Wednesday, March 07, 2007

Hazardous for non-medical personnel....very boring

Like an apprentice learning a handcraft I used to stick around any dermatologist known for "a good eye for skin lesions". Sometimes they wouldn't approve, but that's not the issue. I used to be terribly offended when medical representatives showed up and completely ignored me, they would talk to my mentor giving mini presentations with illustrations about their drugs and may be leave him samples of the drug. Simple isn't it...that's what I thought back then!
I was extremely glad when these reps. as we commonly call them started to knock my door and considered it a milestone and an accreditation of my abilities. Now I am starting to sense things are not that innocent at all and sometimes even malicious.
It is a known fact that the drug industry comes usually as one of the first 2 or 3 profitable industries globally if not the first, competing with industries like crude oil production. With vast expenditures on marketing and a tiny piece of the pie for R&D. In a country like ours administration and marketing are at the top of the list really, R&D is unmentionable, and if we know that ads are legally prohibited for drugs...then where are these marketing millions spent?

This is what I've seen so far through my peephole

  1. Samples are not a light weapon, yet they are not their most seductive means. Samples were originally meant to be given by the doctor free of charge to poor patients. It makes all parties happy. the patient is happy because he doesn't have to pay for the drug, the doctor is happy because the patient is happy and most probably will come back bringing more patients, and the pharmaceutical company is also happy as more often than not the patient will repeat the drug and the doctor is not likely to forget the name for at least a week which means tens of prescriptions containing that name.
  2. Reminders...reminders...anything that can catch the doctor's eye while prescribing... his pen his notepad, brochures stuck right in front of him or glued to the wall, Mugs, Tissues. Iam sure they would like to tattoo it on your hand if you won't mind.
  3. If they think you are not that convinced they would just grab a chair and sit right next to you while examining patients hoping that you would be extremely embarrassed to prescribe other drugs, and sometimes start a conversation in front of the patient to exert even more pressure. And this nagging is one of the very efficient ways.
  4. All of the above is still fairly harmless, but this one is usually very dirty. Physicians need to attend conferences for many reasons science is not the first of which but being informed of what's going on with their specialty and what are the new trends, and soon this will be compulsory for promotions as our syndicate will apply. Bottom line conferences are crucial yet expensive. Ranging from a few hundreds to a few thousands, so as usual drug companies tries to make a deal , if their drug shows up in most of your prescriptions they offer you a seat in a prestigious conference. Someone might ask and how can they detect how many times did you prescribe a drug?....pharmacies in the neighborhood give them a detailed report of which doctor likes what, and they end up as if watching you minute by minute in a real tv show.
  5. Meetings...an elegant dinner, a nile cruise over which more and more unheard presentations are held.

And further inside info found in these quotations:

"Over the past two decades the pharmaceutical industry has moved very far from its original high purpose of discovering and producing useful new drugs. Now primarily a marketing machine to sell drugs of dubious benefit, this industry uses its wealth and power to co-opt every institution that might stand in its way, including the US Congress, the FDA, academic medical centers, and the medical profession itself. (Most of its marketing efforts are focused on influencing doctors, since they must write the prescriptions.)" The Truth About the Drug Companies by Marcia Angell

" The doctors were rude, belligerent, corrupt, and sarcastic. Our qualifications mattered not one whit. The gifts we brought were seized greedily, and copious demands made for further material goods. On occasion doctors would even stoop to rifle through our bags themselves, in order to find more goodies. Our humbleness in their presence served merely to inflate their gross egos still further, and if their surgery had been busy then we served as excellent verbal punch bags before they went for their lunch. Bargaining and bartering skills were far more important to most doctors than knowing details about the quality of the products we represented. Meals out were a popular trading tool that included propositions of little dinners for “just the two of us”—with or without a meaningful wink—for us female reps." The life of a medical representative by Katherine Anderson

2 comments:

Dibo said...

You know, This is only a glimpse from the terrifying picture: the full range of techniques used by the pharmaceutical industry available to mislead through advertising can fill whole books, it runs In our medical literature like the poison in honey .
for example the advertising in journals are rarely peer reviewed.
A deceptive falsely designed economic analysis showing that a company's new, ridiculously expensive drug actually works out to be cheaper than standard therapies , making much use of graphs and plots.
Companies can pay medical writing agencies or consultants to create practice guidelines ; which are favorable to their products.
They try to corrupt every one and every thing.

placebo said...

yes i know this is the tip of the iceberg but as a practioner that's what concerns me, i don't want to be manipulated and it's not easy at all....I can do nothing about notorious biased papers or literature as you say except try to develop a good sense. I was mislead before and this post comes to warn my colleagues.