133 lines
6.3 KiB
Plaintext
133 lines
6.3 KiB
Plaintext
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Taken from KeelyNet BBS (214) 324-3501
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Sponsored by Vangard Sciences
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PO BOX 1031
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Mesquite, TX 75150
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This article was taken from the DALLAS TIMES HERALD
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Sunday, December 24,1989
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By Robin Lichtenstein from Newhouse News Service
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DOCTORS, DOLLARS & DRUGS
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Is your physician helping the medical industry `push' pills?
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For most people, the idea of pushing drugs conjures visions
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of criminals hunkering over piles of cash and illegal white,
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powdery substances.
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But drug pushing - the legal kind - happens every day in a
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medical world that's invisible to patients.
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It happens in virtually every doctors' office through face-
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to-face meetings with gift-bearing drug salespeople, during
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company-sponsored seminars held in vacation resorts and hotel
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conference centers, and whenever a physician opens a medical
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journal to page after page of colorful ads espousing the virtues
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of prescription medication.
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"It's third-party marketing" to a middleman - the doctor -
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whose prescribing behavior helps determine company profits,
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according to a drug company salesman who requested anonymity.
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"It's not like getting [a consumer] to sign on the dotted line."
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Industry spokespeople and some doctors say that marketing
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efforts generally result in a better-informed physician who is
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better able to care for his or her patients.
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Other doctors call third-party, or indirect, marketing a
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waste of time and money.
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Drug industry critics have produced some evidence suggesting
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that drug marketing has combined with other factors to prompt
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doctors into sometimes prescribing useless or harmful drugs.
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Doctors also can be influenced be patient requests for certain
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drugs, research suggests.
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Ideally, a doctor prescribes a drug because the scientific
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evidence shows it will help the patient. To what extent
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prescribing decisions are based on science and to what extent on
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marketing are issues of considerable debate.
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And, with the average prescription cost at about $17.00,
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according to a 1988 survey of 1,850 pharmacies nationwide, many
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people are asking whether drug companies ought to devote some of
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its marketing budget to reducing drug prices.
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Robert Wood Johnson Clinical Scholar Dr. Michael S. Wilkes
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of the University of California-Los Angeles estimates that drug
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companies spent more than $2 billion on indirect marketing on the
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country's 479,000 doctors in 1988.
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While in medical school, students on tight budgets are
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frequently invited to lunches or dinners sponsored by drug
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companies. Many received their first stethoscope, neurological
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hammer, penlight and doctor's black bag from a drug firm.
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According to a 1982 study of 85 Boston area physicians,
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however, marketing may have a much stronger influence on doctors'
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prescribing behavior than doctors realize or admit.
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The study, by Dr. Jerry Avorn of the Department of Social
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Medicine and Health Policy at Harvard Medical School, found that
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the vast majority of doctors surveyed said drug ads and marketing
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efforts were "minimally important" factors influencing their
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prescribing habits.
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The majority also believed that two heavily advertised drugs,
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vasodilators and propoxyphene analgesics (such as Darvon), were
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effective treatments for senile dementia and certain kinds of
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pain, respectively. Meanwhile, "the clinical literature
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overwhelmingly indicates that they are not useful for these
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indications," Avorn and his colleagues wrote in the American
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Journal of Medicine.
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The most controversial way companies market to doctors is by
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sponsoring or underwriting medical education seminars, many of
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which offer continuing medical education credits, or CMECs.
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Doctors need a certain number of CMECs to maintain their licenses.
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Occasionally, the seminars are held in enticing locales such
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as Florida or in Colorado during ski season. Wealthier drug
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companies may cover air fare and accommodations for doctors whom
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they perceive to be opinion leaders in their local medical
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communities.
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In addition to sponsoring seminars and buying advertisements
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in medical journals, drug firms hire armies of sales
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representatives, also known as "detail personnel," to conduct
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face-to-face sales pitches with any doctor who will listen to
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them.
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Nearly every doctor's office sports an array of desk-top
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items bearing a drug name or company logo. Personalized
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prescription pads, pens and paperweights and other "reminder
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items" all come from detail people, doctors say. In addition to
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the perks, detail people leave behind medical literature, free
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drug samples and patient-educational leaflets.
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One potential way to neutralize biased sales pitches is
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"academic detailing," according to Avorn's research. In academic
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detailing, a doctor learns about drugs from a university-based
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expert with no allegiance to a drug company. These one-on-one
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meetings in the doctor's office are even more effective when
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supplemented by "unadvertisements," which point out a medication's
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adverse side effects as prominently as its benefits, research
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suggests.
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***************************************************
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I would suggest two good books to read that give an excellent
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perspective view on this subject of drug companies and the medical
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profession.
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1. Murder by Injection; by Eustace Mullins written in 1988
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2. 100,000,000 Guinea Pigs, written in the 1930's
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Submitted by Ronald Barker
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Vangard Sciences |