October 19, 2010

Database Reveals Drug Company Payments to Doctors

Vital information is revealed on this web site: Dollars for Docs. On it you will find a database that reveals the payments 7 large drug companies made to doctors in return for having those doctors pose as experts while promoting the company's drugs to other doctors. This promotion often involved reciting scripts provided by the company.

These payment revelations were forced out of the companies, after they lost lawsuits that proved these companies had broken the law with how they marketed their drugs.

Needless to say, when a company is reeling in billions of dollars from the sale of a drug this kind of penalty and a fine that isn't even the size of one year's profits from the drug constitute nothing more than a slap in the wrist written off as part of the cost of doing business.

I urge you to read the whole web site, including this important article:

Docs on Pharma Payroll Have Blemished Records, Limited Credentials.

Then use the Search Box on the right of THIS PAGE to see if your doctors are being paid by Big Pharma to promote drugs to their peers.

Unfortunately, what this database does NOT do is reveal whether your doctor has been fed an expensive lunch by drug reps (a common technique to make them feel beholden), sent to resorts to receive "education" about an expensive new drug, or given the opportunity to participate in a "study" which involves signing up as many patients as possible to try the company's new drug in return for a hefty payment for each "study subject" recruited.

In case you wonder what kinds of misinformation drug companies pay doctors to tell their peers here are a few of the more common:

1. The makers of all new diabetes drugs invariably tell doctors that their drug will "rejuvenate beta cells."

This was the case with Avandia, Actos, Byetta, and Januvia. The claim was eventually disproven for Avandia and Actos, but not before these drugs had been on the market for ten year--ten years during which people paid obscenely high amounts for mediocre drugs with dangerous side effects that turn out to do nothing to restore beta cell function. Byetta has been on the market for about five years now and there is still no evidence that it rejuvenates beta cells in humans. Since it's effect on blood sugar wears off after a few years for most people, it's highly unlikely it has any such effect. The same is true of Januvia.

If beta cells are being "rejuvenated" you should see better blood sugar with each passing month that you take the drug.

2. The makers of new drugs pay doctors who pretend to be experts to "teach" family doctors that their brand new, untested drugs are better for patients than old, safe, tested drugs like metformin. As a result, many patients at diagnosis are put on dangerous new drugs that have little impact on their blood sugar but cost a fortune.

The inflated claims about the value of these new drugs make their drugs sound much more effective than they are and these "expert" doctors discourage family doctors from prescribing the insulin these patients really need.

No new oral drug on the market lowers insulin resistance or protects the heart the way that metformin does. No oral drug on the market lowers A1c more than 1% on average in populations whose average blood sugar is closer to 9% than 7%.

There's good evidence that newly diagnosed people with Type 2 diabetes do much better long term if put on insulin immediately after diagnosis. This can lower blood sugar dramatically and lower insulin resistance too. (Very high blood sugar worsens insulin resistance.)

3. Drug company shill doctors are given scripts which they use to convince other doctors that the side effects known to be associated with their drugs are not as serious as they sound, even when the side effect is death.

This isn't hearsay. Someone I know personally very well was working, running audiovisual equipment, at a convention, held inside a locked building guarded by armed guards, where a drug company whose drug had recently been found to kill significant numbers of people were educating their staff in the techniques and language to use to reassure doctors that the drug was still worth prescribing. One technique was to use euphemisms for words like "died" when describing studies.



Scott said...

Thanks so much for sharing this with everyone! NPR had an interesting story about this very today, which can be viewed at http://t.co/b9gLs11. Drug companies use interesting language as "thought leaders" when approaching doctors and that the rules that exist are "sufficient". This is untrue, and by 2013, thanks to the new healthcare law, all doctors who take money from drug and biotech companies will be listed in a government database disclosing their payments. What is most troubling is the attitude within the medical profession that they are somehow immune to influence, when statistics actually prove otherwise.

Jenny said...

Yes, I've seen that research showing how easily someone can be swayed by even a small gift. I heard a long talk on NPR myself a few weeks ago where a doctor described his experiences going around and promoting psychiatric drugs to his peers using the script even though he knew it wasn't true.

The weirdest thing about that show was that the doctor seemed to be telling the story so we could praise him for how noble he was in giving up all that sweet extra money when he quit, but what he was describing sounded criminal and one wondered why there was no punishment for the years when he had earned that money talking other doctors into prescribing drugs that ruin a lot of lives.