Originally posted by Disaster_Boy
I agree with that, but further to that I have heard that doctors have taken money from companies to exclusively push their product at every
I would like to hear from people in the industry or, for that matter doctors themselves. Does this actully go on?
Is this where I wave my "I'm from the pharma industry" flag?
Alrighty. Yes, doctors are sometimes given incentives to prescribe drug A over drug B (when both treat the same illness). Drug companies are in
this to make money, don't forget - and it's in their best interests if Doctor Bob prefers their drug over that of their next competitor. It's
questionable ethically, but generally speaking we'd be talking about only drugs which treat the same disease. It's not as if they'd be paid more
for giving Percocet when ibuprofen would be more appropriate, for example.
This puts doctors however in a bad situation that's not helped by the insurance companies. If anything, it's those at whom I'd be more angry.
Jill has (disease A). Drug 51 would be ideal for her situation, but sadly because it's a new name brand and hasn't gone generic yet, her
insurance company won't pay for it. So, she has a choice - pay out of pocket, or make do with something less effective. Jill's doctor will try
and give her samples when he can (this is so common that it's generally considered the norm), but his hands are tied - he knows that Drug 52 isn't
quite as good, and that Jill really would be better with Drug 51, but there's not much he can do until the drug goes generic....and if, down the
line, the pharmaceutical company can prove to the FDA that their Drug 51 has a new indication, then they'll be able to keep the patent indefinitely,
and prolong the agony, so to speak. Insurance companies can make things very, very difficult for doctors and
Now, in terms of safety, most people don't know that by the time the drug reaches the public (ie, after it's received FDA approval), it's been
tested on less than 2000 human patients on average - and usually a lot less. Within the industry, it's at this point where the real side effects
are noted - that is, during post-approval drug trials (usually studying efficacy versus a similar drug, etc etc). That's when you really start to
see the real numbers for various side effects, complications, etc. We only have to look at the likes of Phen-Fen, Vioxx and the like to see that FDA
approval doesn't necessarily imply safety.
The truth is, drugs are a risky business. Though drug research costs can
run into millions per drug, much of this cost has to be offset by
increasing drug prices. Also, factor in the cases where millions are spent on drug trials, and the drug is not approved by the FDA, or simply gets
dropped (for whatever reason) at some point of the procedure. The "wasted" millions have to be made up somewhere. Bottom line? It's a
Now...moving on to made-up diseases. I've really never seen any evidence of this - trust me when I say that there are enough legitimate diseases
and conditions out there to keep the industries very, very happy for a very long time. On the other hand, there are drugs being prescribed for
"conditions" that probably don't need chemical treatment, and it's certainly true that some conditions are over-diagnosed and over-treated. ADD
is a notorious example of this. One of the biggest tragedies of our time is that 3 and 4 year olds are being fed Ritalin when they need nothing
more than adequate stimulation and perhaps more dilligence paid to dietary needs. Whilst both ADD and ADHD are legitimate concerns.....I heavily
doubt that they're anywhere near as common as we've been led to believe.
One other thing - doctors aren't really "hired" by drug companies. They are paid, yes....but usually the trials are what is called
"double-blind". This means that some patients will be given the drug, and some will be given either placebo, or an alternative - neither the
doctor nor the patient know which one is being given until the trial is over.
It's common to find doctors publishing reports based upon clinical trials where they were directly involved - this on it's own is not proof or
evidence of any underhandedness, although it's happened before (again, I'll refer to Phen-Fen - anyone interested to learn more might want to read
Alicia Mundy's Dispensing With The Truth; whilst it's Hollywood-ized to a great extent, there aren't actually any untruths told). Very simply, we
as a society have elevated drugs and doctors to an almost deity-like status - and if that's to change, then we have to change it ourselves by taking
charge of our own healthcare and not following blindly what we're told. We get second opinions before we have surgery, but very few of us do the
same thing when we're handed a prescription.
I hadn't realised this post had turned into a treatise...so I'll stop for now. If anyone has any questions, I'd be happy to try and help.
(FWIW - I worked with Wyeth (as an independant contractor) as part of the task force dealing with Phen-Fen class action claims, and worked on various
other clinical trials prior to this.)