My first experiences of the Pharma-Doctor financial relationship were lavish dinners at some of the finest restaurants in NYC, soon after I finished my residency. The dinners were sponsored by a pharmaceutical rep, and a short talk about the featured drug was given by a doctor that also received an honorarium ranging from $750 – 1500 for spending about 20 minutes talking about their drug.
At first, it seemed like a good way to learn in a relaxed environment while getting to sample amazing food. We would learn about new medications , or even new details about drugs that had been out in the market for some time. What was not said was the soft marketing — the soft manipulation of prescribing patterns by this sense of collegiality with peers. Of course, in order for the speaking physician to make his Honorarium, he or she needed a quota (usually at least 3 doctors) in attendance, so I used to get invited a lot (especially by one particular doctor I knew that had been in practice for many years).
What slowly turned me off to this method of drug marketing was when I had attended several dinners with the same doctor, finding that one night the doctor was speaking about one particular medication and how great it was, then the other night he was speaking about its competitor and how great it was in comparison to the other drugs. It was such a blatant conflict of interests; yet, underlying the talks was a payment arrangement, so did it really matter what medication the doctor was talking about on a given night? This doctor once boasted to me that he made an additional $150,000 per year just by doing 2–3 dinners per week. That is more than most people in this country make yearly.
It wasn’t about what medication was best for a condition, it was really about who was paying for that night. It turned me off to the entire pharmaceutical dinner ploy. Soon thereafter, I stopped going to them. I still met with drug reps on occasion, but within another year or two, I stopped meeting with them in my office, preferring to learn about any medications (which I try to use as little as possible) at medical conferences, where at least the science is presented without bias (as they are required to be free of commercial bias).
I AM PROUD TO SAY THAT I HAVE NEVER GIVEN A PAID TALK FOR A PHARMACEUTICAL COMPANY.
On September 30, 2014, The New York Times published an article entitled, “Detailing Financial Links of Doctors and Drug Makers.” The database in this article, a federally run program on CMS.org, can help you find out if your doctor has accepted money from pharmaceutical companies. And know that it influences prescribing behavior. So, when your doctor prescribes something, ask this: Are they doing it because the research shows it is the best medication for your condition? Or is it the next best drug that they were recently marketed to by a pharmaceutical rep or in one of these dinners?
I BELIEVE IN MAKING ANY MEDICATION DECISIONS FREE OF COMMERCIAL PHARMACEUTICAL BIAS.
Studies have shown that doctors that meet frequently with pharmaceutical reps tend to prescribe the most expensive medications on the market, even when equally effective and cheaper alternatives exist. Of course, drug cost and the increasing payment burden placed on patients is another story…
I’LL LEAVE TALKING ABOUT REFORMING PRESCRIPTION DRUG COST FOR ANOTHER POST…to be continued!