Slam the Doctor's Door on the Pharmaceutical Companies
We walked out of our office the other day and almost tripped over a little white shopping bag. We looked up and down the corridor, and there were little white shopping bags in front of every door. Somebody wanted to send a message to the reporters in the National Press Building.
That somebody was a joint venture between Johnson & Johnson and Merck. The message: use our new Pepcid antacid to fight heartburn.
In the little white shopping bag was a 100 percent cotton blue t-shirt with the message "Make the Pepcid Complete Switch" on the front and "Pepcid Complete -- We've got heartburn surrounded" on the back.
Also in the bag was a sample of Pepcid Complete and a hand sized plastic chile pepper that informs us that Pepcid complete "starts to neutralize acid in seconds and last seven times longer than Tums." (Glaxosmithkline, the maker of Tums, is suing Johnson & Johnson Merck Consumer Pharmaceutical Co. the maker of Pepcid Complete, for disparaging Tums in a television commercial.)
And then there was a press release, inviting all reporters to the Ninth Annual National Capital Barbecue Battle.
The idea was this: get reporters to come and eat the BBQ, and blazing hot peppers, give them all heartburn, and then force feed them Pepcid "so revelers can experience fast and long- lasting heartburn relief."
That's the M.O. of the drug companies these days -- get people sick so that they can make money treating them.
The drug companies have flipped out in their drive for greater profit margins. They are pushing their drugs into every nook and cranny of society.
This despite compelling evidence that many of the new drugs being developed are unnecessary, dangerous, or both.
Our doctor friend, Matt Hahn, who practices in rural West Virginia, gets 10 to 20 drug reps a day visiting him in an effort to try and persuade him and his staff to buy new drugs and take samples. (Imagine the traffic jam faced in the offices of big city doctors.)
These drug reps offend Dr. Hahn and hundreds of other doctors who believe that much of our suffering -- from high blood pressure, diabetes, emphysema and lung cancer -- is preventable if we exercise, eat the right foods, and stop smoking.
We could cut out a big chunk of drug expenditures if we practiced prevention. This still empty threat of a national prevention program keeps the drug reps on their toes. Imagine what such a program would do the GNPP (gross national pharmaceutical product)?
Dr. Hahn would ban these drug reps from his clinic, but he actually can use some of the more useful samples -- especially the antibiotics -- for his patients who can't afford the drug companies exorbitant prices.
He has tried to put the kibosh on the most obnoxious drug reps. These include the diabetes drug reps, who come bearing fat-laden pizzas for Dr. Hahn's staff -- exactly the kind of food that if eaten regularly triggers weight gain and diabetes.
Dr. Hahn says that out of the hundreds of diabetes patients he has treated, he has never met one who eats well and exercises regularly. And, he says, the drug reps carrying diabetes samples just don't get the irony of their bringing the junk food into the office.
Dr. Hahn understands that these drug reps leave the free food, drink and drug samples, not out of the generosity of the drug companies, but to influence the doctor's future behavior. And he knows about the studies that prove how these gifts, free dinners, and vacation junkets the drug reps throw at doctors and their families influence doctor behavior.
A January 2001 article in the Journal of the American Medical Association, for example, reported that researchers reviewed 538 studies on the topic and concluded that marketing does influence which drugs doctors prescribe and which they ask to be included on hospitals' list of preferred drugs.
"These kinds of inducements are fundamentally problematic," says Dr. Paul Wolpe, a fellow at the University of Pennsylvania's Center for Bioethics. "They are ill-conceived bribes to get more attention of physicians than their rivals."
We like Dr. Hahn's prevention program, which must play a central role in addressing our current health care disaster. But it's a long term program that must start with young people.
In the short term, so that doctors can practice in peace and in a fat free environment, let's slam the doctor's door on the pharmaceutical companies.