Do Doctors get pay incentives to promote Drugs??????

Discussion in 'Fibromyalgia Main Forum' started by carebelle, Sep 15, 2006.

  1. carebelle

    carebelle New Member

    I decided to post this for two reasons .I believe it to be true And I think it should be illegal .It seems a person that is getting a roll back for the drugs he prescribes has not got his patients need as #1.
  2. suzetal

    suzetal New Member

    I asked my Doctor that ? last month when she helped me out by giving me some samples of cymbalta she had cause I told her how much they cost .She said thats crazy Ill give you what I have.

    I asked her how come she has them shes not a shrink shes a neurologist.She said she accepts samples to help her patients who cant afford them.

    I than asked jokingly do you make money on it?She said I wish I would be rich by now.So she does not get money.All she does is help her patients out.

  3. carebelle

    carebelle New Member

    I was told they get things like trips and stuff thats indirect like other gifts.
  4. carebelle

    carebelle New Member

    they do but I have read on this board and Ive had friends tell me they do.I think its important to know the truth and I just did not know .I'm sure others may think this to and we should hear the truth.
  5. Slayadragon

    Slayadragon New Member

    As far as I can tell, the booty that doctors get from pharmaceutical companies include the following:

    1) Drug samples
    2) Pens, clipboards, etc.
    3) Catered lunches for their whole staffs (which might increase employee loyalty or mood)
    4) Money for research (if they do research)
    5) Conferences (although I'm not sure how much of the travel expenses the drug companies can pay)

    and, most, importantly.....

    6) Regular visits from perky flirty and cute former cheerleaders

    This last is not a joke. A WSJ article recently stated that a lot of drug companies recruit _directly_ from college cheerleading programs. They tend to work a few years and then go back to school to get MBA's.

    Pharmaceutical companies say that since doctors wouldn't really trust any drug company rep and only will spend 30-60 seconds talking to one, the best way to maximize the available time is to make the experience a positive one from a purely emotional point of view The brief chats that doctors have with young, peppy, healthy cheerleaders are a nice change of pace from their usual dealings with ill patients and frazzled colleagues, it seems.

    Not that all doctors like such visits (some absolutely forbid them), but some seem not to mind.

    It's illegal to pay doctors on a commission basis to prescribe certain drugs, and it's illegal to give doctors things that are not on the above list (or similar to the stuff on it) in the hope that they will prescribe your company's drugs. I've not heard of any legal cases that have alleged that those things have happened. I'm sure that some doctors would take the money, but I'm much less sure that pharmaceutical companies would risk their reputations in order to offer it. As long as big pharm is a) highly profitable and b) at the mercy of the FDA, they have a lot of incentive to play by the rules.
  6. kjfms

    kjfms Member

    that takes a lot of people who haven't any insurance who aren't on any government assistant and who like me are sick and just trying to make it through life.

    I thank god for those rx drug reps because I get a lot of my medicine this way.

    Not because of where I work but because I am part time and have no insurance and couldn't get them if it weren't for my physician giving me the samples that the drug reps leave.

    Yes I use the pens, sticky notes, and eat the free lunches they bring because it saves the clinic money. They are free--no strings attached it is called advertising with pens, sticky notes, etc...

    I have set at the table with the physicians when the rx drug reps told them about the drug while we (believe me the physicians were in more of a rush than I) wolfed our free lunch from a local restaurant.

    Trust me it isn't any thing fancy and it's on paper plates. I have been to several of these lunches and have never heard any thing about free trips for physicians.

    Most physician only half way listen to rx drug reps if at all for the free samples to help patients who need it.

    Oh--I used to be a cheerleader and we're all not flirty and empty headed as someone suggested (I think) :) some of us former cheerleaders actually have a brain in our pretty little--all be it old--head...and work pretty hard no matter what our job may be.

    As for perking young cheerleaders breaking up a physicians day? Well that would be assuming all physicians are heterosexual males which they are not. Many physicians are in fact women ;)

    I see nothing wrong with physicians accepting rx drug samples for patients especially with the price of prescription drugs in this country.

    I see charts of patients every day who have fibromyalgia syndrome, diabetes, hyperlipidimia, hypertension, hypothyroidism, hyperthyroiism, GERD, bladder issues, restless legs syndrome, depression, anxiety, etc...well you get the idea.

    These patients are non-compliant to treatment that would help them because they can not afford it.

    It is because of these free samples physicians are able to help a little or sometimes a lot.

    Now I ask what in the world is so wrong with that?

    What is so bad about physicians wanting to get free samples to help their patients?

    Speaking for me--free lunches is not enough to buy my loyalty to anything let alone some company. If I take and believe in their rx drug that is another story but that is just me :)

    I'll step down from my soap box for the moment,

    Karen :)

    [This Message was Edited on 09/16/2006]
    [This Message was Edited on 09/16/2006]
  7. Marta608

    Marta608 Member

    I absolutely am thankful for samples for folks who can't afford to buy their drugs but I still think that if someone takes me to lunch and is very pleasant I might be subconsciously a tad more likely to prescribe their drug than one that's had no representation (if such exists). It's just human nature and doctors are human too.

    I'm for no drug samples, no drug rep and Universal or at least affordable health care.


  8. Well I have heard that is true. I DO KNOW that when I wait for over an hr. or more for the dr. to see me, these drug reps. come in with bags and bags of take out restaurant food, pop, etc. So they are trying to bribe the drs. evidentally or why would they do this?

    I do think though it is great that drs. give out samples for people who either can't afford drugs or to try first before prescriptions are paid big $$$$ for something you can't use.

    [This Message was Edited on 09/16/2006]
  9. myalgiamania

    myalgiamania New Member

    all meds once approved recieve a 7year patent. during that 7 years, they can sell that med for whatever they want. and just like any other business, they will use any means available to sell their product. since all prescription drugs are prescribed by doctors, one of the best tools is to reward doctors for prescribing their drugs.

    once the 7 years patent is up generic brands become available at which point the drug companies come up with a new medication. if you don't think this is true, go sit in a doctors waiting room for one day and count how many sales reps stop by.
  10. Tibbiecow

    Tibbiecow New Member

    It is good to have samples, a Godsend for those who can't otherwise afford the drug in question. This is especially true when a drug has no reasonable or effective generic drug in the same or similar class.

    We have to ask, though, why the drug companies spend so much time and money giving out samples. The answer is that it is profitable, because doctors prescribe them more often. The result is that insurance companies pay TOO MUCH MONEY for the newest drugs and make them profitable for the drug companies.

    One point which has not been brought up is why the sampling is effective for the drug company: The doctor gives the patient both a 3-to7-day sample and a 30 day prescription with 6 months of refills. These patients likely have prescription coverage. Now what happens: the patient was just given the most expensive therapy for his problem, and the insurance company has to pay for it. Why? because if the patient can get started right away with the samples, they have a few days before they have to go to the pharmacy.

    So I would ask doctors to prescribe these 'sample' meds only when a)no other appropriate, or less expensive therapy is available. And give the samples out freely to those who use them as their 'script' because they can't afford the appropriate therapy.

    My insurance just went up to $982 per month. No doctors visits, no prescriptions. No way to get a new policy because of fibro, migraines, and my husbands' basal cell carcinoma. This just can't go on much longer. A recent report on public radio stated that 9 out of 10 people in the US cannot obtain health insurance. So now 10 percent of the people are paying for insurance? This obviously cannot work; private-pay and insurance has to pay for those who can't afford medical care and at this point we just can't afford it.
  11. waxdiva

    waxdiva New Member

    A friend of my husband is a rheumy. When Vioxx was taken off the market, he was a bit miffed (to say the least), as he had a "research project" being "sponsored" by Vioxx. Guess what he was, prescribing for the majority of his patients?? Did I hear Vioxx??? How did you guess??

    The pts were informed of this research project by signing one of the many forms that are presented at their first appt. Many do not read what they are signing, so some do not realize they are taking part in the "study."

    The study was for Vioxx, paid for by Vioxx and the doctor received additional compensation for conducting the "study."

    These are the incentives that the doctors will happily see these pharm reps for.

    Yes, as one of the previous posts mentioned (re her father and husband who are MDs), the majority of doctors DO NOT want to see the annoying reps that sniff around the doctor's offices unannounced, who leave little trinkets like post-its, pens, samples, notebooks, little lamps and, yes (because I've seen them), wooden coat hangers (with the drug name stamped all over them). And, like the previous post, they have strict rules for these annoying reps...they are small time and the doctor definitely doesn't want to waste his time on them.

    HOWEVER, when the pharm companies are offering substantial incentives...meaning cash in pocket for pushing their drug under the guise of a "study"...the doctor will drop what they are doing and take the call or meet the rep.
  12. Cromwell

    Cromwell New Member

    I thank your own family for being above this. I have family members who are doctors who are not. They accept seminars at expensive ski resorts, and many doc offices I have known get free lunches sent in by the drug companies, all in an effort to woo doctors. Of course, most doctors will take them andthe samples and not bother pushing the drug, but some do. I have found especially psychiatrists get involved in drug studies and get "supplemented" with research pay.

    This is particularly true for programs involving children as the drug companais rely of psychiatrists involvement to use neuroleptic on kids. Really they are using the kids as free guinea pigs in many state based schools and institutions to help pay for provision of counseling etc.

    Love Anne
  13. mariee

    mariee Member

    Yesterday, Stanford University in California announced it will no longer accept freebies fr. drug companies. The spokesperson said there is definitely a conflict of interest and some patients have questioned this practice . They will no longer go to the free dinners, accept pens, notepads etc. They said it is subtle, but sitting w. a pen fr. a drug co. can influence drug choice.
    I am impressed w. this....
    PS When I get a sample fr. a doctor, I run it by my make sure it doesn't interact w. current prescriptions...
  14. dononagin

    dononagin New Member

    Many of you know.. I work for a 4 star restaurant in Calif.

    I do at least 2 drug "feed and sell" dinners a month as well as several "to-go" lunches a month for pharmacuetical companies.

    Mostly, they invite the local doctors here. They provide wine and sparkling water tray passed on arrival while they look at their "gimmee's'. Usually they are pens, sometimes clipboards, I've seen a few Mousse Pads, random other small token gifts.

    We provide a dinner - Usually Steak, while they listen to an hour presentation by a doctor on whatever drug they are trying to sell. There is usually a video presentation followed by questions and answers.

    A few years back, these dinners were quite expensive.. We served a lot of Lobster in those days.. Now there are laws that regulate how much the reps can spend per client.

    It is regulated now.. At least in California. I have to sign service agreements with most of the reps. Our clientelle is usually doctors from the state hospital or prisons that are fairly close to us. We also get some Navy groups.. No alcohol can be served to Navy doctors during their presentations.

    I haven't seen anyone resembling a cheer-leader.. in fact the most successful rep that I have done catering for is a 60 year old man..

  15. carebelle

    carebelle New Member

    He said its illegal to accept money or gifts .I also think it is settle if its left on a pen or something in the doc's office.

    As far as leaving for people who do not have the money for Drugs .I would question if this is even the best one for you or just a hand off.

    I do not like this practice it leaves to many question about who,what when and WHY ? I think it also has to get pained for somehow .Who's really paying for them and why ?
    Could that be another reason why Drugs are so costly?

    For all anyone knows it could be sugar pills if its a blind study.

    I do have compassion for those who can not afford them but there should be a better way to help them .It should not bring into question any of the questions above or make people question a Doctors character
  16. Tibbiecow

    Tibbiecow New Member


    Sorry to shout, see my above post. The whole sample system is designed to get doctors to PRESCRIBE the sampled drug, which is then paid for by those who have health insurance. Many, many of those with insurance could be treated with a less expensive alternative treatment.

    Some docs and patients have learned to use the sample system to benefit those without prescription coverage, and that's good. But if there were no sampling, theoretically doctors would have to prescribe drugs based on the drug's effectiveness cost, and alternative options.

    Unfortunately, many, many docs get almost ALL of the information (including studies- most likely only the favorable ones paid for by the drug company) from THE DRUG COMPANY. That scares me.

    But what makes me MAD is that health insurers end up paying for all the sampling.
  17. Leaknits

    Leaknits New Member

    Carebelle, I've never seen a hand-to-hand exchange of $$ between drug rep and dr so I can't say Yes, they get that sort of pay incentives.

    BUT: I have been in County Clinic waiting rooms, on time for my appt w/dr wonderful, only to get "my" appt time taken up by drug reps who barge in unannounced and demand entrance to see dr whomever.

    I have seen drs, nurses, pa's, accepting everything from gel pens to glow-in-the-dark stickum-backed things that light one's way down a home hallway to the bathroom, to wall clocks (both in dr offices and exam rooms and these people's private homes) to scales in both offices and homes, not to mention postit notepads, pen and paperclip holders on dr's desks, clip-on name tags, briefcases...and GOOD ones, not cheap...all of these things bearing the name of some drug or other.

    You bet I resented it when some man with more health and strength than I was allowed to jump in line ahead of me to see dr and take up the time that was supposed to be mine.

    I have to (oh poor little me, uh huh) buy my own pens, postits, can't afford those glow in the dark stickum-backed things to put on a wall between bedroom and bath because they are WOW expensive, can't afford but don't need a briefcase because I don't work any more but that's not the point, and the only time pieces in my house are the clock on the microwave, the briefly appearing time stamp when I turn on my tv, and the thank goodness it's there clock in the lower righthand corner of my computer screen.

    In short, I think these goodies should be given to the patients, not the drs who can already afford to buy their own!!

    I absolutely agree with the poster(s) here who said when they see a rep from WhateverDrugCo, they know their dr will try to get them to accept scrip and/or samples of the Drug Of The Month.

  18. jake123

    jake123 New Member

    My doctors are always generous with samples because my prescriptions are expensive.
    I know that the drug companies do provide lunch (Jason's Deli and Olive Garden food) because I have seen them appear at the doctor's office. Hey, the doctor has to eat too! As long as they don't plan to talk the entire lunch hour.
  19. Slayadragon

    Slayadragon New Member

    I didn't make up the part about drug companies going out of their way to hire cheerleaders to be reps for doctors' offices. I got it from a major story in either the Wall Street Journal or the New York Times (I think it was the WSJ, but since I get both I'm not absolutely sure), about six months ago.

    After the article ran, my husband was hired by the head of marketing at a very large drug company to do a presentation for mid-level sales managers. He asked if the story about the cheerleaders was true. The marketing head said that there was a lot of truth in it, for entry-level hires. (Higher-level sales reps do not resemble cheerleaders in any way. They spend their time talking to the doctors about the product--rather than passing out sticky pads--and managing reps, and thus need a different skill set. The people who give talks at four-star restaurants would fall into this higher-level sales manager category.)

    Both the article and the marketing head said that cheerleaders have outgoing and enthusiastic personalities, and thus serve as a nice contrast to the other people that doctors interact with in the usual course of their days (e.g. sick patients, harried colleagues and underpaid office staff).

    Male as well as female cheerleaders are seen as desirable, the article and the marketing manager said. Obviously not _all_ drug reps are cheerleaders, but it seems they have an edge when competing for those jobs (which are amongst the most desirable entry-level sales jobs around, in terms of experience, training and pay).

    As a marketing consultant, I find this to be a rather fascinating story.

    As a patient, I have no objections. For instance, I go to one doctor who seems to be willing to talk to 1-2 reps between each patient, for about 30 seconds to 1 minute each. Basically they drop off samples and chat about the weather etc. I am very fond of this doctor because he always seems to be in a pleasant mood and is willing to spend the time to talk to me about what's going on with me. (I have to wait about six weeks for an appointment, and so it's not like he has nothing else to do....he just seems truly interested.) He also always has a medical student in training (not all doctors have the patience for that), and since he has a lot of CFS patients, the med students always know far more about CFS than almost any doctor I've met. I don't know if the peppy drug reps delivering samples (and sorry, most _do_ seem peppy to me) put him in a better mood, but if so, more power to them.

    My husband actually asked this doctor (during a consultation) about his interactions with drug companies before he did that marketing seminar. The doctor said that he thought the drug companies were doing a good job in formulating new medications that help patients, but that they tended to be too greedy when it came to charging for them. I would agree with that assessment.

    Finally, on average, cheerleaders seem to me at least as smart as the rest of the population. Probably more so, since it takes skill to be able to tune in to people's moods and do the right things to change those moods for the better. The drug reps I've known (including those I met in the MBA and Ph.D. programs that I attended) have been very smart and (even more importantly in the business world) have had great people skills. Undoubtedly the drug companies are very wise to hire them.....
    [This Message was Edited on 09/16/2006]
  20. JLH

    JLH New Member

    ABSOLUTELY NOT!!!!!!!!!!!!!!!!!!!!!!!

    My daughter is a medical doctor. I asked her and she replied absolutely not!!!!!

    They do accept the samples so they can hand them out to patients who can not afford the medication and to patients who they want them to just try a new drug in place of what they are currently taking, etc.

    They also accept the advertising handouts--pens, tissues, note pads, etc.

    They DO NOT accept elaborate trips, etc. Well, at least she doesn't and all of the other doctors in their office. I am sure they are probably offered, but it would be up to the ethics of the doctor involved on whether or not they are accepted.

    The drug reps do sponsor dinners at restaurants in the evening hours to give a speech about their new products rather than take up office time and to hit all of the doctors at once. They do pay for the dinner.

    They do bring in donuts to the office staff, etc.

    But all of these are low dollar items we're talking about.

    Drug reps offering incentives to doctors is NO DIFFERENT than salesmen in other areas of business! I worked in a Purchasing Department. Our Buyers saw many salesmen every day pushing their new products. They would bring us donuts, cookies, etc. and sit them in our office conference room for everyone. They gave our Buyers pens, pencils, postit notes, gadgets, and all types of stuff. They would also offer our buyers game tickets to big sporting events, concerts, trips, etc. Our corporate policy was that the Buyers could only accept anything with a value of less than $25. The only stipulation was that the gift had to be legal and they were not permitted to accept any type of alcohol.

    Salesmen in all areas of business have done this for ages, so it should be no big deal for doctors to accept these things either.

    Our buyers were NOT SUPPOSED TO BE influenced by gifts and doctors should not be influenced to push the products of their drug reps. It all depends upon how ethical the person is.

    Don't blame an entire group on the actions of a few. There are always rotten apples in every barrel!