The Drug Pushers

[HysteryDiagnosis]

Looking out for your and my best interest.... maybe not.

http://www.theatlantic.com/magazine/archive/2006/04/the-drug-pushers/4714/

The Drug Pushers

As America turns its health-care system over to the market, pharmaceutical reps are wielding more and more influence—and the line between them and doctors is beginning to blur
By Carl Elliott

Back in the old days, long before drug companies started making headlines in the business pages, doctors were routinely called upon by company representatives known as “detail men.” To “detail” a doctor is to give that doctor information about a company’s new drugs, with the aim of persuading the doctor to prescribe them. When I was growing up, in South Carolina in the 1970s, I would occasionally see detail men sitting patiently in the waiting room outside the office of my father, a family doctor. They were pretty easy to spot. Detail men were usually sober, conservatively dressed gentlemen who would not have looked out of place at the Presbyterian church across the street. Instead of Bibles or hymn books, though, they carried detail bags, which were filled with journal articles, drug samples, and branded knickknacks for the office.

Today detail men are officially known as “pharmaceutical sales representatives,” but everyone I know calls them “drug reps.” Drug reps are still easy to spot in a clinic or hospital, but for slightly different reasons. The most obvious is their appearance. It is probably fair to say that doctors, pharmacists, and medical-school professors are not generally admired for their good looks and fashion sense. Against this backdrop, the average drug rep looks like a supermodel, or maybe an A-list movie star. Drug reps today are often young, well groomed, and strikingly good-looking. Many are women. They are usually affable and sometimes very smart. Many give off a kind of glow, as if they had just emerged from a spa or salon. And they are always, hands down, the best-dressed people in the hospital.

Drug reps have been calling on doctors since the mid-nineteenth century, but during the past decade or so their numbers have increased dramatically. From 1996 to 2001 the pharmaceutical sales force in America doubled, to a total of 90,000 reps. One reason is simple: good reps move product. Detailing is expensive, but almost all practicing doctors see reps at least occasionally, and many doctors say they find reps useful. One study found that for drugs introduced after 1997 with revenues exceeding $200 million a year, the average return for each dollar spent on detailing was $10.29. That is an impressive figure. It is almost twice the return on investment in medical-journal advertising, and more than seven times the return on direct-to-consumer advertising.

[drokhole]

1. Seems like an appropiate place to post this...

Why Medical Prescriptions May Be Killing Thousands of Americans Every Year
http://www.huffingtonpost.com/ronald-ricker/doctors-drug-dealers_b_987271.html?ref=healthy-living-mind

"The Centers for Disease Control and Prevention recently reported that physicians' prescribing practices have finally caught up with us in a big way. In 2009, the annual number of deaths (37,485) caused by improper/overprescribing and poor to non-existent monitoring of the use of tranquilizers, painkillers and stimulant drugs by American physicians now exceeds both the number of deaths from motor vehicle accidents (36,284) and firearms (31,228). Deaths from street drugs during 2009 were vastly less than those caused by prescription drugs. Medical doctors are leaving regular drug dealers in the dust.

Every 14 minutes one American is killed by prescribed painkillers and psychiatric drugs. The number of "anxious" people or prescription tranquilizers taken by "anxious" people for "anxiety" has jumped 286 percent between 2000 and 2009, and should reach 341 percent by the end of 2011. Really. The prescription of stimulant drugs, amphetamines and methyl-phenidate -- Adderall and Ritalin -- has skyrocketed. The U.S. now consumes 86 percent of these drugs worldwide. The prescribing of painkillers, the leading killer, has also risen dramatically, 328 percent, during this same time period. Vicodin kills the most pain and people, and is the single most prescribed medicine on the face of the earth.

The vast majority of these 37,485 deaths were not caused by intentional suicide. Causes of death range from overprescribing, over-usage, not following the prescriptions directions, drug mixing, mixing drugs with other substances such as alcohol, accidentally doubling doses, replacing doses thought to have been missed, etc. Because of overprescribing, the streets are awash with prescription drugs, which bring lots of money. We doctors have inadvertently created a vast black market for all of these prescription drugs. A prescription of 20 Vicodin pills, for example, perhaps purchased through insurance with a very minor cash outlay, is worth about $1,000-$2,000 on the street -- a nifty profit. Pain relievers (Vicodin, etc.), tranquilizers (Xanax, Klonopin, Ativan, Valium), stimulants (Adderall and Ritalin) are all easily obtainable on the street, although at very high prices. Interestingly, the cost of these prescription drugs on the street are considerably higher than the cost of heroin and cocaine..."

[daggahead]

2. And yet, not a single death from marijuana. n/t

[louis-t]

4. And there is no evidence that these

psychiatric, mood altering drugs do any good. I know people on anti-depressants. They can't stop taking them because they feel so horrible if they do. The drugs also seem to cause some people to smell incredibly bad. I just went through this with a person I have known for 30 years. He moved into my house. I ended up asking him to leave. He looked horrible, had a constant scowl, he was all hunched over, mumbled when he spoke, broke everything he touched, spilled food all over the floor and walked away from it, threw away the silverware instead of putting it in the sink. He was a zombie. And the stench! I had heard from another person about how her estranged husband had started taking them and begun to smell really bad. I also believe that painkillers are seriously over-prescribed.

[HysteryDiagnosis]

6. Wow.... just wow. I see the unreccing crew is hard at it today... pity that. n/t

[MineralMan]

7. Why are you commenting on the recs and unrecs for your

thread? They don't matter. It's the information and discussion that matters.

[HysteryDiagnosis]

8. After all the beating I get in here it helps elevate me a tad.... and if the information is what

matters then there shouldn't be unrecs cuz the information is sound.

[MineralMan]

9. The information is incomplete, and you take a negative

position from the beginning. Yes, there have been abuses by the drug reps. But, they are also providing information on new medications, some of which actually save lives and help people. Nothing is all negative or all positive.

I take a couple of prescription medications, and they work perfectly in controlling my blood pressure. Both are generic and have been around for a long time. Once, however, they were brand new on the market and drug reps were handing out samples. Doctors tried them on their patients, after learning about them. They worked, didn't cause serious side effects, and did what they were intended to do. When my doctor was concerned about my blood pressure, he chose the proven, time-tested generic drugs for me. If they hadn't done the job, he might have tried a different one, possibly one that had just come out. But, he started with the generic, because he knew it worked for my condition from long experience with it. When it was brand new, and not generic, he probably tried it on patients who weren't getting the results from the generics available at the time. Over time, as it proved itself to him, he began to prescribe it more often, when indicated. Now, he knows very well when it works and doesn't, and prescribes the generic drug that was once new as a starting point. He always does that, you see. He's very conservative with prescribing. He's certainly not afraid to prescribe new drugs, if they're indicated or fill a gap in his treatments. But, he starts with the generics. They were once new drugs, too, and were expensive. Now, they're generic and cheap.

So, there's nothing horrible about the introduction of new prescription medications. The drug reps bring samples and literature, and the doctors try the things out on patients who are not responding well to the generic medications. Little by little, the good ones are prescribed more often and the ones that aren't working or have too many side effects aren't prescribed as much.

I suppose there are some doctors who don't do it that way. I went through a couple at my clinic who didn't meet my expectations. Now, I have one who does. We have a decent relationship, considering he only sees me every six months. He remembers me, and he remembers my history, mostly, and consults my chart for what he doesn't remember. We have a chat. He does his thing. He deals with anything new, sends my prescriptions to my drugstore from his computer, and we exchange pleasantries.

So, I take two pharmaceutical drugs. Generic ones. Small doses. Just what is needed to do what is needed.

But, remember, those two generic medications were once the latest thing on the market.

[HysteryDiagnosis]

5. We are most certainly losing the war on drugs.... nt

[Warpy]

3. The detail man comes in to explain why the new drug is better than an old drug

and sometimes, in the case of second generation statins, ACE inhibitors and H2 antagonists, it really is. In other cases, most notoriously Vioxx, it's much, much worse--something they won't really know until it's in wide circulation.

Unfortunately, he also east up physician time and the pens, pads and samples he leaves behind are often scant compensation. However, the sales pitch takes effect and all the patients with a particular condition find themselves with a new drug of the month. Most of the time it works out OK except for the insurance company. When it doesn't, it can be fatal. It's often up to the patient to tell the doc the old medicine is working fine, let's keep it and that's unfair.

Personally, I'd rather they keep the detail men and lose the TV advertising directly to patients, something that is appallingly deceptive and unethical. At least a detail man has to make his case directly to a medical professional and can't get away with the weasel words and vague disease descriptions the TV admen do.

[LeftishBrit]

10. Agree on all points

At least, in the UK, and I think in the EU more generally, it's illegal to advertise prescription drugs directly to patients.

[louis-t]

12. You beat me to it about direct marketing.

I think it is wrong and leads to self-diagnosis and over-medication. And I believe that most of the newer drugs are replacing older drugs, not because they are better, but because the drug companies found a way to make more money on them. The lists of side effects aren't getting any shorter.

[HuckleB]

11. Oh, the irony.

:wow:

[MineralMan]

13. And Big Supplement doesn't push its products?

Really? And they don't even have to pay people to promote the websites that sell their overpriced nostrums. What a deal. I missed my calling, I guess.

[HysteryDiagnosis]

14. .... Why you mad? This is just getting interesting.... while supplements for the most part may

do nothing when not needed.... drugs kill, maim and take no prisoners.

ON EDIT TO ADD: Is that Lutein patented or not?

[trotsky]

15. Is aspirin patented?

"Big pharma" still makes a tidy sum off of it, as they do with a lot of over-the-counter medications that anybody could make because patents have expired.

That is such a lame and misinformed "argument." Says a lot more about the ignorance of the person putting it forth than anything else.

drugs kill, maim and take no prisoners

Except for when they heal, help, and save lives, I suppose. But the world is so much easier to figure out if all you see are black and white.