Pharmaceutical Payola — complemented by a host of tactics that in other circumstances might be called bribes.

Pharmaceutical Payola — Drug Marketing to Doctors - CommonDreams.orgSaturday, May 17, 2008 by Robert Weissman
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Among industrialized countries, only the United States and New Zealand permit drug companies to market directly to consumers. It’s a bad idea, it drives bad medicine, and it should be banned.

But although it has the highest profile, direct-to-consumer advertising is a small part of Pharma’s marketing machine. Researchers Marc-André Gagnon and Joel Lexchin conclude in a recent issue of the journal PLOS Medicine that direct-to-consumer ads make up less than a tenth of industry marketing expenditures ($4 billion of $57.5 billion in 2004). And Gagnon and Lexchin’s estimate of $57.5 billion on marketing excludes many industry expenditures that are really driven by marketing, including clinical trials conducted for marketing purposes.

The bulk of the industry marketing effort — more than 70 percent by Gagnon and Lexchin’s calculation — is directed at doctors.

Why?

Because it works.

The companies spend huge amounts paying firms that carefully track what doctors prescribe, and then they use the information to tailor messages to doctors, distribute samples and develop continuing medical education programs.

Gagnon and Lexchin report that Pharma spends more than $20 billion a year on “detailers” — the pharma reps that knock on doctor doors, ply the staff with free coffee and lunches, distribute samples ($16 billion worth), and prod docs to prescribe their drugs.

This is complemented by a host of tactics that in other circumstances might be called bribes.

“Virtually all physicians in America take cash or gifts from the drug companies,” says Melody Petersen, author of Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs, and a former New York Times reporter. “A recent survey said 94 percent of physicians took something of value from the drug companies. Some doctors take hundreds of thousands of dollars a year from these companies, and there’s no law that says they can’t.”
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The drug companies weave these diverse strategems into an elaborate tapestry — not infrequently to push drugs for inappropriate purposes. One eye-opening case that Petersen details in Our Daily Meds concerns Neurontin, a mediocre drug for epilepsy that Warner-Lambert illegally peddled as an unapproved treatment for bipolar disorder, migraines, attention deficit disorder in children and other conditions. The drug does not work for most of these conditions. Many persons were injured by taking excessive doses of Neurontin, and many others wasted money and emotional energy on hopeless Neurontin treatment strategies. Warner-Lambert ultimately paid $430 million to settle criminal and civil charges related to Neurontin marketing, but Petersen says that, even so, the illegal marketing scheme was clearly profitable for Warner-Lambert (and Pfizer, which acquired Warner-Lambert in 2000). ...