Healthy Skepticism Library item: 14738

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Publication type: news

Stock S.
Luxury lures give doctors the drug company habit
The Australian 2000 Aug 26-27

Full text:

IN the past three months Peter Davoren has been offered a free trip to New Zealand for a conference, a family day at MovieWorld, a night at the Intercontinental Hotel in Bethlehem, a gambling night at the Cairns casino and numerous dinners at expensive restaurants.
They might sound like prizes in a raffle, but they have all been offered to Dr Davoren – a diabetes specialist on the Gold Coast – by drug companies pushing their products.
Pharmaceutical companies are increasingly treating doctors to lavish events and conferences at luxury hotels in an attempt to get around the ban on drug advertising.
While there is controversy about politicians and businessmen accepting corporate Olympic hospitality, doctors continue to take the drug companies’ largesse. Adding to the ethical dilemma is the medical industry’s requirement of an educational component to such outings – often educational in name only.
Specialists treating common ailments such as blood pressure, cholesterol, asthma and osteoporosis receive the most invitations. These include weekends in luxury hotels, sporting events, overseas conferences and theme events such as casino nights.
The conferences are becoming the lifeline of some hotels and convention centres. Rush Lilian, conference manager for Pharma Events, a business dealing exclusively with drug companies, estimates the industry’s share of the events and confer ences market has increased by 35 per cent in the past two years.
Hotels such as the Sails in the Desert resort at Uluru say pharmaceutical companies are their premier market.
Drug companies, keen to woo doctors because they cannot advertise to the public, target specialists believing they influence GPs’ prescribing habits.
Ms Lilian said her company sometimes flew as many as 200 doctors interstate for a weekend conference coinciding with the launch of a drug, spending up to $1700 a head.
The stakes are high – and the public pays. Australia’s pharmaceutical industry had a turnover of $6 billion in 1998-99 and operates in a competitive market because of the number of drugs approved for presription on Medicare. Cardiovascular medicine is the most lucrative market. Its products on the Pharmaceutical Benefits scheme cost the federal Government more than $1 billion a year, according to the Health Insurance Commission.
Alimentary tract and metabolism drugs, which include diabetes medicines, cost more than $500 million, and respiratory medicines, including asthma drugs, cost $266 million.
Guidelines introduced in 1986 ban drug companies from offering doctors free trips and incentives without an educational component.
The Australian Pharmaceutical Manufacturers Association code says entertainment or other hospitality offered to doctors should be secondary to educational content and in proportion to the occasion.
But Dr Davoren – who is head of the Doctors Reform Society – says events and dinners dressed up as educational opportunities for doc tors often have little educational content.
A “specialist talk” may be nothing more than a drug advertisement, Dr Davoren said. An international conference may have its program determined by the sponsoring drug company, or there may be no pretence of educational content – just a quick drug plug then entertainment.
In May about 100 respiratory specialists were flown from around Australia to Uluru for a conference before the launch of Glaxo Wellcome’s combination asthma drug Seretide. They were put up at Sails in the Desert, climbed the Rock, had barbecues and leisure time and were wined and dined – all courtesy of the drug company.
Glaxo Wellcome spokesman Mike Devoy confirmed Seretide was due to be launched, but said the conference was not specific to the drug. He did not know why the Rock was chosen as a venue.
“It was a meeting to talk about recent advances in asthma therapy and how drugs are used,” Dr Devoy said.
Queensland University professor of medicine Charles Mitchell was a speaker at the conference and talked about the history of asthma. But he conceded the event was staged to advance the new medicine.
“It’s more subtle than doctors being asked to plug a drug at an event sponsored by a pharmaceutical company,” Dr Mitchell said. “It’s more a feeling of obligation some people
feel at, a sponsored event – they take the notion of being civil to extremes.”
Conferences usually run from Thursday to Saturday in locations such as the Gold Coast, Fiji or major cities, according to a Sydney specialist. The doctors are greeted by drug company representatives at the airport, driven to a top hotel and treated to unlimited drinks and dinner with company executives.
On Friday and Saturday there are usually talks followed by leisure such as rugby matches, opera, scuba diving, golf or whatever the area has to offer. This is followed by dinner and drinks.
Australian Pharmaceutical Manufacturers Association head Alan Evans insisted the drug industry was ethical, saying it was governed by strict rules and did not try to influence doctors’ prescribing habits through its conferences. Any breach of conduct was investigated, he said.
But evidence shows such company-sponsored events do influence doctors.
Research in the Journal of the American Medical Association shows that attending drug-company events and accepting travel and accommodation meant a doctor was more likely to prescribe that company’s medicines.
Australian Medical Association president Kerryn Phelps said she saw no harm in current relations between doctors and pharmaceutical companies because doctors “are not uninformed passive recipients of information”.
Doctors often attended events that might involve drug promotion but were not unduly influenced and had the opportunity to meet specialists in their field, she said.

How Doctors Are Targeted

Profiling: Representatives compile dossiers on doctors including such information as their children’s narnes, golf handicaps and favourite foods.
The doctor’s personatity type and prescribing habits are then catergorised. ‘A’ means a high volume prescriber of the company’s product, ‘B’ could be a influenced to become a high prescriber, and ‘C’ is a doctor not worth targeting.

Giveaways: Colourful displays of data – or pens, post-it pads, torch lights, anti-stress balls, golf balls, chocolates – are brand name reminders that lead to the drug being remembered more quickly than other drugs.

Competitions: Trade displays might advertise a fun and games section. Prizes might include soft toys and good quality wines, and the winners are often people the company wants to influence.

Intercompany Deals: Competing companies enter into an agreement whereby neither company challenges the other company’s claims.

Incentives: Representatives are given bonuses, trip etc on the basis of thier market share, projected growth estimates, achieving targets. They are told to say anything to doctors but never to write it down.

Indoctrination: Representatives are never allowed to say anything negative about a product but must convert a negative into a positive – nausea would be presented as helping paitents lose weight.

Source – the confessions of a former drug industry employee, published in the Medical Lobby for Appropriate Marketing Inc Australian newsletter, April 1999