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5 Shady Ways Big Pharma May Be Influencing Your Doctor

Pharma can entice doctors to prescribe its expensive patent drugs, even when they are dangerous.

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Psychiatrist Dan Carlat wrote in the  New York Times that he was "astonished at the level of detail that drug companies were able to acquire about doctors’ prescribing habits" and that his drug reps told him "they received printouts tracking local doctors’ prescriptions every week." A 2011 Supreme Court ruling found the collection and dissemination of prescribing behavior was "speech" and protected by the  First Amendment. (See: a corporation is a person.)

2. Continuing Medical Education Courses

In order to keep their state licenses and satisfy insurance regulations, doctors must enroll in a certain amount of CMEs—continuing medical education courses. Not surprisingly, these classes are often “taught” for free by Pharma-funded specialists, sparing doctors from having to pay for them but providing the objectivity of a time-share presentation.

One such class, "Atypical Antipsychotics in Major Depressive Disorder: When Current Treatments Are Not Enough," funded by Seroquel maker AstraZeneca was taught by former Emory University psychiatrist  Charles Nemeroff, who lost his department chairmanship due to unreported Pharma income. Another CME  called "Bipolar Disorder: Individualizing Treatment to Improve Patient Outcomes," was “taught” by Trisha Suppes, who admits to  funding by Abbott, AstraZeneca; GlaxoSmithKline, Janssen, Novartis, Pfizer, Wyeth, Bristol-Myers Squibb, Eli Lilly, Shire and four more Pharma companies. Another CME, "Individualizing ADHD Pharmacotherapy with Disruptive Behavioral Disorders" was  taught by the Johnson & Johnson-funded Robert L. Findling and refers to Risperdal or its generic version, risperdone, 13 times. Many CMEs teach doctors about the lucrative new disease category of  Adult ADHD and how to keep kids from going off their  ADHD meds when they get to college. Ka-ching.

3. Ghostwriting

Being published in medical journals is essential to academic doctors but researching, writing and reworking papers is a formidable job. Luckily for doctors, Pharma is willing to help—as long as they write what Pharma wants. In just three years, medical writers associated with  Parke-Davis, which became Pfizer, wrote 13 papers extolling the benefits of Neurontin, including in the prestigious  Cleveland Clinic Journal of Medicine, in the names of the "author" doctors. Medical writers at Wyeth, also now Pfizer, wrote more than 50 papers pushing the now discredited Hormone Replacement Therapy (HRT) in the names of doctor "authors."

"Is There an Association Between Hormone Replacement Therapy and Breast Cancer?" asked one article in the  Journal of Women's Health. Guess what it concludes? "The Role of Hormone Replacement Therapy in the Prevention of Postmenopausal Heart Disease," another ghostwritten paper is titled, despite HRT's established heart risks, appearing in the  Archives of Internal Medicine. And despite HRT's links to dementia, another paper, which also ran in the  Archives of Internal Medicine, was titled "The Role of Hormone Therapy in the Prevention of Alzheimer's disease."

4. Speakers Bureaus

Few things combine the ego stroking and fast cash of being paid to speak—and Pharma has no trouble finding takers at $750, $1000 and more per pop. Psychiatrist Dan Carlat wrote in the New York Times that his experience speaking about Wyeth's Effexor degenerated as he sensed skepticism and contempt in the audience. "I feared I had become—a drug rep with an M.D." A district manager soon expressed reservations (“My reps told me that you weren’t as enthusiastic about our product at your last talk") and Carlat ended his speaking career.

In her book,  The Truth About Statins, cardiologist Barbara Roberts echoes Carlat's experience. She agreed to speak about Pfizer's Lipitor and gender-specific aspects of heart disease in women, but told Pfizer "that I wasn’t interested in just getting up in front of a bunch of doctors and plugging one or another of Pfizer's medicines." Declining to use Pfizer-supplied slides, she created her own slides for the speeches "until one night a regional manager attended one of my talks—and suddenly I was no longer invited by Pfizer to give lectures."

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