The Exubera Fanny Pack Is Perfect For…
44 CommentsBy Ed Silverman // September 27th, 2007 // 2:55 pm
Just about anything except Pfizer’s insulin inhaler. Ironic, isn’t it? You can put your other meds or a syringe in this fanny pack, but not Exubera. No, for that you would need at least a sturdy Timberland backpack. Doctors, meanwhile, can use this to take home a leftover sandwich from those CME dinners, or pack a healthy lunch to take to the ballgame. And we know who paid for the tickets, don’t we?
Pharma Giles
…er, what exactly IS a “fanny pack”?
I think it’s one of those expressions that has, er, somewhat different connotations between US and UK…
Ed Silverman
Hello Giles,
You wrap it around your waist and it stays in places thanks to a little buckle that snaps. You can actually adjust the pack so it rests on your tummy, along your side or on your tushy, which some call a fanny. Very convenient, unless you must carry Exubera with you.
Cheers
ed at Pharmalot
todd
Ed, we do know who paid for those tickets. Due to the current pharma guidelines we know it was not a drug company. Unless for some reason the rep wanted to pay for the tickets out of his pocket. Now, if it was a cardiologist, orthopedic surgeon, OB/Gyn, general surgeon, gastroenterologist, etc. I would bet on some sort of equipment or device manufacturer. You see they still do that sort of thing. I guess no one thinks of that one, still a little too obsessed with the drug industry, I understand.
Also, PLEASE take some time to talk to reps or docs about CME dinners. This is all about nothing. Most companies have cut out that budget as they are not getting anyone to come. Now you might give up a night with your family for a $50 meal, but the vast majority of docs will not.
Peter
Haven ye neer herrd o a sporran lad?
Ed Silverman
Hi Todd,
Well, I realize I painted a broad brush stroke with my parting comment. But as a recent example, I know someone who is quite close to a doctor, a specialist, and they were considering attending the US Open together. The doc chose not to go, so the other person went and took someone else (not me).
Where’d the tix come from? A drug company sales rep. I have a very good source here, but unfortunately can’t name names. (I live and work in suburban NJ, and so I’m surrounded by all manner of people who are in pharma or interact with pharma in some way).
I’m aware that CME dinners aren’t generally as popular as they once were. In fact, sales reps complain they’re often having a harder time getting their docs to show up. But it’s not as if dinners don’t take place anymore, either.
In any event, I understand your point. But those pharma guidelines don’t have the force of law behind them. Stuff happens.
But thanks for taking the time to write. It’s good to hear from you.
ed at Pharmalot
todd
no, not the force of law. But I would be willing to bet if this is a major company - signed up on the pharma guidelines - a quick call to the home office to tell your story would have a big impact. 1 person getting fired for 1 ticket to a game has a ripple effect and I can bet that anyone who “heard what happened to Sam” would never put themselves in that position.
Stuff does happen - people break rules their company signed on to, they get fired. Simple as that. If no one reports, this just repeats and we have our non-reporting selves to blame.
These are our rules, we signed onto them, we know the consequences.
CME dinners do happen, but have very little impact. Any doc wanting to go, isn’t one you want to see. Now if real docs show up - that is because you are actually providing something of value.
todd
So did you straighten out the company violating the rules?
Ed Silverman
Hey Todd,
No, the name of the company wasn’t shared. Unfortunately. It would’ve been fun to have learned the details, but this person didn’t want to share, given that a personal relationship was involved - and knowing what I do for a living. But get me a good example with details and we’ll see what happens :)
Cheers
ed at Pharmalot
MD
Hey Todd,
A call to the big house would have resulted in sweeping more crap under the carpet or stuffing more skeletons into the closet. Whenever there are ethical issues, they’re just buried.
I’ve been there and it disgusts me.
MD
todd
Ed,
That is my point - people can say “Yeah, they got me tickets”, but I don’t think it happens much anymore. One, they don’t get reimbursed, so then you are essentially “treating” the doc to an event on your own dime - not sure if that is illegal. Might be immoral by the doc to take advantage, but if it is a genuine friendship, I don’t know if I would scream foul.
Two, we all know we WILL get fired. There isn’t a warning, they pick up your computer and you are done. For instance, if I tried to turn in a receipt for the KC Chiefs football game on Monday, not only wouldn’t I get my money back I would get a pink slip on Monday afternoon. So if someone is somehow fradulently getting reimbursed for entertainment expenses they have broken two rules — Expense reporting fraud and Pharma guideline violation. Neither will get you put in jail, but either one will get you fired. I think most reps are not going to risk their good job and benefits to do something dirty to make an extra $100 in bonus. The risk/reward benefit is not in your favor. Reps are not stupid. Believe it or not, pharma companies do not accept ATM receipts for expense reports. You have to have an actual receipt from an actual company.
But seriously if anyone has any proof - real proof that a pharma company actually paid for tickets to any entertainment event please provide the details. Until then, I am going with bragging and misinformation. Who doesn’t like to think that they are so important someone was willing to do something unethical for them. Given some physicians and their egos, I find that a possibility. Also, given this doc knows what you do, maybe he was just “feeding you a story” to make you happy or see your reaction. Physicians have insecurities and relationship issues just like the rest of us.
Maryland - been there, done that — I am guessing that was years ago, because I don’t see anyone willing to do it today. I know my company would sweep you under the carpet before an ethical violation. And since so many companies are now under COI, I don’t see anyone sweeping anything under the carpet.
Maybe I just work for one of the ethical companies, but it seems now to be more the rule than the exception
Lori
I have seen Product Management get a friendly third party vendor to pay for perks, in addition to internal Christmas parties, etc. They set up a large $$ contract with flexibility, then had the third party vendor cover these expenses under their contract. Product Management was always the one to sign off on the invoices, and vendor provides minimal documentation so it was not easily traceable. And this was a company with a reportedly strong compliance program. Just one option used for getting around those regulations.
Ed Silverman
Hi Todd,
I’ve told you all I can about this episode. I don’t doubt your sincerity about what you believe would occur at your employer, and that sounds like it would be a good thing.
One point of clarification, I never said the info came directly or entirely from the doc. But I can’t get into further detail, unfortunately, because I don’t want to compromise anyone.
In any event, I appreciate that you care about as much as you do.
Regards
ed
todd
Lori,
Yes, people can get around rules if they really want to break them. But do you really think a street level rep can get that done. They are not writing large contracts with vendors, they are turning in $100 Applebee’s receipts.
If you are in a management position or with authority to get big deals like that done, then you have extra temptations and hopefully extra oversight as well.
I am not doubting that someone could get it done. Honestly I do not know anyone in my position that would do it. And to have it sound more like the rule rather than the exception is what I am trying to fight. In the current environment, there is much less incentive on sales. It is now more of a salaried position. There is little monetary difference in doing an outstanding job vs. an ordinary job. That takes most of the incentive to do under the table things away. Then, most companies are good at discovering this type of behavior or at the very least not reimbursing for it.
I think in every territory around, we all know of at least 1 doc working for the FDA to record reps and their details. They are then paid a bounty for turning in off-label behavior. So knowing that is out there, no incentive for doing the “gray area” behavior, I don’t believe these stories.
Now if it is about an equipment or medical device rep - then I do believe it. They are not signed onto Pharma, get huge commission and have the incentive to maximize sales.
The pharma reps out there want to do their job, get home and see their families and honestly not have to kiss up to a doc until the next day. They are supporting their families, just like you. Doing the best they can to make it for their families, and when people perpetuate stereotypes that happened years ago it is upsetting.
Lori
> we all know of at least 1 doc working for the FDA to record reps and their details. They are then paid a bounty for turning in off-label behavior.
Nobody from the FDA is paying docs to turn in off-label behavior. There are physicians who participate in message recall studies, but these studies are typically conducted by or for pharma companies.
todd
You are wrong Lori, of course in my area there was incredible Cephalon off-label activity so maybe that is not the rule for offices across the country.
But I can personally take you to 3 different offices and point out the small cameras and microphones hidden. We can then look at the documents and see where the Cephalon information came from. Then you can tell me if I am wrong. Where do you think the FDA gets the info on off-label marketing. The majority of people are just like Ed described above. They want to tell you the system is broken and people are breaking the rules, but don’t want anyone to get into trouble so they aren’t giving up names or companies. They have discovered docs like money and bounties on off-label activity gets then this info.
Let me know, happy to take you on a field day and show you what is really happening out here.
Ed Silverman
Hi Todd,
Just a point of clarification. I always tell people I’d like to see the system improved. There are imperfections, let’s call them. I think that’s a worthwhile goal, and one can have a positive view of things and still want to see that happen.
ed
Donna
Todd,
If Lori decline’s the field trip offer, can Lisa and I go instead????????
todd
You guys would be disappointed. Just a nice guy trying to support his family. Doing things the right way to stay employed. Running home ASAP to see the kids and my wife. Not doing anything fancy, living the clean life in the midwest. I wouldn’t do any off-label promotion, pay docs, or anything that you guys would love to report.
A simple guy doing what he can to provide for his family. But thanks for the offer of company — I am just guessing my company would not want be thrilled to have LVS in their company car. They are scared of lawyers.
Lisa Van S
Todd,
“I am just guessing my company would not want be thrilled to have LVS in their company car”
I have to take that as a compliment!….It brought a smile to my face.For the record,..Im not crazy about Lawyers,.They too, have a tendency to be shady!!!!….
It was a beautiful day in our Nation’s Medicine Chest, and to those who are interested,..my meeting went exceptionally well.
A little advice to those who where interested in my meeting,..May I suggest that sometimes,..Somethings,….are just better left unsaid!!!…….
Donna
Todd,
Bummer on the field trip….By the way how did you find out where the videocamera’s and microphone’s were hidden??
todd
Donna,
Oh yeah, when you know where to look you can find them. But again, that was Cephalon, not my company. I am proud to work for a good company with good policies and that would never be an issue for me. But it is always good to know as well. Just in case you are ever thinking of jeopardizing your family’s stability, you know not to do it there.
Any doc who invites you into his office to talk draws an immediate red flag. Look around close enough and you see the audio equiment. Look in the bookcase and see a couple of pin hole type cameras hidden between books. Once the Cephalon stuff broke and it was thought this might be the source, it just took some looking. So it really wasn’t rocket surgery - just being alert and smarter than the average rep. Not sure if this was simply a sting for Provigil marketing, but the cameras are still up. You still get invited back to his office for sample signatures. If you want to see me more than I want to see you — something is very wrong. So I assume it is an ongoing thing.
Lisa Van S
todd,
Industry could offer me a consultant position…
todd
LVS,
You are talking to the wrong guy. You know plenty of upper level execs, on a much higher level than I. If no one has asked you to come aboard yet, I guess you will have to find a way to survive on what you got from the industry.
Lisa Van S
Todd,
Nice attempt at the dig!!…
Never received a dime from industry…Just ask GSK….
Bob
Lisa, you, as a consultant?
I picture a cafeteria worker or a janitor…
Lisa Van S
Bob
Cafeteria Workers and Janitors are honest, hard working people.
Displaying your prejudice,..for all to see, doesnt do you any justice….
Donna
Bob, that was mean, we all start some where, you ever have someone,try to kill themselves.???curious let me know..
Bob
Donna-I used to be a social worker around the seriously mentally ill.
People need to take some responsibility. Paxil or Zoloft does not make someone kill or try and kill themselves. It’s naive, and it’s a way to not accept responsibility for one’s actions.
Pump me full of Paxil. I can GUARANTEE I won’t harm myself or do harm to others.
Donna
Dear Bob…pump yourself full of Paxil and let me watch……..PLEASE…you will most likely surprise yourself with whatever you end up doing….ever been there Bob?? oh and ps. do you know anyone who has tried or suceeded at suicide while on an antidepressant, well i do, 1 sucessful and 4 attemp’s, alot for one person would’nt you agree, and where do people take responsibility,us or the doctor’s.? Bob quit your job on Monday and someone will be in your seat on Tuesday..
todd
Donna,
You don’t have to take this. I hope you get over your loss, if possible. I can’t imagine the pain. Good luck with everything!
todd
LVS,
The only information I know is from the 5/8 story on Angry Mom goes to Washington. With this cut and pasted :
“Her family later filed and setted a lawsuit with Glaxo.”
So if you made the decision to settle for $0, I understand why you don’t like lawyers either.
I don’t work for GSK, and my company doesn’t have a psych med so I really don’t care. But if you are curious as to why that perception is out there, it is because we are loyal pharmalot readers.
Bob
Donna-
People who take Paxil are on it for a reason: there is some type of mental disturbance. Suicide or rage just happens to go hand in hand with that on some people.
Look at it this way: if your theory were correct, everyone on an anti-depressant would do something bad.
Why don’t they?
I’m sure I’ll hear crickets chirp.
Just sue somebody, and I’m sure that will make you feel better.
Lisa Van S
Todd,
Suit was filed on behalf of a Minor Child…
Nice try anyway…
Laurie
OK, everyone lets all just agree with Bob. He knows more than the FDA, Columbia researchers and the MHRA. Those warnings are just for giggles among social workers. It’s the attitudes like Bob’s that are providing therapy and support for the mentally ill. It all makes sense now. Don’t listen to any reports from your patients, don’t look beyond the “diagnosis” for answers and don’t get information from a source that doesn’t have a marketing firm behind it. Just deny all and any side effect as a ploy to start a lawsuit. This is what those that are truly mentally ill are dealing with..how sad.
Lisa Van S
Laurie,
You go Girl!…
Bob
Sue-happy 1 and sue-happy 2,
I’m not denying any side effects. You two are two of the most naive people I know.
You’re messing with brain chemicals…of course there ar chances for side effects.
However, taking Paxil does not make someone kill themselves, carve themselves up, or kill anybody.
Keep on crusading, keep on suing. Maybe, if you were…Eh, nevermind. I’ll save that one.
Laurie
“You’re messing with brain chemicals…of course there ar chances for side effects.”
But only the ones that you agree with…..those that you don’t agree with are all for lawsuits. And as for crusading…you bet your *** I will. Because left to the system that you are a part of, the children don’t have a chance. So I will continue to do what I do, on my own, without pharma funding.
As for “pumping you full of Paxil”….I wouldn’t even wish that on you..
Lisa Van S
Laurie.
If you and are are sue happy 1&2, then I guess the States AG’S are 3,4,5,6,7,8 and so on.
Pretty good company if you ask me…
todd
LVS,
Someone got paid in your family - that is really all I know. You might start making that distinction in the interviews. Because when I read that, I immediately think that you are greedier than the drug companies.
So how does everyone feel about Sinead O’Connor and her comments recently. How she had suicidal ideations until she was diagnosed bipolar and started on mood stabilizers and antidepressants. She notes she is not perfect, but definitely feels better.
Laurie
How does a lawsuit change the facts of the drug reaction? There are thousands of ssri users that settled in lawsuits,.does that mean they weren’t harmed by that drug? Lawsuits are filed when there has been injury due to neglect or misinformation, which is the case with these drugs.
It’s a nice try to discredit the patient, but companies don’t settle with people who have not been injured.
I’ve never denied the reality of mental illness. But the fact that some benefit from these drugs, or combination of drugs, doesn’t change the fact that some have been harmed.
My goal has always been and always will be full disclosure of risk vs benefit, and a fully informed patient. From there it’s up to the patient to make the decision for themselves. If they decide to take these drugs that is their choice. But they should make that decision knowing what adverse reactions and side effects to look for. Pretty basic medicine.
Lisa Van S
Todd
“You might start making that distinction in the interviews.Because when I read that,I immediately think that you are greedier than the Drug Companies”
Maybe you should enroll yourself into a Reading Comprehension class at your local college.
Maybe you should go back and read it again!!!!
You will notice that “I wasnt quoted”….
Maybe you should have made a “distinction” between a “QUOTE”
and a “REPORTER’S COMMENT”
todd
perception is reality. I bet I am not the only one who made that assumption. An old saying in college ” I’ll take the time when I care” applies.
I really don’t care about this arguement, I was commenting on completely different topics, so I will drop it and start reading better.
So I apologize, you didn’t get millions, your FAMILY got millions. My bad.
Lisa Van S
Todd,
“I’ll take the time when I care”
You summed yourself up, quite well!!
There’s always Ambien for those sleepless nights.
Carpet Boy
Carpet Boy…
…