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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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Carlat and Roberts are in the minority. Despite academic restrictions, faculty at many top institutions including division chiefs "stay on the industry lecture circuit, where they can net tens of thousands in additional income," reported  ProPublica in 2010. Even at the prestigious Cleveland Clinic where the chairman of cardiovascular medicine, Steven E. Nissen, calls industry-paid speakers “whores,” the practice flourishes, ProPublica reported.

5. Clinical Trials

Pharma-funded clinical trials can be paydirt to doctors, yielding as much as $10,000 per patient in  some cases. In 2010, Sen. Charles Grassley (R-Iowa) addressed the frequent conflict of interest of doctors accepting major Pharma revenue while also accepting NIH money, our tax dollars. The medical institutions where the doctors work also are swimming in Pharma money. It is a situation exacerbated by the "technology-transferring" Bayh-Dole Act of 1980 which dangled the riches of "industry" before medical institutions just as the former were floundering and the latter was booming, says Marcia Angell, former editor-in-chief of the New England Journal of Medicine. "Harvard’s Clinical Research Institute (HCRI), for example, originally advertised itself as led by people whose 'experience gives HCRI an intimate understanding of industry’s needs, and knowledge of how best to meet them,'" writes Angell, "as though meeting industry’s needs is a legitimate purpose of an academic institution." 

Not all clinical trials are kosher. Another sneaky way Pharma gets doctors to prescribe its drugs is to set up faux clinical trials to influence doctors. A 1995 study billed as assessing the safety, efficacy and tolerability of Neurontin was nothing but a ruse to get the 772 participating doctors to prescribe the drug, said an article in the  Archives of Internal Medicine, because it gave them familiarity and experience with the drug. (This indirect sales job parallels what is said to happen with speaker's bureaus: the speakers may not convince anyone else, but they begin prescribing the drug  themselves.) In addition to misleading the doctors who thought the trials were valid, the study also misled the patients who did not know it was a marketing, or "seeding" study, and whose participation was overseen by investigators with insufficient training and clinical experience.  Eleven of the 2,759 patients in the trials died, 73 suffered severe adverse events and 997 experienced less serious side-effects. 

Martha Rosenberg is an investigative health reporter and the author of "Born With a Junk Food Deficiency: How Flaks, Quacks and Hacks Pimp the Public Health (Random House)."

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