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Why do doctors interact with pharma reps

It is all about money

Based on the Congressional testimony of  Michael Wilkes, M.D., Ph.D. Vice Dean, Medical Education Professor of Medicine and Public Health, University of California, Davis in front of the Committee on Government Reform with respect to safety of Vioxx.

There are three reasons: 1) free food and perks, 2) doctors feel they deserve such gifts,
and 3) reps often fill a perceived educational need.

The power of free food is not to be overlooked. Doctors and trainees work long hours and often skip lunch. In community hospitals, academic medical centers, Veterans Hospitals and clinics drug reps bring free food. They also hand out promotional material and schmooze with the doctors. Sometimes the drug reps give a 15-minute presentation.  Companies often invite doctors to lavish restaurants to hear these presentations. Merck held such events often to promote their cox-2 inhibitor Vioxx and when asked about the cardiovascular dangers of the drug they downplayed any harm.

Doctors often perceive that they “deserve” these benefits since they are, after all, working long hard hours on behalf of their patients. Little thought is given to the huge cost that patients incur in paying for these meals and gifts that of course are part of the patients’ high drug prices.

A recent study in the Annals of Internal Medicine (Feb 2005) explains why older physicians are less likely to deliver high-quality care. Medical advances occur frequently, and the explicit knowledge that physicians possess may easily become out of date. Therefore, although it is generally assumed that the tacit knowledge and skills accumulated by physicians during years of practice lead to superior clinical abilities, it has been shown that physicians with more experience may paradoxically be less likely to provide technically appropriate care. This applies most particularly to prescribing drugs.  Doctors are aware that they quickly become out of date and seek easy ways to keep up to date. Pharma seeks to provide “a feel good” approach to learning about new medicines.  Unfortunately, the information they provide is insufficient to educate a doctor.

Comparisons between new and existing drugs are rare, and information is spun so as to make newer drugs sound far superior and safe. In fact, only a very small percentage of new drugs offer any substantial benefit over existing drugs.

Related articles:  Truth about prescription drugs  How to doctors come to know about new drugs?

Interaction of drug firms and physicians              Drug promotion to doctors

FDA panel members in Vioxx, Celebrex, Bextra hearings had financial ties to drug firms

Relationship of pharmaceutical companies and doctors    Patient safety tips

Impact on prescription behavior due to marketing by pharma companies

Overall impact of drug promotion and advertising on pharma industry

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