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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

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    Thursday, July 01, 2004

    Payola: Pharmaceutical industry employee Derek Lowe says that the practice of paying doctors to prescribe drugs is worse than payola. It certainly is, for all the reasons he states.

    Given human nature, it's almost possible to understand how this comes about on the drug company's side. The sales force hears every day that it's imperative they increase sales. They have goals to meet to keep their jobs or to make their pay. A salesman with a widely used product, like antibiotics or ulcer medication tries make it up in volume. He'll visit more doctors more frequently and give out more samples to try to persuade them his product is best. But a salesman with a more limited market - cancer drugs, hepatitis drugs, etc. - has a much harder job. There are only so many specialists in any given area and they can't really give out samples. So, they give in to the temptation of the payola scheme.

    But what on earth motivates these doctors to except it? Beyond greed? Sure, some of them are also employees and under pressure to "produce more" by their employers, but it's doubtful that drug company money gets counted as part of their productivity. And certainly, they don't need it to pay the bills. Especially in specialties like gastroenterology where endoscopies are a very lucrative business. It's hard to explain it beyond pure greed.

    It's a practice that should never be condoned. It gives both the pharmaceutical industry and medicine a black eye.

    UPDATE: But according to one of Derek's commentors, payola is even more pervasive in Europe:

    I have a relative who is a doctor in Europe, working for a government hospital and isn't paid much. Several times a year drug companies pay for her and her family to go to "conferences" at resorts around the world. The companies monitor what drugs she prescribes and reward her with more conference vacations. This is Europe where they get at least two months vacation to fill up. Of course she prescribes what they tell her to. Otherwise her family could never go on vacation on her offical salary. And it's not just her, that's the way the system works there.

    Drug companies keep track of what we prescribe here in the U.S., too, a practice I find deplorable since it lets them target the underprescribers for more intensive marketing. On the other hand, nobody's ever come to me offering rewards for being a big prescriber of anything. Maybe may prescribing patterns are too varied.

    posted by Sydney on 7/01/2004 10:06:00 AM 0 comments


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