BRIBES
WHEN a new brand of insulin hit the market in India recently, doctors were quick to switch patients to it. Not long afterwards the new drug's manufacturer took 15 physicians from Nagpur on a vacation with their families. Coincidence? Maybe so but 'patients were fine on the old drug,' says Vijay Thawani, Associate Professor in Pharmacology at the Government Medical College in Nagpur.
Such promotional excesses abound in developing nations which have been slow to adopt regulations and even slower to enforce them. The US, Canada, Europe, Australia and New Zealand/Aotearoa have over time adopted and revised codes on drug promotion. But bribery happens in the West, too. It's just more covert.
'It's becoming more subtle in all sorts of ways,' agrees Peter Mansfield, a general practitioner and director of the international watchdog group Healthy Skepticism. 'It creates a situation,' adds Mansfield, 'where physicians convince themselves it's good for patients.' Big Pharma has innumerable fingers in the prescribing pie. Doctors are flown to luxury resorts for lessons in public speaking, then paid well as 'opinion leaders' to tout the company's product. Millions of doctors every year attend 'continuing medical education' events: necessary to perform their job well, but often company-sponsored junkets that let advertising cosy up to and mingle with science. In such pharmaphysician relationship, it's difficult to distinguish between the genuine and the deceptive, between the pursuit of knowledge and the pursuit of profit.
Meanwhile, old-school kickbacks continue in violation of the codes and policies on drug promotion. Drug giant GlaxoSmithKline has been accused of using exotic holidays, stereos, World Cup soccer tickets and cash to bribe thousands of Italian and German doctors into prescribing its products. (1) In the US last June, AstraZeneca paid a $355 million settlement for a kickback scheme where doctors billed insurance providers for drugs they received free from the company. TAP Pharmaceutical Products--a joint venture of Abbott Labs and Takeda--pulled the same trick and settled for $875 million in 2001. (2)
WHEN a new brand of insulin hit the market in India recently, doctors were quick to switch patients to it. Not long afterwards the new drug's manufacturer took 15 physicians from Nagpur on a vacation with their families. Coincidence? Maybe so but 'patients were fine on the old drug,' says Vijay Thawani, Associate Professor in Pharmacology at the Government Medical College in Nagpur.
Such promotional excesses abound in developing nations which have been slow to adopt regulations and even slower to enforce them. The US, Canada, Europe, Australia and New Zealand/Aotearoa have over time adopted and revised codes on drug promotion. But bribery happens in the West, too. It's just more covert.
'It's becoming more subtle in all sorts of ways,' agrees Peter Mansfield, a general practitioner and director of the international watchdog group Healthy Skepticism. 'It creates a situation,' adds Mansfield, 'where physicians convince themselves it's good for patients.' Big Pharma has innumerable fingers in the prescribing pie. Doctors are flown to luxury resorts for lessons in public speaking, then paid well as 'opinion leaders' to tout the company's product. Millions of doctors every year attend 'continuing medical education' events: necessary to perform their job well, but often company-sponsored junkets that let advertising cosy up to and mingle with science. In such pharmaphysician relationship, it's difficult to distinguish between the genuine and the deceptive, between the pursuit of knowledge and the pursuit of profit.
Meanwhile, old-school kickbacks continue in violation of the codes and policies on drug promotion. Drug giant GlaxoSmithKline has been accused of using exotic holidays, stereos, World Cup soccer tickets and cash to bribe thousands of Italian and German doctors into prescribing its products. (1) In the US last June, AstraZeneca paid a $355 million settlement for a kickback scheme where doctors billed insurance providers for drugs they received free from the company. TAP Pharmaceutical Products--a joint venture of Abbott Labs and Takeda--pulled the same trick and settled for $875 million in 2001. (2)
