1. jsinger on June 29, 2004 11:14 AM writes...

Absolutely.

At the same time, I don't quite get why the pharma companies get blamed for all their incentive marketing while doctors get to play the heros. Hello! Perhaps you guys could stop _taking_ bribes and letting them influence your prescriptions?

2. Gil Roth on June 29, 2004 3:43 PM writes...

My first thought when I read the article on Sunday was, "If you're going to engage in such awful practices, couldn't they at least have some positive effect on the bottom line, the past few years?"

Keep in mind, I actually (well, tangentially) work in the pharma biz.

3. fin2ut on June 29, 2004 5:19 PM writes...

I would be curious as to how you think such flagrant violations develop. The excesses in this case sound Simpsonian (cue Mr Burns), but we both know that those ultimately responsible are some pretty savvy folks, & oftentimes pretty decent folks as well. Well, OK, maybe just pretty savvy. What kind of mental/institutional calculus takes place to lead to such decisions?

4. otey on June 30, 2004 8:13 AM writes...

There are other abuses that are harder to detect. I know of several golf junkets to very expensive courses that must have cost in the tens of thousands. My guess is that these trips, though they put no cash in the hands of doctors, were more effective "marketing" tools than the money handouts.

5. qetzal on June 30, 2004 11:27 AM writes...

otey (or others) - when did those junkets take place?

I was under the impression that big pharma pledged to stop doing such things, as of a year or more ago.

I can add that I have relatives who are drug reps for a major pharma. A few years ago, it was common for them to organize things like fishing trips with groups of docs that prescribed the drugs they repped. Or dinners, or what have you. Nominally, these were supposed to involve "education" about the drugs, but many people argued (with some cause) that they really just amounted to non-cash incentives to keep prescribing the drugs.

I understood that this was common practice among most/all the big pharma marketing groups, with no particular attempt to conceal it.

Then the big pharmas announced that yeah, they could see that maybe those events might seem to be a bit questionable in the ethics dept., so they were going to voluntarily cut it out.

I do know that these relatives were given strict new rules by the higher-ups. They still organize educational seminars, etc., on their drugs. And they may still provide meals at these seminars (I'm not sure about that), but it sounds like these are now pretty clearly real educational events. I.e., no more fishing trips, golf junkets, ski-weekends, whatever. Mostly sitting there listening to presentations about the drugs, and maybe getting to eat a mediocre meal while they listen.

Of course, this is just a couple of reps in one territory at one pharma. That's why I wonder if the golf junkets you mentioned were recent.

6. small pharma rep on June 30, 2004 6:58 PM writes...

Dinners are still going on (and at the best restaurants, definitely not mediocre). Spouses are not able to attend, however Office Mgrs. are allowed. If golf junkets are going on , they are either a rep getting phony receipts, to cover himself, or one of the handful of companies who have not signed the PHARMA code. Speaker training is one way to get around the code, this involves giving docs a trip to learn how to deliver a lecture. The doc than gets 500-2000, to deliver lectures on a regular basis. The docs tell me that this just makes up for what they used to make before managed care started cutting the reimbursements. I have been to numerous offices which have a check, from an insurance company, for 1 cent, framed.

7. otey on July 1, 2004 8:34 AM writes...

One golf junket I know of was two years ago. I know about it because they asked me to fill a spot at the last minute. I am not an MD, by the way, but a good friend of the MD's that went.