Pop art pens and medicines

Physicians and nurses in the United States aren’t the only ones being awarded continuing medical education credit hours to sell them on a sponsor’s products or political interests.

Writing in the Herald Sun, Ben Packham gives amazing statistics on CMEs and describes lavish educational conferences in Australia funded to the tune of $1,800 a head. As in “CMEs and purple light,” the sponsors’ influences aren’t always recognized or disclosed. (Follow link in title for full article.) :

$500,000 seminar at Crown for drug giant

A DRUG giant spent more than $514,000 on a weekend seminar at Crown that included just six hours of "education content". The symposium by Australian-based AstraZeneca included gourmet meals, alcohol and two nights free accommodation at Crown.

A new report shows "Big Pharma" is prepared to spend millions showering doctors with hospitality in the hope they will prescribe their drugs. It reveals drug companies spent $31 million on educational events in the second half of last year... funded 14,643 functions during the period, 52 of which are under investigation for possible breaches of new industry rules... But doctors claimed the hospitality amounted to little more than "a glass of orange juice and a sandwich"...

Australian Medical Association president Rosanna Capolingua said the events were necessary and spending was reasonable.

The Canadian Medical Association Journal published a controversial editorial this past week discussing a recent meeting on continuing education which concluded that the current system is broken. Editor-in-chief, Dr. Paul C. Hébert, M.D., MHSc, describes how CME sponsorship is distorting and compromising the ethical underpinnings of the medical profession. He doesn’t put the blame on the pharmaceutical companies, however, but on doctors themselves who have come to believe “that strong industry involvement is not only normal but also that they are entitled to receive the benefits.” He argues that disclosure doesn’t solve the problem that CME is driven by industry and calls for reinventing the system and disentangling CME from biases. In his editorial, he writes:

Currently, continuing medical education activities are, for the most part, sponsored by the pharmaceutical industry, which has a vested interest in promoting its products. This is big business: of the $2.6 billion spent in the United States on accredited continuing medical education activities in 2006, $1.45 billion (60%) came from pharmaceutical and medical device manufacturers. Although there are no reliable data in Canada, there is also no evidence that the situation is any different here.

Worldwide, IMS, a private company specializing in pharmaceutical intelligence, reports that in 2004 the pharmaceutical industry spent $27.7 billion on promotional activities, and $29.6 billion on research and development...

[T]he evidence suggests that education sponsored by the pharmaceutical industry frequently distorts the topic selection, embellishes the positive elements of studies3 and downplays the adverse effects. In effect, the industry focuses primarily on treatments and treatment-related issues at the expense of the larger therapeutic picture... We seem to have conveniently forgotten that the pharmaceutical industry is in business to make money, not to educate health professionals.

That $27 billion goes for a lot more than pens. Still, Dr. Jeffrey Caren, a cardiologist at Cedars-Sinai Medical Center in Los Angeles, has collected more than 1,000 pens given to him by pharmaceutical sales representatives who’ve tried to sell him their drugs. As a followup story to “Are you being detailed?” at JFS, ABC News this weekend looked at the detailed profiling of doctors and their patients done by pharmaceutical companies attempting to influence their prescription decisions.

Do Free Gifts Dictate Your Medical Care?

…Dr. Jeffrey Caren… said his pillar of pens illustrates an institutional practice in which drug reps make the case for expensive, newer products that haven't been broadly tested, potentially risking patient health… Doling out pens, coffee cups, clocks and free drug samples, drug companies spend about $7 billion a year to convince doctors to prescribe their medicines. The pharmaceutical industry says its sales reps arrive well-informed and with good intentions, but many doctors say the practice is dangerous and needs to stop.

"The information that drug representatives give to physicians is never objective," said Adriane Fugh-Berman, associate professor in the department of physiology and biophysics at Georgetown University. "Drug reps are trained to emphasize the benefits of their drugs, trivialize any risks, and to emphasize the shortcomings of competing drugs." …

At a recent on Capitol Hill, a former Eli Lilly sales rep, Shahram Ahari, gave lawmakers an insider's glimpse into the world of pharmaceutical sales… "The fact of the matter is, we don't just give a doctor a pen," Ahari said. "We give them bucket loads of pens, pads, we take them out to fancy dinners, we give them samples, we give them medical equipment. Everything we do generates this sense to return the favor. And what better way to return the favor to your drug rep than to prescribe their medications?"