Have Doctors Become Salespeople for Drug Companies?
You pay your doctor to keep you well and to heal you if you get sick.
Two new articles from the New York Times [reg. req.] reinforce what we already know, that doctors have a conflict of interest when it comes to prescribing medications.
Doctors get rebates for using drugs to treat anemia.
Two of the world’s largest drug companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses.
The payments are legal, but very few people outside of the doctors who receive them are aware of their size. Critics, including prominent cancer and kidney doctors, say the payments give physicians an incentive to prescribe the medicines at levels that might increase patients’ risks of heart attacks or strokes.
[...]
Neither Amgen nor Johnson & Johnson has disclosed the total amount of the payments. But documents given to The New York Times show that at just one practice in the Pacific Northwest, a group of six cancer doctors received $2.7 million from Amgen for prescribing $9 million worth of its drugs last year.
Psychiatrists are writing off-label prescriptions for children for psychotropic drugs. I don’t see this as a problem in itself, unless they’re doing it to make money off the drug as opposed to being the best treatment for the patient.
Isabella Bailey, Anya’s mother, said she had no idea that children might be especially susceptible to Risperdal’s side effects. Nor did she know that Risperdal and similar medicines were not approved at the time to treat children, or that medical trials often cited to justify the use of such drugs had as few as eight children taking the drug by the end.
Just as surprising, Ms. Bailey said, was learning that the university psychiatrist who supervised Anya’s care received more than $7,000 from 2003 to 2004 from Johnson & Johnson, Risperdal’s maker, in return for lectures about one of the company’s drugs.
Doctors, including Anya Bailey’s, maintain that payments from drug companies do not influence what they prescribe for patients.
[...]
A New York Times analysis of records in Minnesota, the only state that requires public reports of all drug company marketing payments to doctors, provides rare documentation of how financial relationships between doctors and drug makers correspond to the growing use of atypicals in children.
From 2000 to 2005, drug maker payments to Minnesota psychiatrists rose more than sixfold, to $1.6 million. During those same years, prescriptions of antipsychotics for children in Minnesota’s Medicaid program rose more than ninefold.
In defense of doctors, I should note that if you’ve ever seen how much Medicare reimburses doctors for treatments, you would understand why they have to make their money elsewhere if they are to have any hope of staying in business.
I would only expect this problem to get worse, under “universal” health care.
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