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Here's a must-read article for anyone interested in learning how the pharmaceutical industry really operates. It's a case of aggressive marketing gone bad, with a mixture of corrupt physicians, underhanded payola and a near-total disregard for patient health. And yet it's business as usual in the pharmaceutical industry: drug maker Schering-Plough, one of the largest drug companies in the world, has been outright bribing physicians to prescribe drugs and operate sham clinical trials.
Here's how it would work: doctors who prescribed the drug company's products and avoided competing drugs were paid "consulting fees" of tens of thousands of dollars. And what kind of consulting did these doctors do? The kind of consulting that requires nothing more than signing a blank sheet of paper and cashing the check, of course. And thousands of doctors participated in this criminal scam, collecting untold sums of money in exchange for hyping Schering-Plough's pharmaceuticals to patients. (Medical ethics, anyone?)
An article in U.S. News & World Report (2/19/2001) took aim at the impact pharmaceutical sales reps have on the prescribing habits of physicians. Are the decisions doctor's make about which drugs to prescribe based on knowledge, expertise, your needs, or are they influenced by drug sales reps?
There have been a few doctor's offices which have closed their doors to drug sales reps, realizing that it is the job of the rep to sway them toward new and heavily promoted drugs. However, the key word here is "few". It is not the majority of doctors taking this action.
Most doctors claim they are not influenced by marketing ploys but research has shown otherwise. A study published in a 1994 issue of JAMA, reveals that doctors who made specific requests to insurance companies that a particular drug be added to the formulary list were 13 times more likely to have met with a rep promoting the drug than doctors not making any such request.
Last month, the Office of the Inspector General, Department of Health and Human Services (DHHS) issued a "Special Fraud Alert" targeting aggressive drug industry marketing involving cash and other payments to doctors and pharmacists to promote specific products. The Inspector General warned that such schemes may be in violation of Medicare and Medicaid anti-kickback laws (American Medical News, 29 August 1994). DHHS is concerned that aggressive promotional incentives could harm patients if they influence doctors to make medically inappropriate prescribing choices.
But, Epstein says, there is much more. In particular, the book shows how the NCI and ACS are corroded with major institutional and personal conflicts of interest with cancer drug companies ("Big Pharma"). As candidly admitted by a recent NCI director, the NCI has become a "government pharmaceutical company." For the ACS, these conflicts extend to environmental polluters in the chemical industry, and connivance in white collar crime. Not surprisingly, The Chronicle of Philanthropy has charged that "the ACS is more interested in accumulating wealth than saving lives." These close ties to industry have transformed the NCI and ACS into cheerleaders for special interests rather than stewards of the public interest. Astoundingly, and for the first time, Epstein chronicles how the NCI and ACS are sitting on mountains of information about avoidable environmental causes of cancer rather than making this available to the public in any systematic and understandable way.