The event was strictly private, closed to reporters, as the
pharmaceutical company entertained a very select list of doctors and their
guests. But Primetime's undercover cameras saw the kind of big-money
splurge that some say drives up the cost of prescription drugs and corrupts
the practice of medicine.
investigation into the $6 billion spent by drug companies for what they say
is a way to educate doctors showed that tactics like lavish gifts and trips
are surprisingly common.
embarrassing, it's extravagant and it's unethical," said Dr. Arnold
Relman, a Harvard Medical School professor and the former editor of the New
England Journal of Medicine. "It makes the doctor feel beholden
it suborns the judgment of the doctor."
seemed thrilled to have been invited for a weekend in New York City with
some seminars along the way, with all expenses paid by Pfizer on behalf of
one of its drugs, Viagra.
Small-Town Doctor: $10,000 in Goodies
were willing to talk publicly about their relationships with pharmaceutical
companies, but one upstate New York doctor was willing to come forward.
very tempting and they just keep anteing it up. And it's getting harder to
say no," said Dr. Rudy Mueller. "I feel in some ways it's kind of
how the free gifts and trips add to the high price of medicine, and moved
by the plight of patients forced to skip needed medication, Mueller agreed
to provide Primetime with a rare glimpse of the astounding number of
drug company freebies he was offered by various drug companies in a
presented with an estimated $10,000 worth, including an all-expenses-paid
trip to a resort in Florida, dinner cruises, hockey game tickets, a ski
trip for the family, Omaha steaks, a day at a spa and free computer
changes your prescribing behavior. You just sort of get caught up in
it," said Mueller, who said he was offered a cash payment of $2,000
for putting four patients on the latest drug for high cholesterol. The company
called this a clinical study; Mueller called it a bounty.
never been offered money before," he said. "I don't remember that
10, 15 years ago."
Mueller normally declines the offers, he agreed to attend a dinner, which Primetime
secretly taped. Not only were the doctors wined and dined, but each was
also offered a payment of $150 for just showing up to listen to a pitch for
a new asthma treatment for children.
called it "an honorarium," but Mueller saw it differently.
"Again, it's bribery," he said. "This is very effective
wide range in value of the free gifts offered to doctors from lavish
trips to free Mother's Day flower bouquets for doctors willing to hear a
pitch about a new osteoporosis medicine.
latter example, when asked whether a floral shop was the most effective
place for a discussion on pharmaceuticals, one of the representatives said,
"I'm sorry, we're not allowed to comment on anything."
are dispensed by an army of drug company representatives known as detail
men and women, of whom there are 82,000 nationwide.
It's the job
of the detail people to quietly befriend doctors, keeping close track of
which doctors take the free gifts and then determining which drugs the
doctors later prescribe.
think it's sleaze," said Relman. "Anybody who's been in that
position knows that yes, those gifts, $60, $100, $40, again and again, do
influence your attitude about that company
and will influence the
prescriptions that you write."
multibillion-dollar drug company blitz extends throughout the profession,
even at the yearly gathering of one of the most prestigious medical groups,
the American College of Physicians. It was like a carnival: Doctors could
be seen taking free massages, free food, free portraits, free Walkman
players, free basketballs, and from one company pushing a new antacid drug,
free fire extinguishers.
say it's no different than any other business or convention, and that it
doesn't affect their medical judgment. But that's not the view of the new
president of the American College of Physicians, Dr. William Hall, who says
anything beyond a pen or a mug could have an impact.
we like it or not, it can cloud our clinical judgment," he said.
"Unequivocally, I would say that."
So why are
some of the very practices Hall publicly criticizes permitted at his
group's supposedly scholarly convention? "I think there it's a
situation where every physician is going to have to balance what's right or
wrong," said Hall.
concerned about it.," he added, saying that at some point the system
may be changed.
now, Hall's group receives $2 million a year from the drug companies to
have their exhibition booths at the convention, yet another example of how
the big drug companies spend billions to influence doctors in this country.
basic mistake we're making with our health-care system now is that we
regard it as just another business. And it's clearly not just another
business. Patients, sick patients and worried patients, are not like
ordinary consumers," said Relman. "Doctors ought to be
That's the doctor's sacred obligation. They're being
corrupted and undermined by this kind of salesmanship."