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[P]
Drug promotion and bribes

By sudogeek in News
Sun Apr 29, 2007 at 06:29:40 AM EST
Tags: medicine, bribery, corruption, drug companies, those fucking doctors (all tags)

A study published today in the New England Journal of Medicine shows that 94% of doctors take some sort of bribe from pharmaceutical companies. Many doctors argue that these considerations are harmless and that the voluntary controls currently in place suffice.


The most common of these promotions are meals.  Meals brought into the office for the office staff are a way for the drug rep to get his/her foot in the door.  Other are dinners at various resturants with a speaker who is a shill for the company's product under the guise of continuing medical education.

Surprisingly, some 28% of doctors received money from the drug companies. Much of this is from device manufacturers. Accordingly, the two most commonly compensated specialties are cardiology and orthpedics. This certain explains part of the cost of pacemakers ($5000-10000 each) and artificial joints ($1000-2000 for a hip prosthesis). The other is money for speakers to flog the product.  Most of these speakers are faculty at medical schools - the very group that publishes these articles sneering at the corrupt community doctors and drug reps.

78% of doctors receive drug samples.  Some will argue that free samples may be a way for doctors to reduce drug costs for their patients.  For those with less money or no drug coverage, the provision of a month of two of medication can be a significant saving. The real cost includes the potential lock-in to a more expensive product. Companies that provide generic products or products nearing the end of their patent life do not promote these products. They have no budget for it.

The hidden cost of these free samples and promotions is the advertising budget of the pharmaceutical company. This may exceed the cost of drug development in some cases particularly when the drug is licensed from another company. All of this promotion increases the cost of the drug for all. As an example, Nexium is $3-5 per pill while Prilosec - the purple pill until last year - is now <$0.60 per pill. These two are of absolutely equal efficacy.

The net result is that we all pay too much for meds and are prescibed expensive "new" propietary meds while many cannot afford the medication they need. I believe we should ban drug company advertising to doctors and to patients. How insipid are those ads anyway. Medications should be evaluated scientifically and used according to best practices based on the recommendations of experts and researchers in the field, not based on hidden payments and agendas.

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Drug promotion and bribes | 91 comments (80 topical, 11 editorial, 0 hidden)
are you on crack? (2.60 / 5) (#1)
by GhostOfTiber on Thu Apr 26, 2007 at 07:24:39 PM EST

(my wife is a nurse...)  Many places it's illegal for the doctor to NOT proscribe a generic drug.  There are rare cases they have to do it when the filler or coating has an adverse effect on a particular patient.  The example that comes to mind is that many people notice the difference between ACME "claritin" and the real stuff simply because the ACME stuff is uncoated and metabolizes much quicker.  Enter:  Drug samples.  They can't simply give you a major dose of something without a script or it would also be illegal and make them liable.  On the other hand, the samples make fantastic test drugs.  Instead of proscribing exactly one pill, they just hand the samples out.  Most of the time the medical staff either uses it themselves or on an outpatient basis.

Secondly the reason why it's not a bribe (and why the already over legislated medical industry wouldn't dream of doing it any other way) is because they often buy food for the office.  Last week we had chinese on Oxycodone's dime.  Talk about disappointed.  Anyway, they buy food for the office, they don't just take the doctors to some $100 a plate restaurant.  As far as giving them a pile of money, I suppose that someone running a private practice could get away with it but a business full of catty, sexually frustrated women, that wouldn't last a minute.

But, this has been going on for ages, it's nothing new, and certainly not a jewspiracy.  Microsoft buys me lunch about once a month or whenever the sales reps are targeting my shop, but no-one bitches that the tech industry is accepting bribes.

[Nimey's] wife's ass is my cocksheath. - undermyne

Not exactly. (none / 1) (#2)
by sudogeek on Thu Apr 26, 2007 at 08:25:01 PM EST

The laws concerning presciption of drugs in the US are regulated at the state level. I don't know what jurisdiction you are in, but I can tell you how it works in TX and FL.

In FL, a prescription has either a signature line or a check box labeled "medically necessary," "no substitution" or similar language. If not specified by the prescriber and if the patient has no objection, the pharmacist can subtitute a generic drug. In TX, basically the same thing is found with a box or line labeled "medically necessary." A nice discussion of different state's rules can be found in the FL link.

Hospitals and HMOs may have closed formularies and mandatory substitution rules. To my knowledge, in no jurisdiction is it illegal to prescribe a proprietary product. It may be substituted by a pharmacist under certain conditions, but that is a long way from making it illegal. I would be interested where if there is such a place where a doctor cannot prescribe a non-generic product.

The food for the office is a bribe. Without it, the drug rep would never get his/her foot in the door. Drug reps routinely invite doctors to $100+ restaurants, which is not uncommon these days anyway. These soirees are usually billed as an "educational" dinner with some speaker using drug company provided slides. I've seen other education programs including a day trip on a gambling voyage to nowhere, fishing on a charter boat, and the ever-present morning meeting before golf at some swanky resort. No, it's not cash, but that's dispensed as well.

The point is no matter what the drug companies are providing, it increases their costs which are passed along to you and all of us.

There's a sucker born every minute, and you're an hour's worth.
[ Parent ]

TX, FL lol! (none / 0) (#4)
by GhostOfTiber on Thu Apr 26, 2007 at 10:25:14 PM EST

WHAT DOES ALLIGATOR TASTE LIKE?

I am in PA.  I should probably have explained that better.  It's similar, but if the doctor checks one of those boxes, they better have a good reason for it as there's a one liner for the justification.  It might be something like the patient has allergies, but the doctor can't check that box in PA for No Good Reason.

I totally am in the wrong industry if those are the perks you guys get down there!

[Nimey's] wife's ass is my cocksheath. - undermyne
[ Parent ]

Like chicken. (none / 1) (#16)
by sudogeek on Fri Apr 27, 2007 at 11:43:06 AM EST

And so does rattlesnake.

There's a sucker born every minute, and you're an hour's worth.
[ Parent ]
False. (none / 0) (#36)
by debillitatus on Fri Apr 27, 2007 at 07:29:30 PM EST

Although snake and gator taste quite similar, they're both a long way from chicken.  Also chewier than a motherfucker, unless it's deep fried.

Yeah, deep fried gator, w00t.  From this you can safely deduce that I grew up in Louisiana.

Damn you and your daily doubles, you brigand!
[ Parent ]

I thought Nutria was the local delicacy. (none / 0) (#44)
by sudogeek on Sat Apr 28, 2007 at 07:59:25 AM EST


There's a sucker born every minute, and you're an hour's worth.
[ Parent ]
I've never heard of anyone... (none / 0) (#47)
by debillitatus on Sat Apr 28, 2007 at 09:24:11 AM EST

actually eating nutria.  I bet people ate it 50 years ago.  Anyway, there is a lot of hunting of the nutria for population control purposes;  Jefferson Parish gives a bounty which is something like $4 / tail, so some people trap them for the bounties.  But I think they just dump the carcasses, maybe feed them to their dogs or some such.

Damn you and your daily doubles, you brigand!
[ Parent ]

Isn't Nutria a relatively recent introduction? (none / 0) (#66)
by sudogeek on Sat Apr 28, 2007 at 09:51:26 PM EST

I think they were introduced in the 30s for fur. I don't think there was a Nutria problem 50 years ago, but I could be wrong. I remember stories in the Times-Picayune about Nutria undermining levees and such. When I lived in Kenner in the late 70s, people actually hunted then and I'm pretty sure the meat made its way to a few pots of jambalaya.

There's a sucker born every minute, and you're an hour's worth.
[ Parent ]
kENNA, BRAH?!? (none / 0) (#72)
by debillitatus on Sat Apr 28, 2007 at 11:17:56 PM EST

Ok, fair enough.  Maybe I'm too young for that shit.  I also heard stories about people eating cat back in the day, but I've never had the honor.  I'll chomp on some gator like a mug, tho.

I think they were introduced sometime around the 30s, like you said, but I think they became a serious problem pretty quickly (if an organism is going to be a problem, it seems to happen quickly or not at all, ZOMG exponential growth).

I think the levee-undermining is a bit of an issue in the city (because of the Keystone-Cop-style levees we had there) but I think they are doing some damage to the ecosystem out in the swamps as well, you know, eating something or fucking up some plant or something, who knows?  Presumably people who work for La W&F have some data, which is the reason for the bounties.

Damn you and your daily doubles, you brigand!
[ Parent ]

I had some alligator tail a couple weeks ago (none / 1) (#52)
by horny smurf on Sat Apr 28, 2007 at 03:33:13 PM EST

it was breaded and deep fried. I had it at two different restaurants. The first was overcooked or perhaps just cheap tail, and was a little tough and rubbery. It's white meat, so while eating I wondered if it was really pork or chicken, but the taste/texture don't support that conclusion.

The second time, the pieces were bigger and it wasn't as chewy.

[ Parent ]

PA eats possoms (none / 0) (#88)
by newb4b0 on Wed May 09, 2007 at 10:22:24 PM EST


http://www.netmoneychat.com| NetMoneyChat Forums. No Registration necessary. Ya'll.
[ Parent ]

The comparison to your shop... (none / 0) (#6)
by PhillipW on Fri Apr 27, 2007 at 05:04:40 AM EST

...is inappropriate. Noone dies if you pass off a shitty product as good.

-Phil
[ Parent ]
I used to work in medical imaging (none / 1) (#8)
by GhostOfTiber on Fri Apr 27, 2007 at 07:42:32 AM EST

You tell me what happens if the box crashes in the OR.  "Well, while we're waiting for someone to log in, lets just guess where all those bone fragments went".  The MS version is Tablet Windows based.

Thankfully that company folded.

[Nimey's] wife's ass is my cocksheath. - undermyne
[ Parent ]

"prescribe" vs. "proscribe" (none / 0) (#84)
by yuo on Mon Apr 30, 2007 at 01:59:59 PM EST

"Prescribe" and "proscribe" have vastly different meanings. It is almost the same as the difference in meaning between "helping" a man and "murdering" him.

I wish I had thought of pants pants pants pants pants pants pants pants.
[ Parent ]

i went to one of these once (3.00 / 12) (#3)
by circletimessquare on Thu Apr 26, 2007 at 09:57:04 PM EST

courtesy of a female doctor, ehem, friend

swanky steak meal at a very expensive private restaurant in midtown. very hot well-coiffed women (pharma reps) smiling and beaming. drunk doctors making fun of patient's retarded concerns (seriously). and some paid doctor dude presently slides on the effect of noramax, or hervascor, or umatrec on nighttime micturation rates and liver metabolites, or something

i dunno, i was busy eating steak, getting drunk, staring at submissive ex swimsuit model's cleavage, and being entertained by drunk doctors making fun of their patients

good times! bring on more of this pharmaceutical cash you speak of!


The tigers of wrath are wiser than the horses of instruction.

then you realized that (3.00 / 5) (#11)
by GhostOfTiber on Fri Apr 27, 2007 at 09:58:22 AM EST

she was a post-op transvestite and suddenly realized you really should have been paying a lot closer attention to what exactly was being shown on those slides.  

Suddenly, it all made sense to you?

[Nimey's] wife's ass is my cocksheath. - undermyne
[ Parent ]

strangely enough (3.00 / 6) (#33)
by circletimessquare on Fri Apr 27, 2007 at 03:53:19 PM EST

the place was full of uroogists. and they were discussing, and making fun of, patients who wanted penis enlargements. they were making fun of these guys and their general psychological health. they were making fun of their earnestness and overall obsession with their dick size. in fact, according to these urologists, most of them had average and above average dick sizes who were the most earnest and obsessed about enlargement!

the general consensus was that the only solution was psychological as well

however, one russian guy knew of an operation, and the others attentively listened as he described the only operation this guy had the remotest respect for to achieve some sort of results:

they take the... the squishy part of the dick extends into the perinium, the taint. there is an operation where they take that part, "unhook" it from the underlying stuff, and it extend it out of the body cavity further then it would normally go, essentially lengthing your cock

but like taking a pole firmly embedded in the ground that if you hit it stays in the ground firm, and yanking it out so now it is only loosely attached, so if you hit it it flops easily to the side, you can't do any poking with such a modified dick. if you approached your average snatch with such a dick, instead of poking in nicely, it would flop to the side: such a dick no longer has a firm root. and it always hangs straight down. and yet there were guys who wanted such a dick

insane


The tigers of wrath are wiser than the horses of instruction.

[ Parent ]

quit hacking my computer and stealing my innermost (3.00 / 1) (#78)
by br14n on Sun Apr 29, 2007 at 09:58:39 PM EST

thought files

[ Parent ]
i'm hacking your BRAIN dude nt (none / 0) (#83)
by circletimessquare on Mon Apr 30, 2007 at 09:30:51 AM EST



The tigers of wrath are wiser than the horses of instruction.

[ Parent ]
Those are fun (3.00 / 3) (#32)
by Sgt York on Fri Apr 27, 2007 at 01:23:02 PM EST

I always wind up getting invited to those things at conferences. Teh irony to follow:

I went to ATS (Am. Thoracic Society) in San Diego a couple of years ago. At the time, I worked on asthma and COPD, and got invited to a lot of lung things. Fun.

At one of them, they were giving away these little baskets after the meal, and I grabbed one as I was leaving. I went upstairs and tossed it in my room and went back out, and then forgot all about it.

A few days later, I noticed it again and rooted through it. I don't recall most of the stuff that was in there, but the funny one was a little tin box full of Macanudo cigarellos. I guess they were trying to drum up some business.

There is a reason for everything. Sometimes, that reason just sucks.
[ Parent ]

teh stars and stripes of corruption (none / 0) (#5)
by nostalgiphile on Fri Apr 27, 2007 at 02:29:01 AM EST

Your description of the doctor/big pharm relationship has an uncanny resemblance to how I imagine congressmen/big businesses operating generally--they get everything but blowjobs (and probably that too sometimes) at those fundraisers and business-sponsored 'conferences' they speak at. Hmm, let's recall the good ole days when we could maintain straightfacedly that only Asian businesses were supposed to run on the basis of bribes, graft, and a generalized "croney capitalism" on this scale.

Good article btw, +1FP and all, though I can't understand why it isn't sparking more discussion.

"Depending on your perspective you are an optimist or a pessimist[,] and a hopeless one too." --trhurler
ROFL (none / 0) (#30)
by Sgt York on Fri Apr 27, 2007 at 01:15:20 PM EST

Your subject line makes me think of Dead Kennedys, which, in this context, makes me think of their song "Well Paid Scientist," which of course always makes me ROFL.

There is a reason for everything. Sometimes, that reason just sucks.
[ Parent ]

intentional reference to DK (none / 0) (#41)
by nostalgiphile on Sat Apr 28, 2007 at 12:14:00 AM EST

subconscious reference to 'Well Paid Scientist.'

"Depending on your perspective you are an optimist or a pessimist[,] and a hopeless one too." --trhurler
[ Parent ]
The ONLY way drug development is outdone by (1.80 / 5) (#7)
by Egil Skallagrimson on Fri Apr 27, 2007 at 07:27:23 AM EST

advertising is when the company is selling the drug as a third party. And that is a tenuous argument in itself.

No one spends more than a billion dollars on advertising a drug over 10 years unless that drug brings in an amount on par with the the GDP of a medium-sized country.

This article is half-researched and uninformed.

----------------

Enterobacteria phage T2 is a virulent bacteriophage of the T4-like viruses genus, in the family Myoviridae. It infects E. coli and is the best known of the T-even phages. Its virion contains linear double-stranded DNA, terminally redundant and circularly permuted.

Sucker. (3.00 / 7) (#13)
by sudogeek on Fri Apr 27, 2007 at 11:14:00 AM EST

That is big pharma's mantra, smokescreen, and bullshit.

Most of the blockbuster grugs are actually developed on the taxpayers dime. Consider the H2 receptor antagonists, PPIs, taxol, and even viagra. Also, consider essentially all of the therapeutic monoclonal antibodies. The receptors and enzymes were isolated and characterized and specific ligands and reagents were developed in basic research labs funded by the NIH and NSF. In years past, these compounds were not even patented; since 1976, patents are sought by the NIH, but then the compounds are licensed for a song.

It's just like the leasing of federal lands for logging, grazing, and mining for pennies on the dollar. And, we get the joy of paying billions to clean up the environmental mess. That's called corporate welfare by some but "pro-business" by others with their hand in your pocket.

Then we have all the "me-too" products. Add a methyl group here or an imidazole gruop there and viola! the latest, greatest difungomuctane. Development costs, zilch.

Oh, but what about the safety and efficacy testing? Those human trials cost billions, you think. Welcome to the world of globalization. Many clinical trials are now performed overseas in India, China, Brazil, and other countries. The pharmaceutical companies will try to chalk this up to excessive regulation in the US, but that's just so much crap for the suckers and GOP true believers. Read about the furor about testing of new AIDS drugs in Africa under largely unregulated conditions - subject for another rant.

Most pharmaceutical companies have smaller overseas subsidiaries which perform the initial testing, a firewall against liability and bad press. In other cases, smaller development houses get the drug to this stage. The drugs are then licensed to larger companies that have the manufacturing and marketing strength to make a marginally useful drug a multibillion seller. If you want to see the real costs of development, check out the licensing terms for omeprazole from Astra or lansoprazole from Takeda.

If you need anything more to make it clear, the exact same drugs, from the exact same factory, are sold for a fraction of what you pay in other countries. The development costs are overstated and inflated by the drug companies to justify their obscene costs and profits. You won't find any altruists in the boardrooms of big pharma.

There's a sucker born every minute, and you're an hour's worth.
[ Parent ]

Tin Hat's report!!! (none / 1) (#28)
by Egil Skallagrimson on Fri Apr 27, 2007 at 01:09:14 PM EST

Translation from wank-speak: "I might have no idea what I'm talking about, but I did go to university for a few years and I spent a hell of a lot of time at the coffee shop discussing this with a few guys that took some sociology classes, so I know the real deal. I mean I have never bothered to reserch this beyond afew throw-aways articles, but I'm confident that my Micheal Moore style arguments should hold water."

----------------

Enterobacteria phage T2 is a virulent bacteriophage of the T4-like viruses genus, in the family Myoviridae. It infects E. coli and is the best known of the T-even phages. Its virion contains linear double-stranded DNA, terminally redundant and circularly permuted.
[ Parent ]

Conspiracy? (none / 1) (#43)
by sudogeek on Sat Apr 28, 2007 at 07:57:51 AM EST

Not only are you wrong, but your complaint that this is some sort of conspiracy is well off the mark.

Each pharmaceutical company is acting as a rational corporation. The goal is to maximize profits. Sure they point to high development costs but so are the costs of a new chip fabrication plant, a factory, a shipyard, or those of any major corporation.

In fact, and the information is out there in the press and buried in the 10-Q's, the advertising and promotional budget does exceed development costs for many meds. Not all, many. If you read the whole sentence, I said "in some cases particularly when the drug is licensed from another company."

Instead of blandly stating that you know better because you work in the mail room of some me-too pharma, show us the info. But if you're going to parrot the company line, save it for the rubes.

There's a sucker born every minute, and you're an hour's worth.
[ Parent ]

You have no info (none / 0) (#82)
by Egil Skallagrimson on Mon Apr 30, 2007 at 09:24:30 AM EST

You have a report from a think tank that opposes Capitalism.

News will be at 11.

----------------

Enterobacteria phage T2 is a virulent bacteriophage of the T4-like viruses genus, in the family Myoviridae. It infects E. coli and is the best known of the T-even phages. Its virion contains linear double-stranded DNA, terminally redundant and circularly permuted.
[ Parent ]

not true (2.85 / 7) (#40)
by rhiannon on Fri Apr 27, 2007 at 11:38:09 PM EST

From 2000, Most companies spent about twice their R&D budget on marketing.

http://www.twnside.org.sg/title/twr131n.htm

Here is Johnson and Johnson statement for 2007 first quarter

http://www.jnj.com/news/jnj_news/20070416_101945.htm

Pfizer 2006:

http://www.pfizer.com/pfizer/annualreport/2006/financial/p2006fin78.jsp

I'm sorry to say, marketing has a greater return on investment than R&D does.

-----------------------------------------
I continued to rebuff the advances... so many advances... of so many attractive women. -MC
[ Parent ]

Note to sudogeek (2.00 / 3) (#50)
by Sgt York on Sat Apr 28, 2007 at 12:19:02 PM EST

THIS is documentation, and what both Egil and I asked for.

This whole article should rewritten, with documentation in a prominent spot. All copies of the original article should be buried in a shallow grave marked with an epitaph that reads "A stopped clock is right twice a day."

Sudogeek's rambling, conspiracy laden, undocumented diatribe is worse than useless and pointless, it actually works as a smokescreen. It's easy to dismiss the rambling conspiracy theories of sudogeek, it's impossible to dismiss the financial reports of the companies themselves, as posted here by rhiannon.

In millions, J&J spent $4802 on "selling, marketing, and administration" and $1652 on R&D. Pfizer spent $7599 on R&D, and $25,586 on "other expenses."

I'd vote this comment alone +1FP, and would vote the story +1FP if this information was included in the story itself, or even referenced by the author. But as it stands, this story is only so much FUD, with the critical facts buried in a comment not even made by the author, who didn't even bother to check the companies' websites, but instead decided that it was all a grand conspiracy. The reality is that they are doing this and barely making a token effort to obscure it.

There is a reason for everything. Sometimes, that reason just sucks.
[ Parent ]

not that much of a smoking gun, though (none / 0) (#54)
by Liar on Sat Apr 28, 2007 at 05:05:18 PM EST

How much of J&J's marketing budget went to the promotion of Band-Aids, BenGay, Neutrogena, Tylenol, and their excellent line of Baby Shampoos.

Those established products receive probably the vast bulk of their advertising dollars and while I'm sure the world could probably use a better Band-aid, I doubt anyone would criticize them if their marketing budget were much higher than thrice their R&D budget on that product.

Also, analyzing financials requires greater context and Pfizer's aren't nearly as informative as we should like. Manufacturing and supply costs at JnJ were equal to their marketing & administrative costs. Pfizer lists only two primary costs: research and "other" which presumably would include manufacturing and marketing. So, these numbers are still a bit too vague to get a lot out of. Meanwhile, if you look at the financials of a company like HP: marketing outspends research by 4 to 1. Even at Google which has received attention for putting an extraordinary and unique emphasis on research, marketing outspent R&D by 20%. That marketing claims more money than R&D isn't atypical in any industry.

Personally, I think it's because good salesfolk do a better job selling management on their importance.

The real smoking gun is not really provided in the above documents. It needs to be broken down by product and it needs to be shown that this is an extraordinary business practice.


I admit I'm a Liar. That's why you can trust me.
[ Parent ]
Sure, it's vague (none / 0) (#55)
by Sgt York on Sat Apr 28, 2007 at 05:33:35 PM EST

Quite vague, and no smoking gun, as you said. But it's a much, much better argument than sudogeek's original "it's a conspiracy" response. If you notice, I first responded to his claim with great skepticism.

Google and HP may put a lot of money into research, but they don't make the claim that their costs are so high due to the research they do. Drug co's defend the cost of their meds as necessary to recoup research expenditures. These reports don't really back that claim up. Research seems to be a significant expense, but on the low side of significant. OTOH, sales seems to be on the high side of significant.

So yeah, no smoking gun, agreed. But better than the Tinfoil Hat defense presented earlier.

There is a reason for everything. Sometimes, that reason just sucks.
[ Parent ]

...it's even more complicated, infact (none / 0) (#56)
by sausalito on Sat Apr 28, 2007 at 06:58:26 PM EST

A set of circumstances meant that major pharmaceutical companies over the last twenty years have become basically marketing concerns.

First, the early stages of research are very risky, but not that capital-intensive: several approaches to a problem are tested to see which works best. Management research has shown that due to their massive bureaucracy, the majors do a terrible jobs in evaluating which attempts are really promising and which need to be quickly axed.

Second, the financial market distrusts integrated concerns as too many things happen at the same time, making it difficult to undestand earnings.

As a result, pure research companies (a.k.a. "biotech" companies) lead by entrepreneurial scientists who take significant gambles based on their deep scientific knowledge are increasing the source of early research. The biotechs often derive from the spin-off of the major's research labs or sometimes by the initiative of young university researchers. They are lean organisations, with minimal overheads and quick decision-making. High-risk, high-reward specialised investors (venture capital, private equity partnerships, business angels and sometimes - more recently - hedge funds) finance the spin-offs or start-ups.

When a really promising molecule is found, the biotechs sell it to the majors. The majors are financed by the stock market, so they have the vast financial resources necessary to carry out the final, more capital-intensive stages of the research. These late trials on human-like apes and humans are very expensive but the focus is on the strict observation of established protocols in an uniform way with no space for creativity, a task where large organizations do very well as they can enjoy purchasing power and professional financial controls.

Actually, for financial reasons (i.e. accessing the loss made by the biotech to pay less tax) it is often more worthwhile for the majors to buy the whole biotech company and shut it down. Can you see that line on Pfizer accounts called "acquired research and development"? That is the part of the biotech acquisition price that can be amortised by the majors using complicated US-GAAP and SEC rules.

Other than financing advanced clinical trials, the crucial aspect of a major's job is marketing: lobbying to the regulatory authority (FDA) and to the doctors through their army of sales reps. Again, another task that requires financial muscle, discipline and established procedures.

In conclusion, the majors do use a lot of smoke and mirrors to justify the prices of medicines (in this I agree with sudogeek). They want to convince us that the prices are determined somehow scientifically taking into accounts the cost of innovation, when probably they do not know themselves how much they spent in research.

I repeat, majors outwitted the regulators in the United States. But in Europe and elsewhere, old-fashioned central purchasing and price-bargaining is working much better.
_____________

GBH - "The whole point is that the App Store acts as a firewall between busy soccer moms and goatse links"
[ Parent ]

well (none / 1) (#75)
by Liar on Sun Apr 29, 2007 at 05:31:56 AM EST

I'm approaching this as a business man. I used to be licensed as a securities broker, read financial statements all the time as part of the job, taken all sorts of certs, drafted multiple business plans, started my own business (and eventually closed shop when I decided I didn't enjoy all the loss of free time, the increase in paperwork). For much of this I was coming at it from an IT perspective of things, but for what it's worth this is my background on this topic. I'll admit I'm not an expert specifically in pharma financials.

A couple thoughts: research companies have all the risks and costs of other industries with the additional cost and risk of R&D on top of it all. The appearance of doing R&D doesn't exempt them from the normal operation of running business (manufacturing, shipping & logistics, sales, admin) and all the costs entailed in that. I think we all see that and can appreciate that R&D should entail a premium.

Further, marketing is always going to be one of the most significant expenses and (and this is key) it is typically pegged to revenue--not to the expenses in other parts of the company. The effectiveness of blind mailing are well known (response rates of greater than 3% are considered exceptional) and we all know the costs entailed in targetted advertising--and marketing is so much more than just sending out mailers. This can include television time, press releases, sponsoring local events and charities, face to face meetings with decision makers (which may include dinner, golf, maybe even travel), etc.

The point here is: sales is a full time job that is never appreciated by those who haven't tried to look generally at what it takes to run a business.

The financials that we've seen here really tell me little. So what if R&D is one third their marketing budget? In the company I started, I devoted significant time and money towards marketing, in the range of 15-25% of revenue depending on whether it was crunch time or not.


I admit I'm a Liar. That's why you can trust me.
[ Parent ]
I realize all that. (none / 0) (#77)
by Sgt York on Sun Apr 29, 2007 at 01:03:12 PM EST

My complaint is that whenever a new drug comes out and it costs a small fortune, the drug co's defend the high price by saying it's due to development costs. They also defend their patent rights vigorously; again claiming the need to recoup their R&D investment.

However, when it is revealed that they are just like every other business (i.e., marketing is the #1 expense), that defense goes right out the window. When I buy a Mercedes, I know that I'm paying a premium for brand recognition over say, a Honda. Similar quality, a few more bells and whistles; but certainly not enough to justify the double or triple cost. I'm paying for that little emblem on the hood. I know full well that I am paying for them to make their brand recognized as a prime product. I'm cashing in on that by being associated with their prime product through ownership. But when you buy a drug, you are told that the high cost is to defray the cost of R&D, and this is not the case.

Yes, I know it's the cost of business; I'm the first person in my family in three generations that isn't a salesman or entrepreneur. I grew up with it. I know it's all about image. That's not what bothers me; it's the misrepresentation.

There is a reason for everything. Sometimes, that reason just sucks.
[ Parent ]

So, now you agree with me. (none / 0) (#79)
by sudogeek on Sun Apr 29, 2007 at 10:18:54 PM EST

You and Egil accuse me of some conspiracy-laden rant, but I alleged no conspiracy. I simply pointed out the pervasiveness of the drug company promotion to doctors and that they spend a large proportion of their money on advertising, sometimes larger than the R&D expenses.

I did not provide all the data, to be sure, but skipped to the conclusions. I did not present the data later, when I came back to the thread as others had already done it. I do present the information regarding device manufacturers elsewhere in this thread.

I fact, drug companies are really not much different from other large manufacturers in their economic structure and, when you look at their reports, the breakdown of expenses is similar to companies of comparable size.

I repeat, big pharma's advertising that they spend so much more on R&D in order to justify their inflated prices is spin.

There's a sucker born every minute, and you're an hour's worth.
[ Parent ]

See stopped clock reference above (2.00 / 2) (#80)
by Sgt York on Mon Apr 30, 2007 at 01:39:00 AM EST

You did claim conspiracy, almost from the start. here you say it is "big pharma's mantra, smokescreen, and bullshit." You claim conspiracy automatically, without even looking for facts, much less at the facts once presented by another person. You are now using this information like a drunken man uses a lamppost; for support, not illumination. As a result, the only way you could ever find some portion of the truth is if you happen to stumble over it. You are convinced a priori that there is some kind of evil conspiracy afoot, and I therefore call you a nut.

You miss the point that you aren't even right here; you still claim it's all a conspiracy, even though the numbers are published at the expense of the companies you accuse.

Your mind is made up before you see, hear, or know anything. It is reactionary, foolish, and counterproductive. The fact that you were right is sheer dumb luck; hence the stopped clock reference. The fact that you don't even see this just highlights the worse than useless nature of your ignorant zealotry.

There is a reason for everything. Sometimes, that reason just sucks.
[ Parent ]

I think you had an unreasonable expectation (none / 0) (#81)
by Liar on Mon Apr 30, 2007 at 04:03:31 AM EST

From what you and others were saying, you had the expectation that R&D outpaced marketing and you're a bit surprised that this is not the case. But I can't find a single company in any industry where this is the case--Microsoft, Proctor and Gamble, GM, Amgen, Qualcomm, Lockheed, etc. Not a single one.

A proper analysis would need to analyze the profitability of successful products, the costs that must be defrayed from unsuccessful research, and the product life cycle. We'd need a lot more information that what is provided in these financials. In fact, I daresay, that those who are looking at these financials are jumping to more conclusions than are warranted.

But I guess we'll have to agree to disagree.


I admit I'm a Liar. That's why you can trust me.
[ Parent ]
Ah, The Fine Line Between ... (none / 1) (#9)
by Peahippo on Fri Apr 27, 2007 at 09:03:29 AM EST

... education and indoctrination. If anyone can accomplish product education without some form of bribery, please let us know.


no (none / 0) (#46)
by khallow on Sat Apr 28, 2007 at 08:40:18 AM EST

It's the even finer line between giving out swag with your logo on it and paying people to buy your stuff.

Stating the obvious since 1969.
[ Parent ]

Advertising $ > research $? (2.50 / 2) (#10)
by Sgt York on Fri Apr 27, 2007 at 09:37:49 AM EST

Document that. I'm sure they spend a lot on advertising, but development is amazingly expensive. It costs significantly more for me to do my work than it does to pay my salary, and we get academic discounts left and right.

And yes, they do put on the hard sell. At the hospital I used to work at, the docs called the drug reps pushers and constantly made jokes about standing on streetcorners, freebasing Prilosec, etc. The all time favorite was one doc that had a pocket sewn inside his white coat. He'd hang a bunch of sample boxes on the pocket, come up to you and open it up, whispering, "Hey, buddy, wanna buy some Zithromax?"

God, I'm glad I got out of there.

There is a reason for everything. Sometimes, that reason just sucks.

This guy has no idea about what he's (1.40 / 5) (#12)
by Egil Skallagrimson on Fri Apr 27, 2007 at 11:02:17 AM EST

writing about. It's obvious, since the price of advertising is no way near the general average $100,000,000,000 it costs to bring a drug from discovery to market.

----------------

Enterobacteria phage T2 is a virulent bacteriophage of the T4-like viruses genus, in the family Myoviridae. It infects E. coli and is the best known of the T-even phages. Its virion contains linear double-stranded DNA, terminally redundant and circularly permuted.
[ Parent ]

How much of that is subsidized by governments? $ (none / 0) (#15)
by blazzy on Fri Apr 27, 2007 at 11:20:42 AM EST



[ Parent ]
Depends on the government, but the amount of (none / 0) (#17)
by Egil Skallagrimson on Fri Apr 27, 2007 at 11:52:14 AM EST

subsidy will never near the amount needed to take a drug even into the development stage from the discovery stage.

----------------

Enterobacteria phage T2 is a virulent bacteriophage of the T4-like viruses genus, in the family Myoviridae. It infects E. coli and is the best known of the T-even phages. Its virion contains linear double-stranded DNA, terminally redundant and circularly permuted.
[ Parent ]

That's a toughy (3.00 / 1) (#29)
by Sgt York on Fri Apr 27, 2007 at 01:11:05 PM EST

Pharma companies have many ways to get government "subsidies" of one kind or another. A big one is collaboration with someone like me. Say I have a grant to look at the role of angiogenesis in tumor progression. GSW is working with proprietary compound CGS85743, which happens to be the only compound on the planet that interferes with the signaling pathway I am studying.

GSW notices my talk/poster/whatever at a conference and contacts me, "Hey....we've got this cool compound we're looking at, wanna work together?" They give me the compound (as much as I want!), and basically let me go nuts. A typical stipulation will be that I not release the structure, or sometimes even know the structure. They'll probably pay me, too, but with increasing asisstence will come increasing stipulations (manuscript review, etc).

At the end of the day, I'm happy because I can now do these really cool experiments I wanted to do, they're happy because they got this cool new data that no other company can do anything with. And, because the research fell under the aims of my NIH grant, the feds helped pay for it. The only time they get upset is when it makes the tumors grow to the size of watermelons, but as long as I didn't sell my soul in the process, I get to publish anyway, just before selling all my GSW stock.

The second way is the shoulders of giants technique. In the same example, GSW developed in interest in compounds that inhibit angiogenesis as cancer drugs because of the body of literature (mostly NIH funded) that says angiogenesis is important. Even without collaboration, that info is publically available. It doesn't give GSW an advantage over, say Bayer, but it does help.

Lastly, there's the prescription drug care plan that Bush passed a while back. It's indirect, but that $$ is going straight to pharma.

There is a reason for everything. Sometimes, that reason just sucks.
[ Parent ]

It totally depends on the government. (none / 0) (#31)
by Egil Skallagrimson on Fri Apr 27, 2007 at 01:16:42 PM EST

Canada gives major tzcuts for any kind of technological innovation. This includes R&D for Pharma. They also allow generic companies to send AIDS drugs to African countries for large tax cuts.

However, the cost of business is large and the tax cuts help but don't fund much.

----------------

Enterobacteria phage T2 is a virulent bacteriophage of the T4-like viruses genus, in the family Myoviridae. It infects E. coli and is the best known of the T-even phages. Its virion contains linear double-stranded DNA, terminally redundant and circularly permuted.
[ Parent ]

Like Vladimir Illich said (2.50 / 2) (#18)
by sudogeek on Fri Apr 27, 2007 at 12:00:05 PM EST

What matters is who counts the votes.

Your numbers are derived from so much pharmaceutical company spin. They do the accounting and they're not letting you see the books, Egil. It's like Hollywood accounting. Your naivete is typical and unsurprising.

There's a sucker born every minute, and you're an hour's worth.
[ Parent ]

Nope, sorry, that won't work. (3.00 / 1) (#19)
by Egil Skallagrimson on Fri Apr 27, 2007 at 12:07:31 PM EST

The Tin HatTM approach is not going to work for this one. I work for a generic company. I make my living off of reformulating the brand's version. I have no pity or them and the money they spend.

I'm just saying that you are ill informed and have emotion without any knowledge backing your argument. It does, in fact, cost circa. $100,000,000 to develop a new drug. It also costs money to not develop the 10 other ones you thought were going to work out along the way.

Advertising does not get even close to these figures, and they are verifiable figures, any way you want to cut it.

So, alternately, your blind niavete is surprising, but not that surprising. Since I actually see the figures, I might have a better idea than you about what I'm saying.

----------------

Enterobacteria phage T2 is a virulent bacteriophage of the T4-like viruses genus, in the family Myoviridae. It infects E. coli and is the best known of the T-even phages. Its virion contains linear double-stranded DNA, terminally redundant and circularly permuted.
[ Parent ]

The shorter k5. (none / 1) (#21)
by sudogeek on Fri Apr 27, 2007 at 12:26:12 PM EST

sudogeek: Is so.

Egil: Is not.

If you work for a generic company, which has little or no promotional or advertising budget compared to the big drug houses, how would you know. Last time I checked, worker bees for Ivax or Watson didn't see the books of Wyeth, Abbott, or GSK. Good try but too little, even by k5 standards.

There's a sucker born every minute, and you're an hour's worth.
[ Parent ]

I might surprise you to know that (2.00 / 2) (#27)
by Egil Skallagrimson on Fri Apr 27, 2007 at 01:06:50 PM EST

being a generic, you have to do your homework in all aspects.

However, you are probably a student or working in a call centre, so your credibility or even your ability to question mine is seriously flawed. You have presented no actual knowledge about this.

Know how I can tell? No one agrees with you and you have nothign to flesh out the argument.

Face it: you have a bone to pick with Big Pharma (and the World Bank, WHO, Globalization and the declining quality of produce at Whole Foods) and you saw this convenient article as nice tool to latch on to. Unfortunately, people actually know about these things, so it hasn't played out well for you.

----------------

Enterobacteria phage T2 is a virulent bacteriophage of the T4-like viruses genus, in the family Myoviridae. It infects E. coli and is the best known of the T-even phages. Its virion contains linear double-stranded DNA, terminally redundant and circularly permuted.
[ Parent ]

Egil, where do you work? A drug store? (none / 0) (#35)
by United Fools on Fri Apr 27, 2007 at 04:14:41 PM EST


We are united, we are fools, and we are America!
[ Parent ]
No, a drug company. A very big one. (none / 0) (#38)
by Egil Skallagrimson on Fri Apr 27, 2007 at 08:06:27 PM EST


----------------

Enterobacteria phage T2 is a virulent bacteriophage of the T4-like viruses genus, in the family Myoviridae. It infects E. coli and is the best known of the T-even phages. Its virion contains linear double-stranded DNA, terminally redundant and circularly permuted.
[ Parent ]

Really? We will apply for vote counting jobs (none / 1) (#34)
by United Fools on Fri Apr 27, 2007 at 04:13:40 PM EST


We are united, we are fools, and we are America!
[ Parent ]
I think you have three extra zeroes in that figure (none / 1) (#22)
by localroger on Fri Apr 27, 2007 at 12:26:55 PM EST

I've heard $80 to $100 million as the typical figure for new drug development and approval. I'd believe double that with all pure dead-end R&D costs added in, but not much more; the real expense comes from the controlled double-blind studies required by the FDA for approval.

This is in fact comparable to the advertising budget of a large pharmaceutical firm; whether the advertising is really more is open to argument, but all those prime time ads don't come cheap. When you look at the ad campaigns for Lunestra or Cialis, they're very similar to the campaigns for soft drinks and cosmetics; they aren't meant to sell you the product immediately, but to make sure that when you find yourself contemplating *some* product in that vein, their name is the one that will be at the front of your mind. That kind of advertising costs tens of millions of dollars a year.

I am become Death, Destroyer of Worlds -- J. Robert Oppenheimer
[ Parent ]

Yeah, you're right. I meant $100,000,000 (none / 0) (#25)
by Egil Skallagrimson on Fri Apr 27, 2007 at 01:03:16 PM EST

thnkx

----------------

Enterobacteria phage T2 is a virulent bacteriophage of the T4-like viruses genus, in the family Myoviridae. It infects E. coli and is the best known of the T-even phages. Its virion contains linear double-stranded DNA, terminally redundant and circularly permuted.
[ Parent ]

It's not in line for the budget for a single drug, (none / 0) (#26)
by Egil Skallagrimson on Fri Apr 27, 2007 at 01:04:07 PM EST

though. That was the point made by the ignorant above poster.

----------------

Enterobacteria phage T2 is a virulent bacteriophage of the T4-like viruses genus, in the family Myoviridae. It infects E. coli and is the best known of the T-even phages. Its virion contains linear double-stranded DNA, terminally redundant and circularly permuted.
[ Parent ]

i think he meant "canadian dollars" (none / 1) (#57)
by raduga on Sat Apr 28, 2007 at 07:02:25 PM EST



[ Parent ]
See above. (none / 0) (#14)
by sudogeek on Fri Apr 27, 2007 at 11:14:29 AM EST


There's a sucker born every minute, and you're an hour's worth.
[ Parent ]
Yeah, you really fleshed out your argument. (none / 0) (#20)
by Egil Skallagrimson on Fri Apr 27, 2007 at 12:11:38 PM EST

Thanks for the insight.

----------------

Enterobacteria phage T2 is a virulent bacteriophage of the T4-like viruses genus, in the family Myoviridae. It infects E. coli and is the best known of the T-even phages. Its virion contains linear double-stranded DNA, terminally redundant and circularly permuted.
[ Parent ]

I don't see it (none / 0) (#23)
by Sgt York on Fri Apr 27, 2007 at 12:54:18 PM EST

If I had, I wouldn't have asked.

The linked article does not state or imply that advertising spending is higher than research spending.

Also keep in mind that you are talking to Egil (who works in the biotech industry) and me (who is an academic research scientist).

There is a reason for everything. Sometimes, that reason just sucks.
[ Parent ]

Ah (3.00 / 1) (#24)
by Sgt York on Fri Apr 27, 2007 at 12:56:29 PM EST

you probably meant "see below" where you claim it's teh conspiratoriacacy. That's not documentation, that's speculation.

There is a reason for everything. Sometimes, that reason just sucks.
[ Parent ]

You're too US-centric and you miss crucial facts (2.87 / 8) (#37)
by sausalito on Fri Apr 27, 2007 at 07:46:28 PM EST

In Europe, the freebies culture is actually worse: instead of just meals, doctors are typically treated to three-day "congresses" in places like Monaco, Barcelona or Capri.

My ex-girlfriend (a pharma rep) told me that the conference halls are always packed on the first day (usually a Friday), then the next two days hardly anyone is around, as the good doctors are busy having a good time on the beach.

But the price of drugs is much lower, from 20% to 90% depending on the drug and on the country. The reason: centralised purchasing and price controls. The state negotiates a price curve (i.e. the price goes down with time) and imposes this price on the market.

In the US there is no centralised state buying. Healthcare providers are relatively small and their coverage is always limited. So they have not the power to force the manufacturers into offering really good deals. In addition, some laws restrict pooled buying, for example by non-profit organisations (or this is what they said in a documentary I watched on cable).

In conclusion: meals, advertising and samples are a sales practice in a lot of industries. They have  little impact in explaining the exorbitant price that American patients pay for drugs relative to the rest of the world.

If you want to change the situation, you need to look at the structure of the market.
_____________

GBH - "The whole point is that the App Store acts as a firewall between busy soccer moms and goatse links"

Yeah this is my reservation too (none / 1) (#39)
by livus on Fri Apr 27, 2007 at 10:51:30 PM EST

it's a genuinely interesting topic but the writer should have either indicated that his analysis is confined to 2/50 of the states of one country.

Alternatively I'd have liked to see a more wide-ranging article.

---
HIREZ substitute.
be concrete asshole, or shut up. - CTS
I guess I skipped school or something to drink on the internet? - lonelyhobo
I'd like to hope that any impression you got about us from internet forums was incorrect. - debillitatus
I consider myself trolled more or less just by visiting the site. HollyHopDrive

[ Parent ]

You are right. (none / 1) (#45)
by sudogeek on Sat Apr 28, 2007 at 08:13:42 AM EST

There are many less restrictions of drug company promotion in Europe.

In the 70s, we used to get fairly unrestricted drug company money for education and travel of our trainees. By 1980, this had changed. In the 80s when I was working with Schering on a clinical project, they would not pay for me to attend a meeting even when I was presenting data. They could fly their employees, but as a faculty member of a university, they were restricted. They would not pay for travel of our trainees and money to faculty was only in the form of research grants.

At the same time, then as now, they can pay for the travel and housing of European and Asian doctors and fellows to attend meetings in the US. If you go the a medical conference like the last AASLD, foreign attendees far out-numbered US attendees.

There's a sucker born every minute, and you're an hour's worth.
[ Parent ]

Kill all the doctors (none / 1) (#48)
by The return of Lemon Juice on Sat Apr 28, 2007 at 09:24:46 AM EST

scum, every last one of them.

I think there's a lot of blame to go around (none / 0) (#53)
by horny smurf on Sat Apr 28, 2007 at 03:45:36 PM EST

pharmaceutical companies for pushing (and advertising) drugs, doctors for prescribing them, patients for demanding them, insurance companies for paying the bill, the government for interfering with health care, and of course the lawyers.

Consider Vioxx: most of the people who were taking it should have been on a cheaper pain killer. But there was a segment of the population for which vioxx, and nothing else, provided pain relief.

If I truly needed vioxx, I'd be willing to risk the side effects for it.

If I had to pay the costs directly out of my own pocket, I'd choose the pills that were the most cost effective, not the ones that were most widely advertised.

So then (none / 1) (#61)
by trhurler on Sat Apr 28, 2007 at 08:02:30 PM EST

You don't believe in free speech. Understood.

--
'God dammit, your posts make me hard.' --LilDebbie

That's actually a good point. (none / 1) (#64)
by sudogeek on Sat Apr 28, 2007 at 09:10:48 PM EST

In the US, federal courts and SCOTUS have held (at least for the present) that political speech can be regulated. In this regard, it is felt that the common interest is served when large financially advantaged persons, corporations, or groups do not  dominate or distort political campaigns. There is free speech but the playing field must be more equal. That is, the free speech of one group must not drown out that of other persons/groups.

There really is no free speech.  Similar balancing exists in essentially all forms of speech. In addition, all speech is further constrained by customs, morals, and laws. To repeat a hoary old chestnut, one cannot cry fire in a crowded theater. As Mr. Imus most recently learned, one cannot publicly slur some person or group.

Now, does drug company advertising represent free speech? Is selling viagra or statins to uninformed consumers so important that it is protected by those words in the Constitution? I think the point is arguable. The public good may be better served by a restriction on such speech.

I personally do not view advertising or commercial speech as warranting protection at all. The framers intent was not to allow handbills touting snake oil on every surface or unrestricted billboards along every major thoroughfare. It was clearly intended to refer to political speech and speech criticizing government policy or action.

There's a sucker born every minute, and you're an hour's worth.
[ Parent ]

Two things (2.50 / 4) (#73)
by trhurler on Sun Apr 29, 2007 at 12:30:45 AM EST

First of all, SCOTUS makes lots of bad decisions. It usually revisits them eventually. The mere fact that they say something today does not put it beyond question.

Second, of course there is free speech. You are confusing speech with a podium from which to speak. The thing is, if people can provide their own podium, there is no power ennumerated in the Constitution that would allow the government to take it away. And there IS a clause that says if a power is not ennumerated, the federal government does not have it.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
what is this "public good" you speak of (none / 0) (#86)
by Delirium on Thu May 03, 2007 at 07:59:28 PM EST

And where in the Constitution is the federal government given the authority to override other parts of the Constitution in order to advocate for "the public good"?

[ Parent ]
also, they have never held that (none / 0) (#87)
by Delirium on Thu May 03, 2007 at 08:02:53 PM EST

The Supreme Court has never held "that political speech can be regulated". They have explicitly said repeatedly that it cannot be, and struck down portions of campaign-finance regulations that attempted to do so. What they have held, which is quite different, is that monetary donations for political purposes do not constitute speech, and may therefore be regulated. However anyone is free to, on their own behalf, engage in whatever speech they wish to. I cannot donate $1m to Rudy Giuliani to run "McCain sucks" ads, but I could personally, on my own behalf, run as many "McCain sucks" ads as I want, without being subject to any sort of regulation.

[ Parent ]
An abstract or a research paper. (none / 1) (#65)
by sudogeek on Sat Apr 28, 2007 at 09:36:38 PM EST

Many comments in the most recent "k5 is dying" thread point out the importance of a submission creating discussion. Be definition, that submission must take a somewhat controversial position. Who would comment on an article stating that pharmaceutical companies are selfless altruistic paragons of corporate responsibility who spend all of their investors money in the neverending battle to cure the sick and give sight to the blind - or whatever the current advertising campaign states.

How much discussion would a scholarly 3000+ word article analyzing the 10-Q's of the top 5 pharmaceutical companies. And, who would read that. It would sink without a trace.

So, a submission laying out the conclusions/biases/preconceived notions of the author in summary form seems to be appropriate for the "News" section, followed by the usual name-calling and challenges that make k5, well, k5. In the discussion, the author (and similarly-minded readers) defend their assertions while other throw verbal grenades. Perhaps someone learns something, someone else is persuaded, and someone else's eyes are opened. Or, perhaps it really is all anonymous wankery.

There's a sucker born every minute, and you're an hour's worth.

No shit... (none / 0) (#67)
by D Jade on Sat Apr 28, 2007 at 10:19:25 PM EST

... you're seriously trying to tell me that you've never noticed that every item in a doctor's surgery is branded with pharma companies' logoes?

Planners, notepads, journals, posters, life models, jelly beans. You've seriously never noticed all these things?

You're a shitty troll, so stop pretending you have more of a life than a cool dude -- HollyHopDrive

That's not it at all. (none / 0) (#68)
by sudogeek on Sat Apr 28, 2007 at 10:26:26 PM EST

How can you miss it. The point of the article is to make these practices more overt. The drug company ads are even on prescription pads and the prescription handed to the patient fercrissakes. The point is the pervasive nature of the promotion yet doctors seem not to even notice and deny the influence.

There's a sucker born every minute, and you're an hour's worth.
[ Parent ]
And why should they? (2.66 / 3) (#69)
by D Jade on Sat Apr 28, 2007 at 10:39:33 PM EST

All specialists are petitioned by representatives of their respective industries. I don't see how it's unethical in a medical environment.

The onus is on the patient to be more inquiring about their prescriptions. If they're buying antibiotics then they should ask for a generic scripts. If it's something less familiar, find out what it does and ask the doctor why they prescribed it.

I don't see how you can make these practices more overt than, as you say, putting drug company ads on prescription pads and handing it to the patient.

You're a shitty troll, so stop pretending you have more of a life than a cool dude -- HollyHopDrive
[ Parent ]

Your vote (1) was recorded. (1.50 / 2) (#76)
by MisterJiffy on Sun Apr 29, 2007 at 06:31:25 AM EST

This story currently has a total score of 16.

You were the last vote. We've considered the votes and comments, and decided the story should be posted. Thank you!

Victory is mine! I'd like to thank everyone who worked hard to make this possible, especially Jesus.


Pharmaceutical reps (none / 1) (#85)
by EcoLovingGuy on Tue May 01, 2007 at 02:19:22 AM EST

These days virtually every new pharmaceutical rep hire is a good looking girl.  So these companies are throwing money and sex (sorta) at the doctors.  Personally, I don't care what these people give to the doctors.  For the most part, I research my own problems and make a decision about what medicine I need, using the doctor only as an advisor.  My primary concern is that they are dumping as much possible into researching new medicines.  So if this sort of strategy makes them more profitable, thus allowing them to spend more money on research, I'm all for it.  Not that I believe this to be the case, but it bears mentioning.

Green Furniture

Greedy rich bastards. (none / 0) (#89)
by Dev X on Fri May 11, 2007 at 12:20:38 AM EST

If pharmaceutical companies are dishing out bribe money they have a fiscle purpose.

Generics that work just as well are preferable for most. Or older less questionable drugs. Maybe patients should just have a wider selection to chose from. Instead of taking whatever is prescribed.

People who do take generics sure as hell shouldn't have to pay for other pharmaceutical companies lose pockets.

Hydrocodone vicoden or otherwise is hydrocodone. Risk is risk surely an educated patient is just as capable of making a decision based on risk as a doctor if not more so.

Doctors sure as hell shouldn't have control over supply and demand. Nor the pharaceutical companies. Control that and you control the price you control the market.

   
Lost in Unlasting Infinity.

Obligitory link (none / 0) (#90)
by vectro on Fri May 18, 2007 at 02:49:30 AM EST

to No Free Lunch.

“The problem with that definition is just that it's bullshit.” -- localroger
do as i say, not as i do (none / 0) (#91)
by greenisagoodcolor on Tue May 22, 2007 at 07:14:26 PM EST

"Most of these speakers are faculty at medical schools - the very group that publishes these articles sneering at the corrupt community doctors and drug reps."
its so much easier to be a hypocrit and to succumb to the pleasures of the dollar then to maintain your moral integrity.

Drug promotion and bribes | 91 comments (80 topical, 11 editorial, 0 hidden)
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