Med Reps

[fccool]

I just want your opinion on something, especially among those who are employed in Medical field.

About a couple of years ago I was surprised to find out about the Medical Representatives. Basically, it's a group of guys from the drug companies that go to the medical offices and offer free lunches to present to the doctors the breakthrough drugs and persuade the doctors to prescribe these drugs.

On surface it sounds like harmless thing, but at the same time it does ring a bit of "Post Soviet" style corruption through lobbying scheme.

Not that I did not suspect that this sort of thing is going on, but I was surprised as to how widespread this phenomenon is, and it appears to be pretty common... even in Adventist medical community.

Not that it would matter if the drug has no equals, but if as a result of this meeting the doctors would feel the psychological pressure to prescribe it in place of generic ones that would do the trick... that would kind of be for the benefit of the drug companies and not the patients.

My motto is to abstain from drugs as much as possible, unless my life is threatened... but I understand that medical drug usage is somewhat of a lifestyle for others. So, it's really a moral issue.

There was an article in NY Times a while ago about this issue, and in some cases the doctors are offered more than free lunch in exchange for drug endorsement.

I wonder what you guys think about it?

[Woody]

Quote:

Not that it would matter if the drug has no equals, but if as a result of this meeting the doctors would feel the psychological pressure to prescribe it in place of generic ones that would do the trick... that would kind of be for the benefit of the drug companies and not the patients.

It has been my personal experience that it does not matter what the doctor prescribes. The pharmacy does what they want. And at least in the states I've been in ... they automatically give you the generic rather than the brand name no matter what.

There have been times when I needed the brand name for a specific need because in rare situations there are some differences. The doctor clearly wrote it on the script each time. But each time ... I would end up with the generic. It got so that I would have to make a scene before filling ... just to get what the doctor ordered.

Like I say ... it may differ with the state. But in the three states that I have lived recently ... I can tell you that it is difficult to get 'what the doctor orders'.

[fccool]

In light of the following...

http://www.fda.gov/buyonlineguide/generics_q&a.htm

Wouldn't that make sense? Correct me if I'm wrong, but why pay up to 80% for the same chemical composition because of more expensive box and celebrity endorsements?

[Woody]

Yes. It makes sense most of the time. But there are differences in some. The particular issue I had was in application format. But it was an important issue for me.

But again ... I will say that in many pharmacies ... they will not give you what the doctor orders anyway. They give you the generic. So, I don't know what the issue is. If you really need the brand name ... you have to fight for it.

[fccool]

Do you think it has to do more with Insurance companies covering only generics if generic is avaliable? If you walk in without insurance would you get the same treatment?

[Nan]

In this country the possibility of undue influence being exercised by the 'medical reps' is well recognised, and there are some legal restrictions on what they can offer. The commonest offerings were always pens and writing note pads, keeping the medication name continually in front of the user..

Our prescription pads (which are provided by the government health department) have a box to be ticked if the

doctor wants only the prescribed brand to be used. I am not sure how effective that is, with most of what I prescribe I do not have any reason to avoid the generics, and rarely ask the patients what they actually got,

next time I see them.

[Pockey]

It's usually not a group of guys, it's usually female, semi model types. I think it's been going on for a long time, and they've actually clamped down on a lot of the perks. The drug companies used to give out major incentives (trips, tickets etc) but then it got limited to just dinners and pens. Starting in 2009, they can't even give out pens.

Does it influence prescription writing? I doubt it. We have reps come to where I work, but mostly because they give us a lot of free drug samples and coupons which we give to uninsured patients. But it's not an easy street, it's time consuming to listen to their pitch about their drug. Also the drug reps bring lunch for our staff which they really enjoy. But although it's a free lunch for the staff it's sort've painful for us because we have to listen to their drug schpeal. I think most people take their research findings with a grain of salt.

[Nan]

You must be doing it better than us then Sid...that is if you like the female model types as the reps LOL.

We would have equal numbers of males and females I think, I will see a few but not too many. Probably there are fewer in specialist than general practice too.

[Amelia]

Quote:

Starting in 2009, they can't even give out pens.

Ah man, there goes my supply of free pens. The drug reps usually have really nice pens and one of my docs has a basket of freebies in his office. I always take the purple ones or the ones with really good rubber gripping. I do alot of writing during my work day. SOmetimes I get post it notes too. :)

[Pockey]

You must be doing it better than us then Sid...that is if you like the female model types as the reps LOL.

[Pockey]

Sounds rather sexist to me. Been in the field for 30 years, I see all age brackets, male and female, but no 'semi-model' types.

[Amelia]

[dwhite]

1. Taking prescribed drugs is not a "moral issue."

2. Detail men and women do not leave samples, pens, paper, or provide meals for drugs that have gone generic. They only push brand. For example, once Zocor went generic we never saw samples of Zocor again, even though you can still get brand Zocor.

3. We only allowed detail reps in the door to get the free samples. Some patients count on those samples. The meals and pens were incidental.

4. Doctors are aware of the generics, and most are perfectly comfortable prescribing them. Always ask your doctor if a generic alternative is available.

[Amelia]

You can also ask the pharmacy for generic drugs. I use a mail order pharmacy through my insurance. They have a box you can check off for generic versions of your med. Some of the generics are equal to the brand, others are not. My doc will not put me on a generic HBP med because he feels they don't work as well. Whether or not that's true? Don't know, I'm not a doc. :)

[rudywoofs (Pam)]

a note on bioequivalence of generic vs brand name drugs:

Quote:

The FDA requires the bioequivalence of the generic product to be between 80% and 125% of that of the innovator product. Bioequivalence, however, does not mean that generic drugs must be exactly the same (“pharmaceutical equivalent”) as their innovator product counterparts.

"Orange Book Annual Preface, Statistical Criteria for Bioequivalence". Approved Drug Products with Therapeutic Equivalence Evaluations 28th Edition. U.S. Food and Drug Administration Center for Drug Evaluation and Research.

In other words, the generic product only has to be within 80% to 125% of the brand name drug potency.

[Amelia]

Thanks rudy TU

[Tallmark]

Most SDA's are deluded into thinking that being employed by the medical profession means that they are doing God's work of healing. Nothing could be further from the truth. Just because a building has an SDA logo on it doesn't mean that it's blessed by God. Ellen White said that our doctors should be different than the docs of the world. That we should not be prescribing drugs, but using natural means to heal.

I attend a church that has a membership of just over 1,000. I'd say that 98% of the working adults work for the medical god. I went to medical school in the Army, became a Special Forces medic, and left the field when my duty was over. I realized that the AMA is not in the business to heal, but to keep people sick. Whenever I have the prayer, I never ask for prayer requests. Someone eventually will ask God to heal someone who's going through chemotherapy. I cannot ask God's blessing on the devil's treatment.

I guess you could say that I'm prejudiced against the medical community, but with good reason. My mother, one of my best friends, and a woman I was married to were killed by chemo. I believe that all of you doctors, nurses, administrators, and hospital techs will have to answer to God for what you have done to people by your silence. Enjoy your pens and perks!

[Pockey]

I went to medical school in the Army, became a Special Forces medic, and left the field when my duty was over. I realized that the AMA is not in the business to heal, but to keep people sick.

Wait, you went through medical school in the army or you took a medical course in the army?

[Amelia]

Whoa! That was a harsh comment. I see that you are bitter. But...

I just want to say that In no way do I think our members here in the medical field are in it to keep people sick. (although I'm sure Nan would appreciate it if people kept having babies ) And I am fairly sure no one else thinks this way either.

I have a sister who wouldn't have ever made it to 60 if it weren't for the medical community and it's advances. I had my mother and aunt pass from breast cancer. But everything that could be done at the time, was done. Another aunt passed from heart failure. Another from emphysema. An uncle to cancer. My grandfather to altzheimers. My grandmother because gramps was gone. It just wasn't ment to be. I don't hate God for not healing and I don't fault the doctors for not healing. It was what it was. God doesn't not heal people to spite us. The medical community doesn't not heal people to make more money.

Now if you want to talk about the drug companies who create medicines that cost an arm and a leg? Or drug companies that withhold allowing drugs from Europe, that work, to be used in the states? Go for it.

[rudywoofs (Pam)]

BTW, I, erhmm, sold 10 pharmaceutical rep pens on ebay for $10. :smile:

[John317]

That had to be at Ft. Sam Houston, Texas. Great place. I went through the same training. Not really a medical school, though. It was AIT, about 12 weeks or so. Special Forces medics' go through some extra training but still no "medical school" as such.

[dwhite]

Just because a building has an SDA logo on it doesn't mean that it's blessed by God.

[Liz]

{{{{Tallmark}}}} I am so sorry.

[Tallmark]

That had to be at Ft. Sam Houston, Texas. Great place. I went through the same training. Not really a medical school, though. It was AIT, about 12 weeks or so. Special Forces medics' go through some extra training but still no "medical school" as such.

I beg to differ. 52 week course learning surgery, prescription interpretation, dentistry, animal husbandry, etc. It's classified as a medical school by the US Army. In fact, it's the only one where students operate on live patients.

[aldona]

I was going to add my $0.02 worth to this thread, because drug reps and the samples they give out are a topic that is very relevant to me...

but after seeing the direction and tone the discussion has taken, I will refrain, because as a member of the medical profession I am automatically one of the devil's operatives, and anything I say or do will be analysed through that viewpoint.

Keep discussing though - I am finding it very interesting to see the different perspectives.

aldona