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In Defense of Drug Reps and Free Lunches
Anthony Rudine -- Just a little word about drug reps.
As I said before, two days per week, usually, the drug company representatives come and provide lunch to the internal medicine department. With them, they bring many pamphlets and gifts and toys for us to play with. About one day per week, we get an invitation in our mailbox to go out to a nice dinner and hear a lecture about a new drug or vaccine, etc.
To be clear, many people do not like drug reps, but I am not one of those people. From my very limited experience, they have been nothing but helpful. They provide numerous drug samples to our patients who have no way to pay, they provide informational brochures about the drugs they are representing, and are indeed very knowledgeable about their specific pills. Often they bring with them charts, books, or other goodies to carry around in your pocket and help you quickly diagnose. And the pens are great, top quality.
I must be honest that with my MBA we discussed drug companies often, and the feelings were often mixed. The drugs are either too expensive, not good enough, not really an improvement, etc. But here is the deal: no one makes you prescribe a drug. If it were not for drug reps, it would be difficult to keep abreast of the new drugs that actually do provide an improvement over treatments past.
We all know that drug companies are one of the biggest lobbying groups in the US. They provide billions of dollars to their constituents and certainly have an objective. But isn’t that what lobbying is for? Are drug companies the only ones who lobby? I think not.
We also all know that drug companies are a part of one of the largest marketing pushes in recent years. How else are they to promote their new products?
What many fail to realize is that drug research is expensive. For every drug that makes it, which takes about ten years in development, many more do not. We all hear stories of drug companies falsifying information to make their drugs better or more efficacious, and they may be true.
But the bottom line is, drug companies provide a good service, both to the medical community and the patients. Just remember it is your decision whether or not to prescribe the drug. And the toys and food sure are nice.
August 9, 2006 | Permalink
Comments
Anthony,
Please read this rant from my blog - TANSTAAFL
They are influencing you. They know it. They are not altruistic.
Posted by: db | Aug 11, 2006 6:58:12 AM
Take a look at my world.
http://pharmagossip.blogspot.com
The Devil has many forms.
Posted by: Insider | Aug 11, 2006 9:27:36 AM
Anthony,
You hit the nail right on the head. People who think that Pharma and Drug Reps are root of evil are just deluded and speaking nonsense. Keep up the good work.
Posted by: Ricardo | Aug 11, 2006 11:29:18 AM
DB: They are not altrustic (understatement of the year), but neither is Anthony blind. I have no love for Big Pharma, don't get me wrong, but I do have a problem with the radical "no free lunch" people who ascribe so much power and "Svengali"-like control to these reps while simultaneously dumbing down physicians to be powerless minions should they succumb to their wiles.
Posted by: Enrico | Aug 14, 2006 8:40:10 AM
Drug reps are doing the job they are trained to do, in order to earn a living and the fancy cars they drive. Drug companies are out to make a profit. Sure, helping people is a plus, but they wouldn't be in business unless business was ultimate objective. The purpose for giving free lunches, useful office supplies, and drug samples to health professionals is threefold: to butter up the prescribers (and future prescribers), to leave behind marketing devices for the patients to see, and to get doctors to hand out the samples, which then conveniently become future prescriptions for the same drug. Patients see office supplies and TV ads and ask doctors for those products, without knowing the truth hidden in published and unpublished clinical research trials. Drug companies do 10 studies and publish results of the one by chance that had fewer side effects reported by participants. Effectiveness ratings are often judged by raters using vague efficacy scales, where trial blindness is uncovered by differential side effects for drug and active placebo. Yes, medications are necessary for many conditions...but take psychotropic drugs into mind. Psychotherapy is much more effective at actually solving the problem, rather than masking side effects while simultaneousely creating medication dependency. The point, besides ranting, is that medical students, just like their mentors, are too willing to accept what drug reps say as fact; they do not have time to really examine scientific journals because the attitude that seems to dominate western medicine is: "What will the insurance companies reimburse?...see a patient for 15 minutes, in which time a diagnosis is made, a drug is prescribed, and a furute appt. is then scheduled...then, 40 more patients can been today." Rather, take the time to find the good meds and avoid prescribing if alternate therapies can reduce symptoms.
Posted by: Joe | Aug 15, 2006 2:58:05 PM
How many times have I heard my professors rant about the evil drug companies? At least bi-monthly, I'm sure. They are nothing but evil, greedy corporations who make their money on the suffering of others, I am told.
People want a pill to solve their problem; they don't want to eat "right" and exercise, live moderately, etc, etc. That pill is not free. I believe that company deserves every $$ it can earn before its patent runs out.
As Anthony astutely pointed out, without the ability to make a profit, why would these companies take the risk of investing in so many drugs that never do make it to market?
No DR points a gun to their pt demanding they take a pill; each pt has the freedom to decide whether or not to take that pill.
But for those who would denigrate the Pharm companies, do you still charge pts who do not benefit from your treatment or advice? I argue that as altrustic as being a DR may sound, money is a key factor underlying the desire to make it through school.
DR's sell their service; Pharm companies sell their wares, and poor practices of either should be dealt with appropriately.
Posted by: rob | Aug 15, 2006 8:30:36 PM
Sometimes the information they provide is downright wrong, though.
I hate the ad that says, "this pill cures both causes of high cholesterol--your family and your food." What kind of a pill can cure your diet??? It just ain't so. High cholesterol is a symptom of a bad diet, it's not the only problem. Nor is it the only cure.
Not to mention the "helpful" tools which might be wrong--i.e. the charts, "scientific" trials, etc.
I think you've got to be looking at things for yourself and not just rely on a rep to tell you about them.
There are many good drugs/cures/solutions to health problems that are actually pretty old. Noone is making money off them, so a "newer" treatment is touted as "better". We need to know about ALL treatments, not just the newest.
Posted by: ho1 | Aug 16, 2006 5:25:27 PM
oh and by the way, if that doesn't get your goat, listen to this.
Drug and technology companies' reps make more than the doctors they serve. Honestly. Ortho tech companies are the worst--they go out and hire "retired" football players, "train" them to use a drill, and then send them out there to hang out with the ortho surgeons. They get paid 400K/yr or more to do this--with less training and less ability (and taking a whole heck of a lot less personal risk) than the surgeon, they can make more! Something is wrong with that picture....
Posted by: ho1 | Aug 16, 2006 5:29:35 PM
My question is “Who truly benefits from banning drug reps from providing free lunches to medical students?”
1. Drug companies don’t benefit because they can’t market their products as effectively.
2. Patients don’t benefit because without a successful pharmacy industry, fewer medicines would be developed.
3. Likewise, the American economy doesn’t benefit because a smaller pharmacy industry means overall decreased economic growth and hence decreased taxes.
4. Finally, medical students don’t benefit for three reasons: they don’t gain firsthand experience dealing critically with pharmaceutical reps; they don’t get access to practical drug information they may not get in their regular lectures; and they don’t get the much-needed affordable sustenance required to make it through the long days of medical school.
Overall, I feel this has become the politically correct topic of the day. The question should not be “who suffers?” but rather “who benefits?” by any policy that puts limits on the actions of drug companies on medical school campuses.
I believe another way to handle the situation is for medical schools to realize that in the real world of medicine, drug reps play a crucial role in educating busy practicing physicians, and that medical students need to learn to be critical “consumers” of pharmaceutical products.
Therefore, I would support any cooperation between drug companies and medical schools (especially if the students and the school could profit in some constructive way), and would like to see the schools offer a course and/or workshop on how to work ethically with drug reps. In this way, we ALL benefit; drug companies, physicians, AND our patients.
Posted by: Jeff | Aug 18, 2006 9:32:44 AM
Isn't anyone here going to mention the most critical issues of all - 1) providing good medical care and 2) trust between physicians and patients? You better believe that drug reps change prescribing behavior, studies document it well. Is everyone okay with that? And patients are better informed than ever and know exactly who gives doctors the cool pens and fancy clocks. Why should we accept extrordinarily biased information from drug reps while at the same time we spend money on the best books and educaiton we can find.
So we have ourselves an industry that doesn't provide transparent clinical trials, utilizes ghost writing, spends $30,000 per physician in marketing, enjoys record profits year after year. Does this have to be the cost of doing business and having a supply of medications? I don't think it has to be. Instead of defending drug companies, ee should be talking about regulating them more stringently to improve helath for all.
Posted by: Nate | Aug 18, 2006 9:01:28 PM
I've worked as a nurse in an internal med. practice for 10 years and have seen many drug reps and enjoyed many free lunches. The Dr's I work with don't have time to read reports, studies etc. The few minutes they get with a drug rep. gives them time to discuss the pro's and cons's of a medicine. These seasoned dr's don't always agree with the reps and will tell them so. There have been many heated discussions between dr's and reps. Samples are a very valuable resource in our practice. We can see if they're effective for a specific patient without costing the patient anything. Some patients can't afford their meds and because of samples, we can provide their meds to them. All the drug companies have an indigent program to provide those who cannot afford them the drugs they need. I don't think you give dr's enough credit. They know when they are being smooshed. They know what motivates drug reps. Ultimately the samples and info the reps provide is useful in the internal medical practice.
Posted by: Pamela | Aug 20, 2006 6:37:22 AM
I think you are 100% correct. The drug reps do a tremondous service to the physicians, which flows to the patients. There is no way a physician could keep up with all the latest research and drugs on the market. I am all for the first hand knowledge the drug reps bring to the physicians. It is then up to the individual physician to prescribe what he thinks is appropriate for the patient.
Sincerely,
Vonna
Posted by: vonna | Aug 20, 2006 1:56:24 PM
Free lunches and perks are great!
Eli Lilly 3Q 10% profit rise is nearly all from psyche drugs including zyprexa.How have they schemed to squeeze more money from their zyprexa cash cow when pill production has actually gone down?
ANS-Eli Lilly profiteers have jacked up the price of zyprexa to the federal govt,from the Medicare D payouts.Eli Lilly is a big drug company that puts profits over patients.
They covered up findings that their Zyprexa has a TEN times greater risk of causing type 2 diabetes
Only 9% of Americans trust big pharma,right around the same rating as tobacco companies.
Daniel Haszard Eli Lilly zyprexa drug caused my diabetes www.zyprexa-victims.com
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