Originally published at: https://boingboing.net/2019/12/20/duh-but-good.html
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a cheap pen engraved with the name of a drug serves as a reminder to prescribe.
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Whoocoodanode?
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I mean it’s pretty self-evident that the Pharma companies have always believed this to be true or they wouldn’t be spending that money to begin with.
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The system works! (Unfortunately…)
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I know a doctor who still kicks himself for once taking a free $20 lunch at a hospital from pharma company – the only freebee he’s ever taken in a 30+ year career. He thought it was some other meeting and was half way through eating when a pharma speaker started up. So he disclosed it and it’s in the database.
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A previous employer once switched insurance providers, and the new system was so bad that it was far easier to go to urgent care clinics than try to schedule appointments with a PCP. I discovered that urgent care centers are propped up by pharma companies and just shovel meds all over the place. I remember once going in for a physical and casually mentioning that I’d been having a bit of insomnia, and the nurse/tech just handed over a bottle of Ambien and a package of Zoloft and said “these will help”. (spoilers: they didn’t)
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What this study did not show is that patient care suffered one iota from free pens.
We live in a pharma world where me-too drugs abound. Docs make a choice of therapeutically-similar drugs every time they prescribe. When docs see reps they get more than free pens. They get thousands of dollars of free samples which many patients desperately need. They get (hopefully) useful medical and insurance coverage information about the drugs they select. It is not surprising they might choose a drug they are more familiar with, or have more experience with, or have more samples of, or know whether it is covered by the major plans, rather than something else. The question is whether this is a bad thing or not. I daresay most of the time it is a good thing.
Nota bene: I used to be a pharma rep. And I can tell you when I would visit my daily quota of pharmacies, and talk to the pharmacists about patients having problems with the drugs I repped, it was always problems with docs that refused to see any reps. They made dosage, drug interaction, efficacy mistakes.
This cuts both ways.
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This strikes me as a bit disingenuous, as if free pens are the only incentive given out to doctors by pharmaceutical companies. Additionally, even if the medical outcomes were to be the same (which is not a claim you actually make since, presumably, you don’t have any overall proof to that effect) that doesn’t take into account the financial outcomes for individual patients, and the healthcare system as a whole, of doctors prescribing expensive drugs under the influence of pharma reps.
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“More than one in five doctors who prescribed OxyContin under Medicare in 2016 had a promotional interaction with the drug’s manufacturer, Purdue Pharma. The company did not respond to a request for comment.”
In other words, ~80% of the doctors proscribing did not have any promotional interaction. So, by a large majority, doctors proscribed without any promotional interaction anyway?
That quote is incomplete. How much oxy did the different doctors prescribe?
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Shocker.
I’m sorry, but I am one of those doctors who refuse to see or deal with pharma reps. Any doc relying on their reps to determine dosing or specific meds is an idiot. You are right, there are gobs of “me-too” meds out there, but you what else is out there? Gobs of generics, which do not get a rep in the office and do not cost nearly as much. I don’t prescribe brand name drugs unless there is no choice, which is vanishingly rare, or if the patient’s insurance requires a branded drug, which offends me but I am not going to stick the patient with the bill for my ethics. I would like to see evidence to back your statement, because i am calling bullshit. I will happily recant if there is such a study, but I seriously doubt such a thing exists. If it did, pharma would trumpet it from the rooftops.
Edit cause I type bad
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The “Who’s Your Daddy?” pen.
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There’s enough of this stuff out there that I could post them all day long:
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What we need to do is remove the ability of the pharma companies to find out what the doctors prescribed. If it’s payoffs we will see a drop in prescriptions. If it’s information there will be no change.
Note that there is an innocent explanation beyond what the pharma rep above said about me-too drugs: Pharma reps mean samples in the drug cabinet. That means a doctor can give a patient some from the cabinet to see if it works for that patient.
