Examining Big Pharma influence on Medical Practice



Can Big Pharma Actually Buy a Doctor's Allegiance for a $20 Meal?

As the Fiscal Times reported in March, a new study by the independent publication ProPublica revealed that physicians who receive payments from major drug and medical device manufacturers are far more inclined to prescribe brand name medications than doctors who don’t accept payments, gifts or other honoraria.

What’s more, the bigger the payments they receive, the more doctors tend to take out their prescription pads and steer their patients to the newer brand name drugs instead of the far less expensive generic drugs that essentially have the same effect. For instance, docs who received more than $5,000 from drug companies and others in 2014 for speeches, meals, consultations or other promotional activities “typically had the highest brand name prescribing percentages,” ProPublica found.

But a new study published Monday on-line on JAMA Internal Medicine that makes a similar case strains credulity.
The report’s findings were based on analysis of federal government data that tracked and correlated payments received by doctors and the prescriptions they wrote under Medicare Part D. The study focused on 2,444 Massachusetts physicians who wrote prescriptions in 2011.

The study focused on the prescriptions that were written for three specific statin drugs: AstraZeneca PLC’s cholesterol-reducing Crestor; Allergan PC’s Bystolic that is used to treat high blood pressure, and Daiichi Sankyo Co.”s Benicar, another treatment for high blood pressure. Each of those drugs has a less costly generic alternative.

Researchers found that 899 of the physicians, or 37 percent of the total, had received payments from the drug industry. Most commonly, those payments came in the form of free meals. Among those doctors, they prescribed the brand name statin 23 percent of the time, By contrast, the other doctors who hadn’t received industry payments prescribed those brand name drugs 18 percent of the time.

“Industry payments to physicians are associated with higher rates of prescribing brand name statins,” the study concluded. “As the United States seeks to rein in the costs of prescription drugs and make them less expensive for patients, our findings are concerning.”

However, as ProPublica’s senior health care reporter Charles Ornstein noted in an analysis of the latest study, “The researchers did not determine if there was a cause-and-effect relationship between payments and prescribing, a far more difficult proposition, but their study adds to a growing pile of research documenting a link between the two.”

And PhRMA complained to the Journal that the study essentially “cherry picked” physician-prescribing data “to advance a false narrative.”
Interesting, but not surprising. I've worked in a few moderate sized clinics and at all of them the drug reps are there almost every day with free catered lunches, sweets, ice cream and even a snow cone truck. I also saw the piles of gifts they would receive every Christmas from these same drug companies.

It's sightly better than it used to be since as far as I know free vacations to Hawaii and such are no longer legally allowed.

All the doctors I've worked with seem like good people so it bums me out to think they would let such trivial things alter the care they give to their patients, but I have no idea if it did or not.

On the flip side, when I worked for a small reference lab that was a big Roche client, Roche would often bring cookies, donuts, cake etc. for all of the employees. Then the executives of the lab put a stop to it because they were concerned about the "ethics" of the whole thing. The crappy thing about that was, most employees had virtually no say in what products were being used in the lab. This was the same lab that cut all employee bonuses "because of the recession" even though said recession was not affecting lab volumes or revenues. We also later found out that all upper management continued getting their bonuses, so it was just the people doing the actual work that made the company a profit that got short shrifted. We were then told by one of the managers that we should all be happy we still had a job and to stop griping about bonuses. Needless to say, I don't work there anymore.