Drug Company Gifts to Doctors:Prescribing Under the Influence

E. Haavi Morreim's article "Prescribing Under the Influence" in the publication of the Markkula Center for Applied Ethics of Santa Clara University clearly provides realistic examples of the influence of pharmaceutical companies "gifts" to doctors. If you don't yet know what has been going on to get physicians to prescribe and advertise their drugs, please go to the site and read her entire article. The excerpt from the first part is posted below. ..Maurice.

Gifts to doctors from drug companies have implications for patient interests.

It’s morning report in the Department of Pediatrics at an academic medical center. A senior faculty member is working through a case with a group of residents and interns. "First we saw these symptoms. Now that the laboratory results are back, how does that change what we think?"

In the back of the room, there’s a table with bagels and juice. On the table is a supply of pens, notebooks, and little stuffed toys, all with a pharmaceutical company logo prominently displayed. Next to the table is a representative from the drug company.

When you ask doctors whether this kind of drug marketing is effective, the answer is always the same: "It doesn’t influence me at all. They’re not going to buy my soul with a laser pointer." In a recent syndicated newspaper column, one doctor commented, "I blame the pin-striped MBAs, who mistakenly believe that physicians are going to prescribe certain medicines because the company plies them with pens."

The truth is, the physicians may need to reconsider. This kind of advertising is crucial to sales. A doctor is not going to prescribe something he or she has never heard of, and it’s the drug representative’s job to get the products’ names in front of the physicians. Maybe the drug representative does that while the resident is slathering cream cheese on a bagel; maybe it’s while the intern is saying, "Oh, what’s this cute little stuffed bear?" Either way, the doctor stops and spends a moment.

In private practice, the little gifts are often even more important. If you’re a drug representative, physicians are usually not interested in talking to you unless you have something to catch their attention. Then you can get your three sentences in: "We’ve got such and such on the hospital’s formulary now." Or "The new form of this drug can be given once a day instead of four times a day. The patients will love it." It’s a way to get in the door so that your information rather than somebody else’s reaches the doctor’s brain.