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U.S. doctors steeped in financial ties to drug money to Big Pharma

Pharmaceutical firms in the United States are shelling out massive funds for doctors travel and entertainment expenses in hopes of boosting sales of new drugs. More than 160,000 doctors have received related payments in 2011 already.

The big push includes free samples, hospital detailing, journal ads, gifting, and the sponsoring of continuing medical education, but patients fear this all leads to doctors prescribing popular, money making drugs instead of following standard of care practices .

Pfizer, Eli Lilly, and AstraZeneca top the list of companies also spending far more on "marketing" than on research, with a total estimated $57,000 billion in overall marketing expenditures in just one year in the United States.

Pharmaceutical giants are claiming they are just trying to be open about how they conduct business, but the statements come at a time of intense scrutiny, and after several prosecutions regarding unlawful marketing practices.

In fact, some of these databases were actually set up as part of settlements of federal criminal investigations into the illegal marketing of drugs to doctors. Many companies have not released any data whatsoever, but Lilly and Pfizer combine to have paid out over 90 million dollars.

United States government agencies are preparing guidelines that will make such information mandatory by 2013. Currently there are over 80,000 pharmaceutical sales reps in the U.S. pursuing about 800,000 pharmaceutical prescribers, so it can be extremely difficult to track the money for one doctor from several sources, or to identify the largest recipients, like an entire hospital, without laborious work by a whole team of computer experts.

By 2013, new federal healthcare laws are expected to make it easier for the public to track a doctor's payments from multiple companies; however, there may be controversial business opportunities available in the setting up and running of these supposedly transparent websites, such as PharmaShine, which was founded auspiciously by a former attorney for Merck.

Critics are complaining about the extreme conflicts of interest that arise from all the gift giving and promotional items, saying doctor's can negatively influence the cost of medicine by recommending or prescribing brand name drugs over cheaper generics. In many instances, the reward is substantial for doctors to do exactly that. Over 380 doctors have earned more than $100,000 from drug companies in just the past two years.

But there is also a flip side to these perks. One doctor said he had to follow a slide show presentation word for word in order to receive funding for a speaking engagement promoting certain pharmaceuticals, or there would be changes made to his contract.

On top of all the other problems inherent in proper ethics and disclosure, many prominent doctors at academic medical centers have failed to disclose millions of dollars in drug company payments, and Federal prosecutors say some payments are really kickbacks for illegal or excessive prescribing. Are doctors now moonlighting as drug salesmen in order to keep the perks flowing?

Sources:

http://www.pmlive.com/find_an_article/allarticles/categories/General/2011/august_2011/news/big_pharma_pays_us_doctors_$150m_in_2011

http://www.ft.com/intl/cms/s/0/7e597dfc-d181-11e0-89c0-00144feab49a.html#axzz1Wj56M3oH

http://www.nytimes.com/2010/04/13/business/13docpay.html

http://www.pbs.org/nbr/site/features/special/archives/pharmaceutical_companies/big_pharma_and_physicians_101019/

http://www.alternet.org/health/141369

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