It's an open secret that the pharmaceutical industry spends billions marketing to doctors, deliberately misleading them about their products, raking in record profits that they shift into offshore tax-havens through legally questionable means, while lobbying for global treaties that benefit them at the expense of the sick.
Despite all this, doctors and their professional associations have fervently denied that the pharma industry's bribery and persuasion have any effect on prescribing, meaning that there is no reason to shut down the lucrative pipeline from drug companies to doctors.
A new, meticulously performed analysis by Propublica shows the definitive link between pharma "marketing" (which usually involves some roundabout way of giving doctors valuable things, from lunches to junkets to cold, hard cash) and prescribing practices. The blindlingly obvious (and now indisputable) conclusion: "Doctors who got money from drug and device makers—even just a meal– prescribed a higher percentage of brand-name drugs overall than doctors who didn’t."
The idea that people are influenced by gifts isn't new or controversial -- Sam Walton famously forbade his reps from accepting so much as a cup of coffee from their accounts, lest they form an attachment to the people they were supposed to be getting the better of through negotiation. It would be surprising if doctors, alone among humanity, were immune to this effect.
“I do prefer certain drugs over the others based on the quality of the medication and also the benefits that the patients are going to get,” said Dr. Amer Syed of Jersey City, N.J., who received more than $66,800 from companies in 2014 and whose brand-name prescribing rate was more than twice the mean of his peers in internal medicine. “My whole vision of practice is to keep the patients out of the hospital.”
Dr. Felix Tarm, of Wichita, Kansas, likewise prescribed more than twice the rate of brand-name drugs than internal medicine doctors nationally. Tarm, who is in his 70s, said he’s on the verge of retiring and doesn’t draw a salary from his medical practice, instead subsidizing it with the money he receives from drug companies. He said he doesn’t own a pharmacy, a laboratory or an X-ray machine, all ways in which other doctors increase their incomes.
“I generally prescribe on the basis of what I think is the best drug,” said Tarm, who received $11,700 in payments in 2014. “If the doctor is susceptible to being bought out by a pharmaceutical company, he can just as easily be bought out by other factors.”
Now There’s Proof: Docs Who Get Company Cash Tend to Prescribe More Brand-Name Meds
[Charles Ornstein, Ryann Grochowski Jones and Mike Tigas/Propublica]