Magazine article Drug Topics

Drug Firms Spend $165 Million a Year to Influence Prescribers

Magazine article Drug Topics

Drug Firms Spend $165 Million a Year to Influence Prescribers

Article excerpt

What do Jay Leno, Marie Osmond, and the Drifters have in common? They are some of the headline entertainers that brand-name drug companies paid to perform at national pharmacy association conventions last year. But under new ethical guidelines adopted recently by the Pharmaceutical Manufacturers Association, the shows might not go on.

The PMA's voluntary glidelines are identical to those adopted two days earlier by the American Medical Association. The AMA acted out of concern, the association told Sen. Edward M. Kennedy (D, Mass.), over expensive gifts, trips to resorts, meals and entertainment, and cold cash the pharmaceutical industry has been lavishing on M.D.s to promote its members' drugs. Kennedy had charged that drug firms were spending more than $165 million a year on such promotional practices and that the cost was ultimately paid by the patient.

All white: In two days of hearings last month, the Senate Committee on Labor & Human Resources, which Kennedy heads, heard a litany of alleged abuses that one witness called "classic examples of white-coated and white-collar crime." PMA president Gerald J. Mossinghoff said that the statement by Sidney Wolfe, M.D., director of the Public Citizen Health Research Group, was "outrageous and totally unsupportable."

Wolfe presented half a dozen examples to support his charges, several of which he said came from M.D.s via the "Doctor-bribing Hotline" -- (202) 872-0320 -- he started last year. They included:

* Wyeth-Ayerst Laboratories' awarding 1,000 frequent flyer points on American Airlines to doctors every time they prescribed Inderal LA and filled out a short form about the drug's use and the patient (50 Rxs brought one free trip);

* A Hoffmann-La Roche salesman's offering a Florida doctor $1,200 for information on 20 patients prescribed Rocephin. The doctor calculated the task would take him about 80 minutes;

* A consortium of 10 firms' offering M.D.s $35,000 worth of computer equipment that allowed the firms to monitor prescribing practices. The doctors agreed to watch up to 32 promotional messages a month and answer a "clinically oriented" question about each.

Response rated: "So the companies not only find out what drugs the doctor is prescribing but can carefully monitor the response to the video ads the doctors are required to watch," Wolfe said. Sen. Orrin Hatch (R, Utah) accused Wolfe of "using isolated examples to tar an entire industry."

Daniel H. Johnson Jr., a Louisiana radiologist representing the AMA, told Kennedy that "physicians who are charged with patient care are not bought by anyone." But he also noted that "some research suggests that physicians may unknowingly be influenced by promotional techniques."

Wolfe said he had turned over information on the incidents and others to the Justice Department and the Inspector General of the Department of Health & Human Services. Kennedy said Wyeth-Ayerst, Hoffmann-La Roche, Abbott Laboratories, and Ciba-Geigy declined to appear to discuss the issues.

Roche later submitted a 17-page statement defending its record. It said in part that the money for the Rocephin studies is "intended to defray a portion of the study costs, which may include the acquisition of medication, payment for the services of nurses or research assistants, or to help defray the costs of a patient's medical stay and associated medical costs."

Pharmacy is not immune to similar attention from drug firms either, testified Arthur M. Zoloth, director of pharmacy and IV therapy at the Virginia Mason Medical Center in Seattle. …

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