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Are Doctors Being Bribed by Big Pharma?

Big Pharma has been required to reveal its payments to doctors and hospitals. You will be amazed at how much money drug companies spend on physicians.
Cash money bucket

We trust umpires, referees and judges because they are supposed to be impartial. They have strict ethical standards that are intended to prevent conflicts of interest. That’s why they are not allowed to accept money from teams or organizations they are overseeing.

Imagine for a moment that the umpire calling balls and strikes during the World Series was later found to have accepted gifts or money from one of the teams. There would be such outrage that organized baseball might have a hard time recovering.

Why Aren’t Doctors Held to Similarly Strict Standards?

No such concern exists when physicians take money from the pharmaceutical industry. Our doctor should be like an impartial judge, determining the best treatment for us based purely on the evidence and our particular health condition. Money should play no part in the decision to write a prescription.

Dialing Dollars for Doctors…600,000 of Them!

The federal government has started requiring the makers of drugs and devices to report how much money they pay to physicians and teaching hospitals under something called the Sunshine Act. The first full year of numbers are just in and they are shocking. During 2014 the industry spent roughly $6.5 billion on 607,000 doctors and 1,121 hospitals.

Let that sink in for a moment. Over 600,000 physicians were reported to have received money from either the pharmaceutical or device industry last year. That might not mean much until you factor in that there are less than 800,000 doctors providing patient care in the U.S. So, roughly three out of four physicians seeing patients took money from Big Pharma. Some took only a few dollars. Others received millions.

A big chunk of that money ($3.23 billion) was related to “research-related activities.” On the surface that sounds perfectly reasonable. Doctors should get paid to do cutting-edge research that will lead to important drug advances. What is not mentioned, though, is that a big chunk of this “research” is for medicines already on pharmacy shelves.

A Dirty Little “Research” Secret

Years ago a drug company insider told us a dirty little secret. He himself, although highly placed, was an ethical physician appalled at what he observed. He revealed that many of the clinical trials were not designed to advance science or discover new uses for old drugs. He disclosed that a surprising number of the studies were supervised and funded by the marketing arms of drug companies rather than the research side. They provided a sanitized system for Big Pharma to funnel money to doctors for research that was never intended to be published.

Many of the so-called studies were intended to “familiarize” doctors with expensive medicines. A doctor who believes he or she has helped contribute to the development of a particular medication is likely to feel that it is special. Participation certainly could influence a doctor’s judgment about a certain drug or pharmaceutical company. Given the choice of prescribing an older generic product or a newer and pricier brand name drug, some physicians might opt for the medication they had been paid to “study.”

Consulting Fees, Talks, Travel, Food and Lodging

The industry spent roughly $370 million for doctor consultations. Over $400 million went for travel, lodging, food, beverages and entertainment. In many cases doctors are incentivized to do the “dog and pony show.” That means they get paid a pretty penny to stand up in front of their colleagues and discuss the benefits of a particular company’s new drug at a nice restaurant. Last year the industry spent over $600 million on such “promotional speaking.”

Once a doctor gets the reputation for being drug company friendly, she may get hired by other pharmaceutical firms. According to a story (“A Pharma Payment A Day Keeps Docs’ Finances Okay”) co-published by ProPublica (July 1, 2015) and NPR’s Shots blog, one physician received over half a million dollars last year from 29 drug companies for consultation and speaking gigs.

What Do You Think?

We recognize that some drug company payment to doctors is justified. Real research is a time-consuming and important endeavor and doctors should be compensated appropriately.

Some doctors may be able to remain objective despite getting big sums from pharmaceutical manufacturers for consulting and promotional speaking. But if we expect referees and umpires to remain impartial and never accept money from the teams they are overseeing, then perhaps it is time for doctors to adopt similar standards.

When a physician examines a patient, makes a diagnosis and then recommends a course of treatment it should be determined exclusively on what is best for that patient without any potential conflict of interest. Although most physicians believe they do that every time they see a patient, research demonstrates that:

“Physicians fail to recognize their vulnerability to commercial influences due to self-serving bias, rationalization, and cognitive dissonance. Professionalism offers little protection; even the most conscious and genuine commitment to ethical behavior cannot eliminate unintentional, subconscious bias… In order to resist industry influence, physicians must accept that they are vulnerable to subconscious bias and have both the motivation and means to resist industry influence.”

The Journal of Law, Medicine & Ethics, Fall, 2013

We would appreciate your perspective. How do you feel about ProPublica’s “Dollars for Docs” data?

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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CAROL, from FL. where do you get this information about these doctors?

I know this for years, when a doctor insist to prescribe a very expensive and very dangerous medicine without telling you that can kill you…. is something wrong and makes you think about that doctor.

Will send this to everyone…over-medication and physician kickbacks are a travesty.

My local GP always tries to slip me the generic brand. I tell him to mark on Computer NOT Generic as most only have l/2 the brand ingredient cheap nasty adjuvants & are NOT long release.
I then told Pharmacist not to give me generics. Pharmacist says I must have generic as your doctor knows best. Hog wash- I told her the only reason he pushes generic is he has shares in the Generic makers and they also pay him $7 for each generic script.

I don’t trust rheumatologists anymore, I’ve seen around 8 of them and they all got it wrong. They only want to push the dangerous drugs. One rheumy did not recognize the cancer drug I was on could give infections bacterial/fungus. Sure enough it started eating both lungs with opaque round holes. He told me I was just negative to my medicine. Lost half a lung.

Biologic drugs are deadly and now lost several friends to them. Last year a Professor of rheumatology told me the lump over my lower spine was cancer and I needed 10cm cut surgery. I didn’t believe him and went to a Cancer hospital who confirmed I was right was not cancer but a rheumatoid nodule which goes away with cortisone injections. I have found SAMe Methionine helps and have started Turmeric/curcumin 600mg day. Australian rheumys get a free trip with family to the Mayo Clinic in USA each year via Aspen for skiing paid for by a big pharma so of course they prescribe their drugs. Some sales reps look like massage parlor girls with bits popping out of the blouse under their jacket last year one bought in 2 doz bottles of fine red wine to my GP and he gets a long weekend paid for to the golf country club too. Now getting paid $12 for each flu vaccine given.

Sad it is not doing us any good and setting them up for mistrust.
Medical Marijuana would help (while on it) my rheumatoid as it has for my cousin who’s traveling in Mexico this year.

Even though I am a retired RN,I keep up with current trends in medicine and pharmacology. My biggest pet peeve is the enormous cost of certain drugs (e.g.
the Hepatitis C drug which costs $1100 per PILL. The course of treatment is one pill a day for twelve weeks which brings the treatment total to over $90,000!)
I also find it unconscionable that Big Pharma advertises drugs on TV such as Pradaxa and Eliquis for which there is no antidote; if you take Coumadin, you can reverse the effects with Vitamin K but these other drugs cannot be reversed. For instance, if you are on these drugs and have a fall,it is possible to have a hemorrhage which cannot be controlled and can possibly cause death. There are numerous lawsuits in the pipeline
regarding this very situation. TV advertising is expensive and Big Pharma’s ads are deceptive; they show people having fun while in the small print they are listing horrendous side effects (which you cannot really read since they run it by so fast.)
Physicians should really abide by the Hippocratic oath and “First, do no harm”;
fortunately there are some great physicians out there, but you really have to do your homework to find them.

Completely fascinating report and website.

I have spent a good deal of time looking at ProPublica’s data and using their search engines, and it was very interesting to see how much money each name I searched had received from Big Pharma and medical equipment companies, and in what form. Doctors I had found questionable in their practices, and who prescribed drugs that turned out to be flat-out dangerous were big winners in the money market: doctors I had come to respect had taken in much, much less.

Frankly, I’m astounded that the “Sunshine Act” ever saw the light of day!

In the future — although I have increasingly avoided getting involved in allopathic medicine any more than my Type 1 diabetes absolutely requires — I will certainly check on any doctors suggested to me in the future by looking to see just how big their “takes” from Big Pharma are.

As an English and journalism teacher (centuries ago in high school) tried to tell me, “Follow the money.” Good advice then, and good now.

Pharmacists are also wooed and pampered by drug companies. The reps provide free lunches and free dinners, while the pharmacists sit and listen to the rep “talk up” their latest new drug offering, then they leave with gifts of free products (pens, tote bags, pill-cutters and other items) bearing the drug name. Pharmacists often influence prescribers concerning drug choices, especially in hospitals, so the companies want to get their drug name firmly imprinted on pharmacists’ minds, too.
Also, I’ve had a renowned specialist barely listen to my physical complaint during an office visit and then rifle around in his cabinet searching for a free drug sample he’d just been given for a medication whose name he couldn’t remember! He cheerfully said, “Ah, here it is. Try this,” patted me on the back, and that was the end of the visit. It’s a corrupt system and patients are the losers.

The best response is a presenter on your program a few weeks ago who said big Pharma is a another crime syndicate. They’re not in business to help people: stopping or slowing production on safe good medications people need–like cancer drugs, when a pill goes generic, replacing it with a more expensive pill, and jacking the price up on generics. And on and on.

Bribing doctors is just another version of their criminal activity. We checked our doctors’ income from pharmaceuticals and they ranged from $135 to $3802. We wondered if this figure includes samples, because that has helped us bridge when insurance companies balk at the high prices.

Congress is abetting this problem by not letting Medicare bid and push down prices, like the VA can do and does.

My doctor has retired now but was a good one that I hated to see go. He used to lean toward more natural cures and often told me to “go the natural route.” In his last few years however, he must have been accepting more advice (and maybe money) from ‘Big Pharma’ as he began pushing certain cholesterol meds. He asked about guns in the house and other questions he would have never bothered with before. Maybe the extra money helped him toward his retirement. I saw him as a friend as well as a doctor and he was good, but I’m sorry he ‘sold out’ in the end.

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