We can attempt to teach the things that one might imagine the earth would teach us: silence, humility, holiness, connectedness, courtesy, beauty, celebration, giving, restoration, obligation and wildness.
David Orr from "Earth in Mind"

Mar 29, 2007

The State of the World; Pharmaceutical Companies

Lately I have been wondering about the state of our country. I don't mean the environmental crisis or international politics but more the ability of many of it's inhabitants to completely ignore those and other issues. As a public radio listener I live in a fairly well informed bubble. I am aware that most people, at least in USA, get their news from the TV evening reports who spend more time on local eye catching tragedy than global issues. I think the problem goes beyond the lack of real news, it has more to do with people in this country having more concern for their own status than the greater good.

I over heard a disturbing conversation the other evening. [I won't say where I was] But there were two guys, both drinking discussing the benefits of certain house remodels. Then the conversation shifted to where one was bragging about his girlfriend's job. (this is a general retelling)
"She gets 70,000 a year just wine and dine the doctors," he says. "Like going out for meals with seventy dollar bottles of wine and stuff. I mean this money is just to use to persuade them."
"What else?" the other guy is impressed. "Well you see she doesn't work for one of the big companies like Merck or anything so I guess it isn't a lot but it's seventy thousand dollars to spend plus they pay her like 300,000 for doing the job."

I stopped listening after that. I'm not sure what part of that information is more disturbing, that a sales person for drugs makes 300,000 dollars or that she has 70,000 dollars to spend on persuading doctors to use the drugs. I guess I thought that was illegal. But either this guy was being stupid and telling his friend something that was or or it isn't. Even if it isn't I'm upset that drugs are subject to being sold to the doctors that way. When I go to the doctor I would like to assume that her diagnosis and treatment for me is decided because of what is best for my situation not because she was wined and dined by a sales person to promote their pills.

Not only is the idea of medicinal sales disturbing but the fact that this guy thought it was very cool that his girlfriend had 70,000 dollars to spend on things like dinner and skiing to get the doctors. In fact he must have mentioned the 70,000 number four or five times during the conversation. What ever happened to the medical profession focusing on the well being of humanity (the other guy was still in his scrubs so I assume he worked in some sort of medical field).

I am not ignoring the fact that there are doctors, nurses, and other practitioners who spend their lives helping people who truly need it. But they seem to be more and more in the minority. But things get more confusing when you add to the equation that doctors are not all making as much as they used to, not since the advent of managed health. I thought that HMOs made lists of what medicines that they would pay for. So what is the goal of the sales people with the doctors? Yes they have a population who is no longer the pinnacle of earning in this country offering them "things" but these doctors also have less control.

What about the ethics? These sales people don't have any commitment to the patients but the doctors do, how can they be doing the best for their patients if they are being bought to suggest one pill over another? Can they really be looking for the best treatment for their patients or their pockets?

I found this group called No Free Lunch who are a group of doctors who:

We are
health care providers who believe that pharmaceutical promotion should not guide clinical practice. Our mission is to encourage health care providers to practice medicine on the basis of scientific evidence rather than on the basis of pharmaceutical promotion. We discourage the acceptance of all gifts from industry by health care providers, trainees, and students. Our goal is improved patient care.

We aim to achieve our goal by informing health care providers as well as the general public about pharmaceutical industry efforts to promote their products and influence prescribing; provide evidence that promotion does in fact influence health care provider behavior, often in ways that run counter to good patient care; and provide products that can replace pharmaceutical company paraphernalia and spread our message.

We believe that there is ample evidence in the literature--contrary to the beliefs of most heath care providers--that drug companies, by means of samples, gifts, and food, exert significant influence on provider behavior.
There is also ample evidence in the literature that promotional materials and presentations are often biased and non-informative. We believe that health care professionals, precisely because they are professionals, should not allow themselves to be bought by the pharmaceutical industry: It is time to Just say no to drug reps and their pens, pads, calendars, coffee mugs, and of course, lunch.

We hope to serve as a source of information, inspiration, and assistance for those who are trying to rid their practices, institutions, and colleagues of promotional influence. We provide a forum for the exchange of ideas as well a way to connect and work together with others who are concerned about this issue.

It seems that I should give more doctors credit for working for their patients and against the pharmaceutical companies methods. This is reassuring to me, especially as we embark on our business plans in the world of complimentary and alternative medicine.

Still the fact that people involved in such important things such as medicine and drug creation should be focusing their efforts on helping all the people of the world. Not just through affordable medicine but through health education. Imagine how much could be done just with one years marketing budget.
"Drug companies spent another $27.7 billion on promotion, including $15.9 billion on free drug samples and $7.3 billion on sales-rep contacts (free lunches and pens), $4 billion on direct-to-consumer advertising and $500,000 on journal advertising..." Newsweek.

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