If The Patient Only Knew…
2 CommentsBy Ed Silverman // April 9th, 2007 // 8:59 am
Gene Carbona, a former Merck sales rep, now runs The Medical Letter, the non-profit that evaluates drugs in its newsletter. As part of his job, he gets to view prescribing trends and physician behavior. Here’s what he says about the danger of doctors becoming corrupted by gifts, dinners and the like from sales reps:
With an estimated 100,000 sales reps working doctors offices in the US, “each one of those 100,000 reps usually calls on eight to 10 doctors a day. That’s 1 million discussions a day,” Carbona notes.
“Patients don’t know, and they definitely should care. The physician has a fiduciary responsibility to the patient. If patients knew that their doctor put them on a very expensive arthritis medication that’s going to break the bank because they have a relationship with a drug representative that takes them to dinner or the theater — and there is another drug that costs $15 a month — I don’t think they’d still have that doctor as their provider.”
Maybe. Of course, most patients have no idea. And that’s why the practice, in various forms, continues. Doctors complain such items compensate for lost wages in an era of managed care, but this behavior existed long before capitation, didn’t it? And there’s nothing to require any doc to disclose such ‘gratutities’ to patients is there? Lucky thing for the sales rep.
Further reading…
The complete story in The Tennessean;
The Medical Letter.
Hat tip to PharmaGossip.[tags]Freebies, Sales Reps[/tags]
Pharm Aid
This is a great discussion. When presented, the choice is always between the “really expensive drug hawked by the evil reps” and “the really cheap and ALWAYS equally effective generic.”
It’s never this black and white. Does the patient have a dosing preference? Is the patient willing to take 3 or 4 pills a day instead of 1? Or how about a 2 pills a day vs. one a week?
The anti-pharma crowd needs it to be black and white. Unfortunately, reality is never as simple as what they twist it into.
ed
Hi PharmAid,
That’s very true, agreed. There is a simplistic tendency to boil things down to a black-and-white argument on these topics.
But can all that explaining about dosing, titration and compliance be done without introducing the tchotchkes, lunches and other freebies into the picture? Isn’t that the issue these guys raise?
I thought so. That’s why I threw this up there. Just because a drug and a rep is from a brand-name company doesn’t make either bad. But the freebie stuff, well, that can be problematic. And doctors are part of the problem if they’re not part of the problem, by the way.
My two-and-a-half cents.
ed