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"There's a big bucket of money sitting in every office ... Every time you
go in, you reach your hand in the bucket and grab a handful."
That's how a sales manager at AstraZeneca described to colleagues the
rewards of pitching the company's products to doctors. His unguarded
remarks showed up on the Internet—and got him fired, as the company
confirmed—just as a new storm is brewing over tactics drugmakers use to
influence doctors' prescribing habits.
A two-year Senate Finance Committee investigation, for example, has
concluded that the companies, by funding continuing medical education programs
for doctors, have been able to "increase their market for new
products" and to illegally promote off-label uses for their drugs. The
committee is concerned that persuading doctors to prescribe the newest,
costliest drugs hikes government spending for Medicare and raises safety
issues.
The drug industry in 2002 issued its own code of conduct declaring that
interactions between sales reps and doctors should benefit patients and that
meals—but not entertainment—are allowable if modest and connected
to educational presentations. Today, 94 percent of doctors report a
relationship with drug reps, according to a survey led by Harvard Medical
School and published in the April 26 New England Journal of Medicine. The
interactions range from receiving drug samples (78 percent) to getting free
meals (83 percent) and expenses for attending industry-sponsored meetings (35
percent).
The authors of a second study wrote in the Public Library of Science's
April medical journal that "reps scour a doctor's office for
objects—a tennis racquet, Russian novels, '70s rock
music"—to establish personal ties, and some give doctors food and
gifts.
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