Drugged Children

[keokie]

Just for clarification, prescribers are not paid for writing scripts. Its against the law...

 

[SloBurn]

GSK is going to stop paying Pharm reps. on a commission basis, this is a huge change for the market! Pharm reps are probably the biggest reason for the way Drs. write script the way they do. I've seen it first hand, as my Ex, and current GF are nurses in Dr's offices and deal with Pharm reps almost every day.

 

[keokie]

I come at this from a little different perspective. I have been a pharma rep (a long time ago), and have close family members who have been in the industry for decades. Pharma reps are no different than other manufacturer's reps. They call on people who specify products in their category, and try to educate them of the value of their product. The primary difference being there is TREMENDOUS regulation by the FDA as to what can be communicated, and how it is done. In fact, the FDA commonly forbids reps from providing factually correct information if it has not received prior approval from the FDA. Reps can't take a doc to lunch, dinner, a ballgame, or anything of the sort. As I said, the promotion of products is highly regulated. The primary thing the reps do is inform the docs of the results of the FDA approved, peer reviewed, double blind, random studies that were done on the products, as well as proper prescribing, drug-drug interactions, side effects, etc.

 

[Boat Guy]

Keokie, Thank you for a different perspective. But, aren't those issues about comps, etc. relatively new because of the abuses that were going on. Further, are you trying to say "incentives" don't happen? I understand you were just doing your job. But, your job was to sell as many SKUs as you can. So there is little motivation to get people off medications.

Lastly, did you ever have any direct involvement with the FDA? From what I've seen, they have little resources to check on compliance and some working for them aren't even motivated to do so.....

 

[keokie]

Boat Guy, I appreciate the conversation. I think public discussions on these issues are very important. A couple things.

Throughout the course of my professional life, I have only been asked to do things I considered unethical a few times. In those instances, I refused. None of them happened in my few years in Pharma. My job was to ensure the physicians I called on were aware of the strengths of my products. I was never motivated to get people off medications, and would not be qualified to determine if they should be off medications. I was very qualified to explain my products and their proper use, which is what I did.

As I mentioned earlier, I do believe we are an over-drugged society. I just don't blame the drugs for that (or their manufacturers). Being over-drugged is a result of decisions made by docs and patients. Docs and patients have been clamoring for a pill for everything. In some cases this is good. Drugs that have great efficacy with cancers (such as CML), or blood pressure, or asthma, seizures, ED, pain, and psychological disorders, etc. greatly prolong and enhance our lives. Unfortunately, some conditions such as the last two are ripe for abuse by doctors and patients. But Pharma companies generally do not create the need. I say generally, because I know there are exceptions. I think ADHD drugs and Psychotropic drugs are examples where I believe pharma is contributing to the problem. But again, there are vast regulations to limit this. You still cannot bring to market a product for a condition it has not scientifically proven to alleviate with an appropriate limit to side effects.

I believe that a key in life is to educate ourselves (and yes, that is a hell of a responsibility), because we will never have a situation where we can rely on government and/or corporations to protect our interests. The best we can hope for is that there are checks and punishments for either if they harm us out of malice or negligence.

I would do a lot of research before taking a new med. In today's world, research has gotten much easier.

The FDA is pretty rigorous (and the fines are often truly astronomical). Yes, I saw, and still see routine and specific involvement from the FDA.
The issues of not being able to take a doc to lunch etc., go back about ten years. I have never known a time when it was legal to compensate a doc for prescriptions. The press gets this wrong all the time. Even in many of the GSK articles, reporters stated, "GSK will no longer compensate doctors for prescribing or promoting their products." They were never compensating for prescribing.

In fact, even back in the day when you could take a doc to dinner, or a baseball game, their prescribing habits very rarely changed as a result of how they were entertained. Education is truly the best way to change prescribing habits.

Incidentally, what product a doctor writes is correlated VERY heavily to what product the insurance company covers. That is not intended to be a knock on insurance companies. Whether the doc writes a med at all is between him/her and the patient.

 

[Boat Guy]

I appreciate you taking the time to reply.

I agree, to a large degree, with what you have written. Yes, insurance companies play a large role in what the doctors prescribe. Though, with all the "direct to patient" advertising pharma is doing, patients are being fed what to ask the doctor for. I see doctors so overwhelmed by insurance companies, know-it-all patients, and paperwork, that they just write scripts hoping to satisfy their patients. Ultimately it's the patient that needs to be responsible for their bodies. But, I don't care for an industry that self promotes their products like drug pushers. ADHD is just one example.....

I, for one, would still be on three different pills a day if I hadn't gone against my doctor and said absolutely not. He was writing me scripts that would have continued indefinitely. So, I know first hand how easy it is to blindly listen to a doctor and get into a health care system that's hard to crawl out of.

 

[OldSkool]

I believe the doctor has the bigger responsibility here. Patients put their trust in someone that can relieve their pain. That trust must be appreciated by the doctor and not push the latest designer med that comes down the pike. I also believe that university hospital foster new drugs and are willing to use patients as unwitting guinea pigs.

 

[MonacoMike]

I am not commenting on the original topic of children as I did that in another thread, but this applies to the medication epidemic in our country. Today, patients DEMAND a drug for every little thing and 90% refuse to even try any holistic approach, such as weight loss or diet modification. Of the 10% that are willing to try 90% fail to discipline themselves to reach success. If as a patient you ask a physician what program you should implement to avoid medication they are shocked as it is so rare. While it is a first amendment right to advertise their drugs, the ads do create an illusion that they produce a pill to cure anything and all you need is that pill.

Our society has created some amazing life saving drugs but we also abuse them. Sadly, the system favors creating pharmaceuticals for daily type regular use rather than something that will permanently cure you. Simple economics will bear this out as it would cost similar to make a drug millions take daily as opposed to a drug taken by thousands for a set period to a cure.

I think they ramp up business by constantly redefining the condition. Blood pressure for instance, in 1977, "160/95 mm Hg" was when you were deemed high and needed to take corrective action. In 1984, "140/90 mm Hg", in 1997, "130/85 mm Hg", and in more current times "115-120/75 mm Hg". Some will say our knowledge of the science of the issue has evolved, but others make a great case that the system, in the name of protecting the public, promotes this and the effect is that doctors have more regular patients, pharmaceutical companies have more steady users, and the patients don't care because for most of them someone else pays for the drugs.

MM