Claritin sales rep (cute little calculator and
>pen included). I've got pens and pads of paper coming out of my
>ears (as well as apo-tex socks, novo-pharm cookie jar, benedryl
>sweatshirt, Procotor and Gamble cassette holder case, etc, etc....)
>
>I won't even mention the free pizza every month from the Abbott sales
rep,
>the dinners put on by Glaxo, ........
>
>Michelle
>pur...@datanet.ab.ca (as of Sept 14/95)
>--
>pur...@nyquist.ee.ualberta.ca
>University of Alberta,
>Edmonton, Alberta.
>
Maybe they give better stuff to pharmacists than just the front line
docs. Or maybe it is a Canadian thing. I have gotten my share of
free pizza lunches. I felt it my obligation to prescribe many an
expensive and dangerous drug for no particular reason afterwards, too,
or at least until I got hungry again. A Benedryl sweatshirt, eh? What
color? Does it have a dry-mouthed allegator on the tit, asleep?
Steve Harris, M.D.
Kurt James Purcell
MAIKAI
>>>Could you post the names of drug companies who give briefcases and
computers to doctors? Somehow I've always missed them and got nothing
but the lousy pens.<<<
Were they MontBlanc or Waterman, by any chance? You mean you actually
bought your first stethoscope? (not a gift from a drug co?) Groan, you've
forced me to go through my stacks of literature........I'll give you the
"referrals" this weekend when I have more time. I did read that the docs
that were good customers tended to get the good stuff......so perhaps you
can't be bought..... and the drug reps could see that....and nowadays,
blatant expensive gifts are illegal...I do think the bogus study
reimbursements are still being done, though.
Peter H. Proctor
>sbha...@ix.netcom.com (Steven B. Harris ) writes:
>> Could you post the names of drug companies who give briefcases and
>>computers to doctors? Somehow I've always missed them and got nothing
>>but the lousy pens.
>> Left Out,
>> Steve Harris, M.D.
>Steve,
>Perhaps you are working to hard and not seeing the right sales reps. Last year
>every pharmacist where I work (abit in Canada) got an Italian Leather
>briefcase from the Claritin sales rep (cute little calculator and
>pen included). I've got pens and pads of paper coming out of my
>ears (as well as apo-tex socks, novo-pharm cookie jar, benedryl
>sweatshirt, Procotor and Gamble cassette holder case, etc, etc....)
>I won't even mention the free pizza every month from the Abbott sales rep,
>the dinners put on by Glaxo, ........
>Michelle
>pur...@datanet.ab.ca (as of Sept 14/95)
>--
>pur...@nyquist.ee.ualberta.ca
>University of Alberta,
>Edmonton, Alberta.
Boy, I now sure do wish my great to the fourth grandfather had never left
Nova Scotia for Tennesse.. You Canadians have all the luck.
Dr. Dr. Peter Proctor
Steven B. Harris
>
>>>>>It appears there is some concern on the part of at least one
individual
>>in
>>our group about the abundance of promotional literature in doctors'
>>offices. He or she stated that if they enter an office with a lot of
>>promotional literature, they leave (not a quote but a paraphrase).<<<
>
>>NO NO NO!!! I said promotional "items" not literature. By items I
mean
>>computers with the drug company's name plastererd all over it,
briefcases,
>>etc......items that are given as gifts to docs---with the drug
company's
>>name and drug in plain view. Literature---particularly brochures
that
>>outline adverse side effects of drugs and symptoms to be aware of is
a
>>good idea.....since not all docs or pharmacists tell the patients of
>>adverse effects, or why they are even prescribing the drug.
>
MAIKAI
>>>For example, my gastroenterologist gave me a packet of Fiber-Con a
couple of weeks ago. I wasn't sold on the idea of trying it but since I
didn't have to go out and buy the first one I used it. Now that I like it
I
find that it's the only brand on the pharmacy shelves.<<<
See, it works!!! You get one month's supply, and then you're hooked, and
continue buying it. Personally, free samples do not particularly bother
me.
>>>This is an area where professional standards can be imposed. Basically,
the
medical societies can state where the line is drawn on accepting gifts
from
pharmaceutical companies. And the public can dictate to the medical
societies, a letter to their committees might to the trick.<<<
Problem with professional standards is that the Medical Licensing Boards
are responsible for enforcing them.....many states have a lousy track
record for taking disciplinary action as it is for more serious
violations---think they'll care about a free gift here and there? I do
believe the AMA has (finally) taken a stand on this, and has stated they
are not in favor of some of some of the bribery that went on in the
past---any coincidence it was a politically correct stand to take? Best
thing the public can do is become aware of the marketing and advertising
practices, and practice "caveat emptor" (buyer beware)---like in any other
business dealings.
AlWeissman
writes:
>Excuse me if this is a dumb question. But how do the drug companies know
>which doctors are "good" customers? Aren't what the doctor prescribes
>and who it's for kept confidential? What's to keep the doctor from
>taking all those expensive gifts, telling the rep he's prescribing their
>overpriced meds, and then giving his patients a generic alterntative
>which works just as well?
>
>
Many pharmacies sell their data to polling companies. The patients' names
are stripped from the data so there is no breach of confidentiality.
Periodically the data is sent (via disk or modem) to these companies who
can then massage it to find out, for instance, how many Rx's are being
written, how much market share a particular drug has, what the zip code of
the patient is, and which doctors are writing for what products. Many
pharmaceutical companies buy these reports to help with their marketing,
and many reps' bonuses are based on this data.
Al Weissman, R.Ph.
Steve Work
: Were they MontBlanc or Waterman, by any chance? You mean you actually
: bought your first stethoscope? (not a gift from a drug co?) Groan, you've
: forced me to go through my stacks of literature........I'll give you the
: "referrals" this weekend when I have more time. I did read that the docs
: that were good customers tended to get the good stuff......so perhaps you
: can't be bought..... and the drug reps could see that....and nowadays,
: blatant expensive gifts are illegal...I do think the bogus study
: reimbursements are still being done, though.
Excuse me if this is a dumb question. But how do the drug companies know
which doctors are "good" customers? Aren't what the doctor prescribes
and who it's for kept confidential? What's to keep the doctor from
taking all those expensive gifts, telling the rep he's prescribing their
overpriced meds, and then giving his patients a generic alterntative
which works just as well?
Also, are there cases where drug companies try to give "samples" of
addictive medications to doctors in order to motivate them. I remember
in the novel "Strong Medicine" by Arthur Hailey, that addiction by
doctors to sample drugs was quite common. In this book, a doctor under
the influence of such drugs ended up killing a patient.
Peter H. Proctor
>From: slw...@netcom.com (Steve Work)
>Subject: Re: Unethical practices - drug industry
>Date: Thu, 14 Sep 1995 04:12:00 GMT
>MAIKAI (mai...@aol.com) wrote:
>: Were they MontBlanc or Waterman, by any chance? You mean you actually
>: bought your first stethoscope? (not a gift from a drug co?) Groan, you've
>: forced me to go through my stacks of literature........I'll give you the
>: "referrals" this weekend when I have more time. I did read that the docs
>: that were good customers tended to get the good stuff......so perhaps you
>: can't be bought..... and the drug reps could see that....and nowadays,
>: blatant expensive gifts are illegal...I do think the bogus study
>: reimbursements are still being done, though.
>Excuse me if this is a dumb question. But how do the drug companies know
>which doctors are "good" customers? Aren't what the doctor prescribes
>and who it's for kept confidential? What's to keep the doctor from
>taking all those expensive gifts, telling the rep he's prescribing their
>overpriced meds, and then giving his patients a generic alterntative
>which works just as well?
I do this all the time. Still all I get is those dumb pens.....(g)
Dr. P
Jason Kennerly
> computers to doctors? Somehow I've always missed them and got nothing
> but the lousy pens.
HAHaHAH!
I've seen a really spiffy "Zoloft" clock - see thru, appeared that LCD
numbers were "floating" in glass. Nothing more expensive ever...
Promotional literature is cool. I especially like the creative ways
journal articles and data are "extracted" into one big packet that makes
a drug look like a godsend. ... and makes the competitors drug look evil.
One of the best examples of such promotional PR I have seen to date is
the one Lilly puts out about "dose titration in the naturalistic
setting"... the actual study contained at the core is very interesting as
it never mentions how initial antidepresant choice was made, WHY zoloft
dose was raised wheras prozac dose was not (fluoxetine, being less
selective than sertraline, probably has a higher incidence of SIDE
EFFECTS at higher dosages... heheheh) etc etc
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