Some doctors say no more free lunches
Patients visiting Creekside Family Practice in Rapid City won’t find any pens, mugs or prescription pads advertising the newest medication on the market.
They also won’t find any free drug samples, and they certainly won’t run into any pharmaceutical salespeople bearing free lunches.
Two years ago, when Dr. Nancy Babbitt joined Dr. Craig Hansen in the practice, the two physicians decided to cut all ties with pharmaceutical sales representatives.
Hansen already had a longstanding policy of not meeting with drug-company representatives, something he began during his residency.
“I’ve been an antagonist of the drug pharmaceutical reps from the beginning,” he said.
During his residency, Hansen remembers drawing criticism from an instructor when he refused to meet and greet pharmaceutical representatives as part of his training.
“I thought it was a conflict of interest,” he said.
He still does.
For as long as most doctors can remember, pharmaceutical and medical vendor “reps” have been a fixture in clinic and hospital environments. Drug reps visit doctors and their staff, promoting and selling their company’s medications or products.
They often bring goodies to grease the sale.
In the early years, it wasn’t uncommon for drug reps to ply doctors with free vacations and elaborate gifts. Those practices have largely been eliminated, but less elaborate practices remain, including providing free lunches to clinics and their staffs.
The relationship between doctors and pharmaceutical companies has drawn fire from the medical industry and industry watchdogs alike in the past 10 years.
Two huge settlements have undoubtedly played a role in that growing attention.
In 2001, TAP Pharmaceuticals paid the government $875 million to settle claims that it paid kickbacks to doctors to promote Lupron, the company’s prostate cancer drug, and cheat Medicare by filing false claims.
In 2004, pharmaceutical giant Pfizer was fined $430 million to resolve criminal and civil charges that it paid doctors to prescribe its epilepsy drug Neurontin to patients with ailments that the drug was not federally approved to treat.
Such settlements drew attention to a system that many believed made it too easy for pharmaceutical companies to influence doctors. As a result, the government and the pharmaceutical companies themselves began to take action.
In January, the Pharmaceutical Research and Manufacturers of America, the organization that represents pharmaceutical companies, adopted an updated voluntary code regulating their relationship with health care providers. The code makes recommendations regarding gifts, medical information and the relationship between pharmaceutical representatives and doctors. It also does away with the practice of giving doctors such things as pens, cups and pads advertising a certain medication.
The current House health care reform bill addresses the issue as well, including a regulation that would require pharmaceutical companies and vendors to closely report all gifts and samples.
Several states have adopted stricter regulations to limit the contact that drug reps have with physicians. Minnesota is one of them, said Dr. Douglas Wood, a physician at Mayo Clinic in Rochester. The state passed regulations this year restricting gifts and even the amount of food a drug rep can provide to a doctor’s office, Wood said.
Mayo Clinic itself has an extensive policy requiring doctors to report any details that may prove a conflict of interest. Even a family member of a doctor who owns stock in a pharmaceutical company raises a red flag, Wood said.
“If a conflict is identified, we have to find ways to mitigate that,” he said.
South Dakota does not have such a state law, but most clinics and physicians follow American Medical Association guidelines, according to Megan Myers of the South Dakota Medical Association. The guidelines restrict physicians to gifts that benefit the patient and are not of substantial value. “Textbooks, modest meals and other gifts are appropriate if they serve a genuine educational function. Cash payments should not be accepted. The use of drug samples for personal or family use is permissible as long as these practices do not interfere with patient access to drug samples. … Individual gifts of minimal value are permissible as long as the gifts are related to the physician’s work, (e.g, pens and notepads). …”
Regional Health allows pharmaceutical representatives and medical vendors to visit their clinics and hospitals, but it has two policies addressing the practice, said Shawn DeGroot, vice president of corporate responsibility.
DeGroot said Regional Health is scheduled in an upcoming meeting to explore that policy further. “Conflict of interest is an issue,” she said.
Dana Darger, Regional Hospital’s pharmacy director, has seen the relationship between pharmaceutical companies and clinics/hospitals change in his 30 years as a pharmacist. He remembers a time when pharmaceutical companies themselves provided speakers at medical conventions to talk about diseases and promote their medications. That practice has largely been replaced with a grant system that allows convention organizers to hire their own, hopefully unbiased, speakers.
Please Wait…
So one suit against one company proves a blanket theory?
To wit: November 25, 2009 from Voices of the Law web site. The Indiana Attorney General’s Office joined in a lawsuit along with 13 other states against Amgen Incorporated, alleging the pharmaceutical manufacturer illegally promoted its anemia-treatment drug Aranesp by offering physicians kickbacks and other illegal inducements to prescribe it.
The multi-state investigation and lawsuit was initiated by a company whistleblower, a former sales and marketing professional in California, who came forward about alleged illegal marketing practices.
A private individual filed suit in 2006 on behalf of the government to recover public funds wrongly paid due to health care fraud. The case remained under seal while the states and the federal government investigated.
I find it interesting that these physicians prescribe to 3 major journals where they get their latest pharmaceutical information. With over 80 new medicines being approved by the FDA each year, only a fraction of them will get "reviewed" or published in these three journals.
Having a child with a debilitating disease that has little known about it pushed us into a specialists clinic. I do not know of many specialists that could get their information from three journals and be on top of their game.
I want my primary care doctor to be on top of their game too. My primary care doctor does all the follow up care for my son. I am hopeful my primary care doctor can see through the information like Dr. Bendt mentions in his comments. After all, are physicians suppose to be the most intelligent group in our society?
There is nothing wrong with making money...certainly something wrong prescribing drugs to appease pharmacy reps and especially when they are not approved to treat the symptoms. But really there isnt much money to be made in curing anything, if pharmacy companies could cure with their drugs they would lose their repeat business. Treat the symptoms instead of the disease and keep people hooked.
This nation wouldn't have many of the healthcare problems we have if ALL doctors locked their doors to pharma reps... no more free tickets, no more free extravagant vacations, no more back room back scratching deals that cost the American public BILLION$ of dollars each year in excessive prescription costs and over prescribing of "medication"... after all they are drugs. DRUGS ARE DRUGS!
The historic PROHIBITION of DRUG ADVERTISING on TV and in magazines should go BACK IN EFFECT immediately! People self diagnosing and doctors prescribing dope that is more insidious that the affliction itself has become the American way. A doped up culture of excess and willful disregard for making healthy lifestyle choices and general wellness.
When you consider the ramifications of the mumbled fast-talk warnings of all the "possible" and clinically proven side effects from taking the dope - no matter how casually they brush them off and spin them as 'negligible' - the fact is many if not most of them are essentially life threatening. Big Pharma is merely trying to sidestep liability for poisoning you.
If you were growing it in your backyard and smoking it, with the laundry list of those kinds of life threatening and dangerous side effects - not the least of which is the risk of suicide, you can be absolutely certain you'd go to jail for selling it!!! So should they... and the FDA.
But the underlying tone in a discusson of this sort is an indictment of Big Pharma as bad guys.
As in many other huge industries, there are problems. There is fraud. There are backroom deals.
But what industry is largely reponsible for the development of life-saving drugs? Big Pharma. How do they get the money to develop said drugs? Profits.
But making money somehow has become a bad thing.
Think about that the next time you wonder why there's no drug for a terrible disease that you or a loved one may contract.