By Julie Appleby

The Bush administration told doctors October 1 essentially: Buy your own golf balls, concert tickets and vacations because drugmakers who offer such incentives risk running afoul of the law.

In a draft meant to offer guidance to the industry, the Office of the Inspector General took aim at some common practices and said they could lead to civil or criminal charges.

Suspect activities include:

• Paying doctors to act as consultants or researchers in marketing efforts.
• Paying pharmacies or doctors to switch patients from one drug to a competitor.
• Providing scholarships, grants for research or other gifts with more than nominal value to doctors.

The guidance comes after years of concern about some drug industry marketing practices. Critics say such tactics influence doctors to prescribe certain drugs and lead to higher costs for consumers. The draft lays out for the first time in one document what the government expects.

The draft - now up for 60 days of public comment - says some nominal-cost gifts are OK but does not give specifics. Instead, it says a voluntary ethics code adopted this summer by the Pharmaceutical Research and Manufacturers of America should be considered a "minimum standard."

That code says sales reps can buy doctors meals on occasion but only in conjunction with medical education. Golf balls or bags emblazoned with drug company logos are not allowed. Neither are tickets to entertainment events, cash payments or other incentives given for prescribing products.

The draft guidance also says drug companies can face charges for reporting average wholesale prices that differ substantially from what is actually charged - and touting those prices in marketing.

That's because the government uses those prices on the few drugs covered by Medicare. If the drugs are sold for less, doctors can bill for the higher amount and keep the difference. It's a tactic drugmakers use to lure doctors to their products, costing taxpayers $1 billion annually, the government estimates.

USAToday.com October 2, 2002

Dr. Mercola's Comments:

Most physicians have no clue that the drug companies are spending (on average) $10,000 per doctor to influence their behavior. They, of course, do not receive a check, but the perks are quite significant.

They also don't realize that they actually lose that much income and more if they factor the time they lose by sitting with the drug company reps and going to their "free" meals and lectures. They are also clueless on what a fiduciary responsibility is, that they need to carefully analyze the costs involved in recommending expensive drugs.

Clearly, they are sometimes appropriate and can save someone's life. But most of the time they are unnecessary, cause harm and cause the patient to divert much of their hard-earned income to the drug companies that further perpetuates this indirect physician subsidy.

One thing these drug companies are not is stupid. There is no way they would spend $15 billion a year to do this unless they received a significant return on their investment.

Did I say return on investment?

Yes, I did.

The fact of the matter is that the US alone is spending nearly one trillion dollars for drugs.

Folks, that is one thousand billion dollars.

The late Senator Everett Dirksen from Illinois was fond of talking about Defense Department spending by saying "a billion dollars here and a billion dollars there, and before you know it you are talking about real money."

You'd better believe that there is plenty of profit in that trillion dollars.

Related Articles:

Drug Company Gifts May Affect the Way Doctors Practice Medicine

AMA Criticized for Letting Drug Firms Pay for Ethics Campaign

Drug-Company Influence on Medical Education in the USA

Drug Firms Still Lavish Pricey Gifts on Doctors