Sam the drug rep:
"Though it is getting harder
to find ways to give gifts to
docs -even docs who know
how to play the game--
there are still
lots of ways to get docs to
prescribe medications they
really shouldn't be
prescribing..And it doesn't
exactly require a rocket
scientist to figure out what
is going on. It shouldn't be
very hard for a sharp or
interested journalist, or,
the feds to figure out what's
Pharmaceutical companies know exactly how many prescriptions your doctor prescribes- so they can reward him for his services or make sure he is telling the truth about his “faithfulness to the company and its product. Prescription information is collected by health information organizations (also known as HIO's):IMS Health is the largest HIO; others include Verispan, Dendrite, and Wolters Kluwer. And for a nice fee many pharmaceuticals can find out just how many prescriptions a doctor writes for their drug or for the competition's.
There are a bunch of drugs on the market that I just don’t know why anyone would prescribe consistently, unless they had some kind of reason, like money, dinner, or sex.
Some that come to mind include Lovaza, Sular, Bystolic, and Avandia.
Lovaza (GSK) is a drug that is approved only for patients with isolated elevations in triglycerides of above 500 and , in my opinion, has no particular clinical advantage when compared to the inexpensive fish-oil capsules one can buy at places like Costco
The company is required to place the following in their prescriber information:
LOVAZA, along with diet, helps to lower very high triglycerides (≥500 mg/dL) in adult patients.
Talk to your doctor about any medical conditions you have and any medications you are taking, especially those that may increase your risk of bleeding. In some patients, LDL-cholesterol levels may increase. Your healthcare provider should do blood tests before and during treatment with LOVAZA to check your cholesterol and
triglyceride levels. If you have liver disease, you may require additional monitoring.
Now, there aren’t a heck of patients out there with isolated triglycerides over 500mg/dl, the only FDA approved indication for this drug, and even the manufacturer states that LOVAZA can increase your bad cholesterol and that there is ZERO data to show that the drug reduces your risk of heart attacks. So all of you reading this: Go tell your friends that some doctor may have prescribed this very expensive drug for them, even though it may not do them much good.
Sular (Sciele Pharaceuticals) is a calcium channel blocker, used to treat hypertension. It is not generic, and while quite expensive, it is arguably no better ( many would say that it has more side effects) than another and similar type of calcium channel blocker known as Norvasc (amlodipine.) The price for Sular 17mg at Costco comes to around $1,800 dollars a year while the price of an equivalent dose of Norvasc (amlodipine) will cost you a little under $40 bucks!
So why the heck are there doctors out there prescribing Sular? Are they naïve, indifferent, or are they getting some type of compensation (friendship, lunches, dinners, paid meetings) from someone selling Sular? I’ll say it again and again, go find the top 100 prescribers of Sular and you will most likely find doctors that have some type of relationship with the manufacturer or the reps of Sular – Sciele Pharmaceuticals.
Bystolic (Forest Pharmaceuticals) is a beta-blocker medication approved only for high blood pressure. The FDA recently denied its approval for heart failure, and it is actually a generic drug in Europe. Most experts believe that these Beta Blocker medications are not the best treatment of hypertension, and most guildelines now suggest that you not chose this type of drug as the first line treatment of high blood pressure. Many generic blood pressure medications can be purchased, in bulk , for under ten –cents a pill (some as little as five-cents) while Bystolic will run around $2 dollars a pill in the US. So, how come sales keep going up and up?
Avandia (GSK) is a medication used to treat diabetes. It also causes weight gain and raises LDL (bad) cholesterol! Why the heck would anyone give a diabetic a medication that raises LDL cholesterol? This drug may eventually be taken off the market since many believe it is responsible for many deaths. So tell me what you think? Do you think that if we found the hundred, or perhaps even the top 1,000 prescribers of this medication, that many of them would have some sort of financial or other relationship with the makers or reps of this drug?
This seems obvious to me yet, evidently, it is not obvious to the FDA or to any decent investigative reporter. So, I suggest to the FDA or any good investigative reporter: Go out and purchase the same information that these drug companies do and find out what doctors are prescribing these drugs in disproportionate numbers and my guess is you will find a doctor involved with the company and playing a quid-pro-quo game with the reps for his own gain -- at his patients expense.