It's been a few months since pharmaceutical companies announced last summer that effective January 2009, they would stop giving doctors branded coffee mugs, pens, paperweights, boxes of tissues and the like because "such items may foster misperceptions that company interactions with health care professionals are not based on informing them about medicines".
There's no free lunch either. Lunch may only be offered "in conjunction with informational presentations". There are supposed to be no more tickets to sports or entertainment events either, but I suppose a rep can give an "informational presentation" on their Blackberry during time outs and intermissions.
This won't decrease any health care costs for anybody. Next, we're going to hear about the need for a Promotional Product Advertiser bail out bill.
The voluntary code has notable companies who signed onto the ban, but I doubt those mugs or pens really did much to sway a doctor's prescription choice anyway.
Really, now. How many of you are going to buy Corona beer because the Corona rep gave you this sweet cooler that carries exactly 6 bottles of....Corona beer? Maybe you do buy beer, but you use the cooler for your Amberbock. Don't drink beer? It'll neatly hold a 6 pack of Crystal Light or your lunch - cool. ...but cool enough to get you to always buy Corona? I thought not.
No, those pens or coffee mugs didn't influence physicians' prescribing behavior any more than a free cooler will get you to buy a specific brand of beer. The physician is going to prescribe what will work for the patient. At the same time, I'd have to be naïve, and so would physicians, to think that regular tickets to sports events, concerts or theme parks wouldn't be effective in getting a physician to remember who gave them the swag. It's ridiculous to think paying a physician 150,000 dollars for a pharmaceutical company related speaking engagement would have no effect at all. We'd have to be morons to believe that if a physician only receives pharmaceutical company sponsored CME's (continued medical education units), they'd remain unbiased - they'd get Stockholm Syndrome or something like it).
According to the most recent data available from the national organization in charge of accrediting the courses, drug-industry financing of continuing medical education has nearly quadrupled since 1998, from $302 million to $1.12 billion. Half of all continuing medical education courses in the United States are now paid for by drug companies, up from a third a decade ago. Because pharmaceutical companies now set much of the agenda for what doctors learn about drugs, crucial information about potential drug dangers is played down, to the detriment of patient care.
Do trinkets have impact, yes. Get a physician to order a drug inappropriately? No. The ban on gadgets, meals and entertainment is a joke, I know several doctors who will miss the "free" pens.
While some doctors applaud the gift ban, others seem offended by the insinuation that a ballpoint pen could turn their heads. "It seems goofy to us; we like getting our pens," Dr. Susan B. Hurson, an obstetrician and gynecologist in Washington, said in a telephone interview.
Trinket expenses will be turned into "presentations" that are lavishly catered or held at an expensive restaurant. The physician will have to sit through the presentation, receive a qualifying CME to maintain their medical provider's license, then lunch will be served. How effective can a "voluntary ban" be? The ban doesn't preclude reimbursements for costs associated with professional meetings or CME's. Banning trinkets won't prevent GlaxoSmithKline from paying a physician $150,000 for a speaking engagement giving other physicians qualifying CME's. No, not very effective at all:
...some critics said the code did not go far enough to address the influence of drug marketing on the practice of medicine. The guidelines, for example, still permit drug makers to underwrite free lunches for doctors and their staffs or to sponsor dinners for doctors at restaurants, as long as the meals are accompanied by educational presentations.
It's bunk. Just like this pdf that gives you a lot of charts and references to research that says how helpful pharmaceutical reps are in helping doctors understand new drugs. It also references how there is no direct relationship between prescribing behavior and DTC (Direct to Consumer Advertising). Heh, if it didn't work, then why do they spend so much money on it? That's a lie, Consumer Reports documented that (sorry, not a direct link)
A new survey published in Consumer Reports magazine, 78 percent of the physicians surveyed say their patients have asked for drugs advertised on TV. More importantly, however, is the fact that 67 percent admit to prescribing the drug after patients ask for it. The report underscores the impact direct-to-consumer advertising can have on both patients and physicians. Consumer Reports urges patients to ignore the ads. Some doctors think that DTC drug advertising does have some value, since it informs patients of treatments or conditions they might not have known about otherwise.
(In a random observation, it seems that internet advertising isn't as effective as television advertising.)
The real issue is that drug companies spend nearly twice as much on marketing their drugs as they do in developing their drugs. In 2004 pharma gave doctors just under $16 billion in samples, obstensibly for poorer patients; but since underinsured and unisured people aren't going to doctors, they don't get the samples.
In their analysis of data from two market research companies, IMS and CAM, Marc-André Gagnon and Joel Lexchin (York University, Toronto, Canada) found that US drug companies spent US$57.5 billion on promotional activities in 2004, the latest year for which figures were available.
In comparison, the National Science Foundation reported that in 2004 the amount of industrial pharmaceutical research and development (including public funds for industrial research and development) was US$31.5 billion in the United States.
Does pharma propose anything effective such as transparency as to which physicians are working with them to get new drugs to market? How about just telling us who they are sending to professional meetings? I guess we need a congressional investigation as to which physicians and which medical societies partake of these perks.
No, pharma doesn't want any change that will hurt their bottom line. In fact, Pharma is gearing up to "work" with the Obama Administration and our new Congress. They want no interference with their profit taking. They don't want reimportation of drugs from Canada. They don't want anything really radical that could interfere with their profit seeking ways.
But...It's possible there could be either a voluntary or official DTC ban on new drugs. Neither the AMA or ANA support a complete DTC ban. Waxman's for a partial ban on new drugs.
Waxman (D-CA) told attendees at a Prescription Project conference in Washington yesterday that he would support legislation allowing the agency to ban ads for new drugs on a case-by-case basis for up to two years after approval.
"It is in these first few years of a drug's life that drug companies often aggressively market their products and engage in direct-to-consumer advertising," Reuters quoted Waxman as saying. "This increases the number of consumers exposed to safety risks of new products long before those risks are truly understood."
You can freep a poll on DTC advertising here.
Banning trinkets and demanding to know who pharma sends to conferences is a ploy that won't change our underlying problem that pharmaceuticals are priced beyond what the market can bear. Banning DTC on new drugs will save pharma money, but they won't be passing those savings onto consumers in the form of lower priced drugs. It won't change how the economy is preventing people from getting health care. It won't help the 40 million people who didn't fill their prescriptions in 2008.
How about doing something real? Something simple? ...like selling drugs in the U.S. at the same prices they are sold for in Canada? Do that and the excessive amounts of money spent on marketing will solve itself.