Tuesday, April 17, 2012

Drug Companies

During my intern year, the primary care intern group (of which I used to be a part) received a lecture on how drug companies suck for spending more on advertising than they do on research. I volunteered as a guinea pig and the lecturer emptied my white coat pockets of all drug company related materials.

I'll be honest: there was a LOT. Between at least half a dozen pens, my ID badge holder, my pharmacopoeia, and some various other stuff, I was loaded. Even the lecturer was surprised. "I didn't think you'd have this much stuff," he said, shaking his head in utter disappointment.

I used to go after those drug company pens like they were... drugs. I spent a day in a urologist's office and I was so excited that I got a pen for Viagra, Levitra, AND Cialis. Every time I saw a drug company representative, I'd go after them to get that pen and whatever else they had to give me.

Why did I do this? One, when you're a med student, DRUG COMPANY PENS ARE COOL. The fact that the drug reps are willing to court you makes you feel all special. Plus, I love clicky pens and the drug pens are all clicky pens. Because you can't, like, BUY clicky pens or anything.

Over the course of residency, I'm proud to say that I purged my white coat of all drug company products. I went to Costco one day and they had this huge package of clicky pens (exactly the kind I like) and purchased enough to last me the rest of my career. I still kept wearing the elastic ID holder from a drug company, but the drug name had completely rubbed off.

The way I look at it is this: If a drug company paid you 10 cents to wear an ad for their company for months, would you do it? No, of course not. But that's what you're doing when you use drug company pens.

However, there was a drug company that sponsored all our grand rounds in residency. And our grand rounds were MANDATORY. So I was forced to go to these drug company sponsored dinners. And it honestly wasn't that huge a hardship, because we'd always get to go to a nice restaurant and have a delicious meal that I couldn't afford on my own. IS THAT SO AWFUL?

I know the arguments against drug company advertising, but I just can't get passionate about it either way. I like getting a free meal. And when they tell me their spiel, I mostly just nod and say, "Uh huh, uh huh." It takes more that a cute drug rep to penetrate my sleep deprived brain.


  1. I have mixed feelings about this. It's hard to believe that little gifts like pens, or even slightly larger gifts like meals, would sway a doctor's decision over what to prescribe or how to handle a treatment. I've heard anecdotal stories about how it happens, and it certainly isn't unbelievable. Finding out how much truth there is to physicians being influenced, and how widespread it is, would make for an interesting study if one hasn't already been performed.

    Although Fizzy, I must say that as a lady, you're probably unaware of the power that a cute sales/drug rep has over your male peers :) THAT is a marketing tactic I have seen successfully used on a number of occasions!

  2. You are so right. We (med. students) still get lectured about the evilness of drug companies, but they permeate everything. Our pharm. professors are getting paid by them, they also sponsor our hospital's grand rounds, and they are EVERYWHERE--even at the private practice's office where I complete my clinical preceptorship. I listen to what they say and try to ask intelligent questions about the data, but I'm not going to lie--as an impoverished med. student, if you're trying to feed me or give me a cool pen that I don't have to buy myself, I'm TAKING that sh*t! Maybe I'll try to rub the logo off to make myself feel better. (Or just not go prescribing a med. to get a free pen when I'm a real doctor.)

  3. My cousin tells me that free pizza from drug company reps kept him fed through med school.

  4. Ledgem - drug reps must be a completely different species. I mean, they are supposed to inform/manipulate and somehow that entails wearing a uniform completely different from your target group? Drug reps are dressed like uppity department store mannequins, complete with 4 inch heels, recently highlighted hair and manicured fingernails. In the pharmacy (my field), you wear sneakers or what can be justifiably passed as professional footwear you can stand being in for 12 hours. Your nails are short because that is easier with gloves and your hair like low-maintenance, like a ponytail. I don't know how you are dressed for work - my docs seem be be in scrubs and sneakers, or the professional-with-comfortable-shoes look, although here in TX, that occasionally includes jeans. My point is, there is a divide between drug reps and the actual medical community. That said, some of the reps I encounter are good at leaving studies or answering questions or giving us more insulin training pens. Others.......seem to strain their ablities by remembering to hand over flyers.

  5. big pharma is spending billions on advertising, and willing to pay massive fines for advertising off label uses because the profit is there. the sunshine law will help, but shifts the blame to docs and midlevels. when you sign the sheet for your slice of pizza, your name will go onto the registry. beware.

  6. I can't think of one piece of information a drug rep has told me that I absorbed and as for the pens, I have dozens but I don't really look at them so the advertising is lost on me. I honestly don't get the drug rep hate. What am I missing?

  7. They are helpful on getting information on drug assistance for the truly poor patient that has no insurance, doesn't qualify for Medicaid.
    That is about the only info I've absorbed from them.

  8. Being but a humble RN, the drug reps don't care much about me. However, similac and enfamil do their best to buy my brand loyalty with delicious dinners (usually including a continuing education credit) in hopes that I will choose their product over the competitor when recommending formula to a family. I've had my preference for a long time no matter whose fancy dinners I'm eating, I barely ever get asked which one I prefer, and most of the moms in our NICU breast feed anyway... but I'll still happily take their delicious dinners!

  9. I suggest you read,(yea, I know you barely have time to put in your contacts)----ON THE TAKE: How Medicine's Complicity with Big Business Can Endanger Your Health
    "these innocuous-seeming gifts are just the tip of an iceberg that is distorting the practice of medicine and jeopardizing the health of millions of Americans today."
    Thank God, I now work in a vender-free environment. I was sick and tired of being caught in the middle of the reps fighting over my patients, hustling the staff, etc. And leaving their cheap ass products with a logo. . . break in a week or two.

    The drug companies are selling sickness. Coming up with "new diagnosis" that needs this drug or that. What has happened to life style change instead of popping a pill. If your arteries weren't clogged, you wouldn't need cialis! ("HARD SELL" is an interesting book, too)

    Charging exorbitant prices and media blurbs that we shouldn't use drugs from Canada or Mexico cause they are unsafe!?!?! If we could use their profits- - -everyone could have insurance!! High CEO compensation troubles me as well! It is obsene! (Alergen CEO 34 mil and all the CEO's getting literally millions/yr)

    So you are in the wrong profession. . . . . Get out before it is too late.

  10. Its the same in veterinary medicine with drug companies and pet food companies. The big pet food companies give you free food or food at a huge discount so you are more likely to recommend it to clients (especially since nutrition completely sucks at vet schools). Granted, now that I have to pay for dog food (even at a great discount), I'm thinking I should just switch my dogs to something super cheap. Dog food is expensive!

  11. I've a lot of drug company stuff. But I honestly can't remember what any of those are off the top of my head. I have a lovely lanyard from some company I don't recall. I've yelled (well more like complained) at a Tylenol rep - that felt nice. I know I have pens from them. And I've had delicious lunches and dinners sponsored by drug companies. But I really don't recall ANY of the names. And since there aren't the many companies, I don't think "subliminal messaging" matters. Say, Pfizer - big name, but do I know why?? No. Same with Bayer - all I know is they're proud of their aspirin.

    So does it matter that I have sponsored stuff if I can't remember who it's from?
    I don't think so.