There is No Such Thing As a “Free Lunch”

I have had several patients ask me about the recent change in the pharmaceutical industry’s indiscriminate practice of giving gifts to physicians. It has long been known that drug reps were a great source for an assortment of pens, staplers, coffee mugs, and even years ago, elaborate fishing and golf trips. I daresay I haven’t purchased a pen in over seven years and have provided many a nurse with the latest gadget. Recently, the Pharmaceutical Research and Manufacturers of America (Pharma) has noted that branded gifts “are not based on informing physicians about medical and scientific issues” and subsequently banned all gifting to doctors. No more pens. No more note pads. The pharmaceutical companies have always hoped that use of their pens may ultimately influence physician prescribing habits, thus increasing their bottom line. This practice has come under great scrutiny as research suggests that they may be right!

Further, even the practice of drug sampling has been examined. Drug reps typically leave a slew of their expensive “branded” products for doctors to dispense. It is quite handy to be able to provide the samples to patients as a “free trial”. The reality is that these free trials result in greater long-term prescription costs given that cheaper generic medications may be equally effective. According to studies, out of pocket costs for prescription drugs increased 47% for patients who received free medications to try when compared to those who were not offered samples.

As alluded to above, when physicians have access to samples, they tend to prescribe more expensive medications. Medication sampling accounts for $16 billion a year, or roughly half of the industry’s marketing budget. The annual cost of prescription drugs is $227.5 billion per year, or 10% of all health care spending in the United States. This is a disturbing trend, certainly. I personally make every attempt to limit an individual’s expenditure and will only use branded drugs if I feel it is absolutely necessary. I’m a consumer, too, and would hate to feel ripped off if there was a cheaper, equally efficacious alternative.

The pharmaceutical industry also offers a litany of articles supporting the use of their products, many with skewed data and funded by the very company marketing the drug. Is it any wonder their studies so convincingly advocate use of their medication? Most physicians cannot be bothered to systematically examine each article and therefore, they tend to take the data at face value. This may, in turn, result in the skyrocketing use of $200 a month meds As Mark Twain said, “There are lies, damned lies, and statistics”.

Now, where’s my free lunch!

Do you have any medical questions or concerns that you would like addressed? You can contact Dr. Spence by email at scripna@hotmail.com or by mailing your question to Daily Dose, P.O BOX 6107, Marianna, FL 32446.