Based on four different papers, published in The New England Journal of Medicine, the PLoS Medicine, and the Journal of General Internal Medicine, the efforts to curb drug companies’ courting of your doctors is still ineffective.
In fact, the industry is working harder than ever to influence which medicines you are prescribed, by sending out sales representatives with greater frequency, bringing gifts, meals and offering consulting fees to high prescribers.
According to the study published in The New England Journal of Medicine,
- 94 percent of doctors have some type of relationship with the drug industry
- 80 percent of doctors commonly accept free food and drug samples
- One-third of doctors were reimbursed by the drug industry for going to professional meetings or continuing education classes
- 28 percent of doctors have been paid for consulting, giving lectures, or signing their patients up for clinical trials
Contacts between doctors and sales reps have jumped from an average of 4.4 visits per month in 2000, to an average of:
- 16 times per month with cardiologists
- 9-10 times per month with internists
- 8 times per month with pediatricians
- 4 times per month with surgeons
The only group appearing to be meeting drug company representatives less often than before is anesthesiologists, who now see reps twice a month.
These sales tactics are working. In the second PLoS Medicine study, visits by drug detailers (sales reps) prompted nearly half of 97 doctors to increase their prescriptions for Gabapentin, an anti-seizure drug. In many cases the reps were advocating the use of Gabapentin for non-approved, so-called “off-label” uses.
The Journal of General Internal Medicine study found that physicians do understand the potential conflicts of interest, but that they still view their meetings with drug reps as both valuable and appropriate. According to the authors of that study, this proves that the voluntary guidelines currently in place are inadequate.
The New England Journal of Medicine April 26, 2007; 356:1742-1750 (Free Full Text Report)
PLoS Medicine April, 2007; 4(4):e150 (Free Full Text Report)
PLoS Medicine April, 2007; 4(4):e134 (Free Full Text Report)
Journal of General Internal Medicine February, 2007; 22(2): 184–190 (Free Full Text Report)
If you do not believe your doctor is influenced to change their prescription patterns for personal attention, dinners, gifts, and cold hard cash, think again.
It’s not entirely their fault though, because drug company sales reps are highly trained in using very refined and specific psychological warfare techniques on your doctor. In many cases, they may not even realize they are being bamboozled.
Doctors usually believe they are immune to persuasion tactics, and drug reps know just how important it is to maintain that illusion – which is why it works so well.
According to the in-depth report published in The New England Journal of Medicine, co-written by a former Eli Lilly drug rep, Shahram Ahari, and Adriane Fugh-Berman, an associate professor of physiology and biophysics, pharmaceutical sales reps are trained in tactics that are on par with some of the most potent brainwashing techniques used throughout the world.
It’s a fascinating read. I have supplied a link to the full text report above, so you can find out for yourself just how meticulously trained these drug reps are to spot the “in’s" and weaknesses of every client.
Remember, pharmaceutical companies spend more than $20 billion each year promoting prescription drugs in the United States.
These campaigns are designed to effectively alter prescribing behavior, in order to sell more of the high-profit drugs, as opposed to the most effective, and least dangerous.
In the end, you are the one paying the price twice, by emptying out your wallet, and endangering your health with drugs you probably don’t—and never did—need in the first place.
But it doesn’t end there. In recent years, the additional practice of script tracking has gained momentum as well. Health information organizations, like IMS Health, Dendrite, Verispan, and Wolters Kluwer, buy pharmacy prescription records and resell them. This is how drug companies keep tabs on the return on their bribes, as it tells them the prescription rate of each individual doctor.
This information also reveals how many of a doctor's patients receive specific drugs, how many competing drugs are prescribed compared with the target drug, and how the physicians prescribing habits change over time. It tells them if a drug is “in favor” or not, and gives them the tools to cook up a winning strategy for future manipulations.
Between 1990 and 2004, spending for prescription drugs increased five times, to a whopping $188.5 Billion, and drug reps increased from 38,000 to 100,000 strong. That’s a ratio of one drug rep for every 2.5 physicians targeted for “detailing.” Talk about having a personal “Big Brother.”
The idea that reps provide some kind of valuable, informative service to physicians is total fiction, created and perpetuated by the drug industry, to keep this deadly, but profitable, scheme going.