PAYOLLA: YOUR DOCTOR AND THE PHARMACEUTICAL INDUSTRY

On Monday, 21 March 2007, The New York Times printed a front page investigative report titled, “A State’s Files Put Doctors Ties to Drug Makers on Close View”. And now, for the first time this ugly, closely guarded secret was revealed to the public by a prestigious journal. This is, at the very least, what I would call an earth shattering revelation! This concerns both legal and moral issues for many many doctors throughout the United States (every state included) who are taking huge sums of money from the Pharmaceutical Industry in exchange for recommending their drug products.

We are NOT talking about doctors taking millions of dollars from the Pharmaceutical Industry, but rather, we are talking about doctors TAKING BILLIONS of dollars, that’s right, TAKING BILLIONS of dollars from the Pharmaceutical Industry in order to insure that these doctors will strongly, vigorously and in many cases downright demanding that you, their patients follow their recommendations to purchase a specific pharmaceutical manufacturer’s products. This relationship between these thousands and thousands of doctors and the drug industry is by any other names a PURE CONFLICT OF INTEREST, QUESTIONABLE PERSONAL ETHICS, and by every common standard, it is PURE PAYOLLA.

The New York Times research pointed out that these payments to doctors take the form of so called “research grants”, “educational programs”, “consulting fees” and “speaking fees”. One prominent Minnesota doctor (just one of many) received in excess of $1.9 million from Amgen who by chance, manufactures the most expensive drugs used in the treatment of kidney disease. And this particular doctor just happened to be a kidney specialist. And just so our readers understand, this doctor resides in Minnesota, the first of a very small handful of states that are just now starting to pass laws that require drug makers to disclose payments to doctors. The official records of the State of Minnesota showed that between 1997 and 2005 health care providers (mostly doctors) received $57 million in payments from the drug companies! And keep in mind that
Minnesota has a total population of only 5,132,799 habitants which represents just 1.7% of the population of the United States. Can you imagine if the drug companies are paying the health care providers (principally doctors) in excess of $57 million in just Minnesota and in fact, Minnesota represents less than 2% of the total population of the U.S., how much are they paying to influence all of the doctors in the total United States?

CONFLICTS OF INTEREST

“In dozens of interviews”, the New York Times reported, “that most doctors said that these payments had no effect on their care of patients”. But, research clearly shows that doctors who have close relationships with drug makers tend to prescribe more, newer and pricier drugs – whether or not they are in the best interests of the patients.

When honest human beings have a vested stake in seeing the world in a particular way, they are incapable of objectivity and independence said Max H. Bazerman, a professor at the Harvard Business School.

A doctor who is a kidney specialist at Washington University stated that he was troubled all of these payments to doctors and especially the payments to the National Kidney Foundation. “The Foundation’s recent pro-industry anemia guidelines – the revisions due out next month – have to be viewed with great skepticism.”  This doctor recently wrote an editorial decrying the guidelines written last year by the National Kidney Foundation that encouraged doctors to use more Amgen drugs to treat anemia in kidney patients despite studies showing that this increased use led to MORE DEATHS.
Oh! By the way, the same doctor who is noted in Paragraph 2 above, is the same doctor who accepted $1.9 million from Amgen for kidney research and who was instrumental in writing the soon to be released guidelines for the National Kidney Foundation. Talk about CONFLICTS OF INTEREST!

CONFLICTS OF INTEREST UNKNOWN TO MOST PATIENTS

The New York Times research found that doctors in Minnesota said that they generally did NOT tell their patients of their personal arrangements with the drug companies. Indeed, few patients were aware of the financial connections between those prescribing the drugs (principally doctors) and the companies making them. And yet, a very recent New York Times / CBS News poll found that 85% of the respondents thought it “not acceptable” for doctors to be paid by the drug companies to comment [promote drugs to patients] on prescription drugs. Eighty-five percent also said that such payments would certainly influence the decisions that doctors made about patient care.

The fact of the mater is, influential doctors are hired by the drug companies to give speeches and talks to other doctors in return for payments. The drug companies “want somebody who can manipulate [other doctors] in a very subtle way,“ and in return for these payments, these lecturing doctors followed the gentle marketing pitches that adhered strictly to messages approved by the drug makers and federal drug regulators (The FDA for example, which is rampant with documented conflicts of interest).

The speech giving doctors said that the lectures were “highly educational” and that drug makers hired them for their “medical expertise and speaking skills”. But former drug company sales representatives said that they hired doctors as speakers mostly in hopes of influencing THAT doctor’s prescribing habits.

“The vast majority of the time that we had any sort of paid relationship with a physician, they increased the use of our drug,” said a former sales representative with Bristol-Myers Squibb and Johnson and Johnson. “I hate to say it out loud, but it all comes down to ways to manipulate the doctors.”

A former sales representative for Pfizer and Eli Lilly said that drug makers seduced doctors with escalating financial inducements that often start with paid trips to “learn about a drug.” “If a doctor says he got flown to Maui, stayed at the Four Seasons – and it didn’t influence him a bit? PLEASE!” the former sales representative said.

‘A SILENT QUID PRO QUO’

These lectures and trips earn doctors more than cash. “You’re making him money in several ways,” says a former Merck regional sales manager. “You’re paying him for the talk. You’re increasing his referral base so he’s getting more patients. And you’re helping to develop his name. The hope in all of this is that a silent quid pro quo is created. “I’ve done so much for you, the only thing I need from you is that you write more of my products.” The fact is, the number of drug marketing presentations delivered by doctors across the United States rose nearly threefold between 1998 and 2006. For drug makers, among the most prized consultants [doctors] are those who write the guidelines instructing their peers (other doctors) about how to use drugs.

This list of top “prized” doctors in Minnesota includes one doctor who served on government sponsored hypertension panels that create guidelines about when to prescribe blood pressure pills. Last year this same doctor served on the National Kidney Foundation panel that wrote guidelines about when kidney patients should be given cholesterol pills. Between 1997 and 2005 this doctor earned more than $798,000 from drug companies, according to records. In 2003 alone, Pfizer paid this doctor more than $231,000! Oh yes…in case you did not know, Pfizer markets Lipitor, a cholesterol drug that last year had $12.9 Billion in sales, more than any other drug in the world. Guidelines (such as those this doctor and his panels issued) that suggest greater use of these drugs would be a huge boon to Pfizer.

“Drug companies are like lions,” said this same doctor of his sponsored talks. “For lions, it is their nature to kill zebras and eat them. For drug companies it is their nature to make money. They’re not really trying to improve anybody’s health except if it makes them money.”

SUMMARY

Since the 1960’s when doctors began to lose their prestigious position on their imaginary social pedestals and the HMO’s came in and began to reduce the ability of doctors and hospitals to raise their fees 10% - 25% per year over the inflation level, doctors increasingly searched for other ways of augmenting their HMO reduced incomes. At this very same time, the drug companies were able to lobby Congress for changes in the strict protocol for the development of new drugs and thus, drastically reducing the time required to bring new drugs to market. This was a situation that was made in heaven as far as each party (the doctors and the drug companies) were concerned. The drug companies needed the doctors to promote their products and the doctors needed to recover the lost income. And year by year these two groups have become closer and closer. Today, we have a totally
unacceptable situation wherein the drug companies flagrantly overcharge our society because they can. They use this enormous excess cash to buy doctors and legislators as is now being conclusively demonstrated. This is being fueled by one thing and one thing only: Grossly exaggerated market prices being charged by the drug companies which are as much 550,000% over costs! With this enormous amount of excess cash, the drug companies are free to buy thousands and thousands of doctors every year and in every state in the U.S. And in turn, these doctors promote and sell the drug company’s products. This is the dirty secret which is now coming out and of which; both parties (doctors and drug companies) have done everything in their power to conceal from their patients and from the public.

I am a staunch proponent of the free enterprise system. But when the free enterprise system is flagrantly abused through the use of horrific greed as demonstrated by the drug companies AND their doctor puppets, there is a necessary adjustment that needs to be forthcoming.

As for the legality of the RAMPANT PAYOLLA taking place between the drug companies and the doctors, I am quite shocked and amazed that such practices are deemed “legal”. In the late 1950’s there was a “big scandal” that hit the record business. Disc - Jockeys were accepting payments for playing records. Several disc-jockeys went to prison and many lost their jobs. Congress jumped all over this “big scandal”. And yet by comparison with what we have in front of us today with what the drug companies and the doctors are pulling off “legally”, the disc-jockey “scandal” would be a lost drop of rain in the Sahara Desert. The fact is, this Doctor PAYOLLA SCANDAL is probably the worst scandal perpetrated on the American people in the history of our country.

Finally, let me make it clear that I do NOT believe that all doctors have been seduced and manipulated by the drug companies. There are many doctors who have simply said “NO thank you” and have gone on to develop excellent reputations and prosperous practices. Unfortunately, they are not always easy to find.

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OUR NEXT SEMINAR:

DIABETES PREVENTION and BLOOD SUGAR  ISSUES                    Wednesday, April 4, 2007 at Energia Body Centre in the Del Monte Shopping Center.   Naturopathy CAN Help you to Deal with Hypoglycemia,  Blood Sugar Fluctuations, Insulin Resistance, Obesity and Diabetes...and all NATURALLY!  Come to this informative Seminar and learn how.  Please call 831-642-0202 to reserve you place or, reserve by email to john@montereybaynaturopathy.com. Door Fee: $10.00.

The entire contents of HEALTH AWARENESS are based upon the opinions of Beatrice Levinson, Naturopath, unless otherwise indicated. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as an offering and sharing of knowledge and information from the research and experience of Beatrice Levinson, Naturopath within the U.S. and Europe. Beatrice Levinson, Naturopath encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.

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