Pharmaceutical Companies Manipulate Doctors and Patients

Inventing Disease to Sell Drugs
— By James Ridgeway| Tue May. 11, 2010 8:15 AM PDT
Pharmaceutical companies are ingenious in all the different ways they
pump drugs into the system.The best known techniques include buying
medical experts to put their names on articles written by the drug
companies which can then be placed in medical journals; or  hosting
small casual dinners of docs to tell them about supposedly new and
proven but still off-label uses for drugs. Docs get asked to come along for
wonderful vacations with the dealers. They get great money making

Adriane Fugh-Berman, a Georgetown University doctor and colleague of
mine on, drives the pushers nuts with her research
and writing exposing their underworld. She has published a new article
in the Boston Review setting out a basically unknown and genius way
that Big Pharma makes a killing. In addition to buying docs, the
drugsters invent or exaggerate diseases. They then pump knowledge
about the creepy new condition into the medical world through a
process known as Continuing Medical Education, or CME. This is how
docs and health care professionals are supposed to keep abreast of new
developments in their field. It works like this:

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CME is the pharmaceutical industry’s most important marketing tool.
Through a largely unnoticed process that plays out over a course of
years, the pharmaceutical industry uses CME—which, unlike other
forms of drug promotion, is not regulated by the Food and Drug
Administration (FDA)—to prepare the market for new drugs, expand
existing markets, position products against competitors, and promote
unproven uses of treatments.

Here’s how it works. Pharmaceutical-company employees, or specialized
vendor services, identify opinion leaders—influential (or up-and-coming)
health-care professionals at academic medical centers. Physicians are
the primary target, but as nurse-practitioners and physician assistants
become increasingly important in primary care, these hidden
prescribers are also being targeted. Industry’s influence on NPs and PAs
has not received enough attention; for example, the recently passed
Physician Payments Sunshine Act requires that pharmaceutical
companies disclose payments made to physicians, but not those made to
other prescribers.

Selected opinion leaders are wooed, perhaps over an expensive one-on-
one meal with a company researcher or executive—not someone
identified with marketing. In the course of discussing the opinion leader’
s work, the industry representative will elicit his or her opinions on a
variety of topics, including the “disease state” of interest. Opinion
leaders whose perspectives align with a company’s marketing goals are
then courted. A company may nurture relationships with targeted
health-care professionals over many years and will pay them to educate
their peers at CME events and other settings.

Industry-paid speakers frequently deny espousing marketing messages. I’
ve heard many physicians justify their pharma-funded speaking gigs by
saying, “I never emphasize their product” or, triumphantly, “I don’t even
mention their drug!” But these comments only highlight their sales
skills. Pharma doesn’t hire doctors to sell drugs; that’s a drug rep’s job.
Pharma hires physicians to sell diseases.

Read the entire article in the Boston Review, and then, if you want to
follow the ups and downs of the industry, take a look at
It provides recent developments in the drug business, a lengthy
bibliography of blogs and sources of information as well as a few videos
of drug reps spilling the beans and telling how the business works
inside out.

This post originally appeared on "Unsilent Generation," James
Ridgeway's blog about the politics of aging.

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