Photo: Dianna Porter and Ed Coyle of the Alliance for Retired Americans,
and Senator Debbie Stabenow (D-MI).
On January 24, 2008 PAL held our Annual Dinner in Washington, D.C. Every year, we host this event for the organizations in the PAL Coalition, to celebrate our victories and gird ourselves to continue the fight in the year ahead against illegal drug industry tactics. Last year, we began a tradition of honoring key consumer advocates for their leadership in fighting for affordable prescription drugs and against drug industry greed.
This year we honored Dianna Porter, who recently retired as Director of Policy at the Alliance for Retired Americans, and Senator Debbie Stabenow (D-MI), for their leadership in fighting to hold drug companies accountable. PAL Director Alex Sugerman-Brozan presented them both with our first annual Blockbuster Award.. “Blockbuster” is the term used to describe a prescription drug that has more than a billion dollars a year in sales., often more due to aggressive marketing and promotion than some clinical breakthrough. We decided to name our award “The Blockbuster Award” to turn the concept on its head and suggest that our priorities should be affordability, accuracy and access, not sales figures. The recipients of the Blockbuster Award epitomize the priorities we should be striving for.
Dianna Porter has been advocating for seniors for more than 30 years. She started her career in senior advocacy as the Director of Education for the Section on Mental Health and Aging at the University of Texas Medical School. She spent two years at the U.S. Special Committee on Aging, followed by two and half years as the Public Policy Director at the National Council on the Aging. Her policy advocacy work on senior issues continued at the Older Women’s League, where she was Public Policy Director. She then took her expertise abroad, spending four years in Skopje, Macedonia, as the Director for the Macedonia Pension Reform Project. She documented her experiences in a book titled “Your Woman in Skopje: Letters from Macedonia.” In January 2001, she joined the staff of the Alliance for Retired Americans as their Director of Policy. Among her projects at the Alliance, she drafted policy positions and Congressional testimony, and analyzed pending legislation of concern to the Alliance’s members. She wrote numerous reports on senior issues, including “The Profit in Pills: A Primer on Prescription Drug Prices,” and “Outrageous Fortune: How the Drug Industry Profits from Pills.” She recently retired.
Senator Stabenow made history in 2000 when she became the first woman from the State of Michigan elected to the United States Senate. Elected to a new term in 2006, she has been appointed to the powerful Senate Finance Committee which is responsible for our nation’s taxation, health care, pension and trade policies, critical to Michigan’s future. She will continue serving on the Senate Budget and Agriculture committees and is chairing the Agriculture Subcommittee on Rural Revitalization, Conservation, Forestry, and Credit.
From the County Commission to the State Legislature to the halls of Congress, she has become one of Michigan’s most accomplished leaders, leading the fight on jobs and manufacturing issues, and becoming the Senate’s “go to” person on the issue of health care and prescription drugs. She has sponsored and advocated for numerous pieces of critical legislation to increase the affordability of prescription drugs and close drug industry loopholes. These include:
The Lower PRICED Drugs Act (Lower Prices with Increased Competition and Efficient Economic Development of Drugs), which would help lower the skyrocketing costs of prescription drugs by increasing competition from generic drugs, resulting in dramatic savings for consumers, manufacturers, businesses, and taxpayers.
The Medicare Part D Reform Act, which had provisions designed to address some of the major problems in the Medicare prescription drug plan.
Legislation to require the Center for Medicare and Medicaid Services (CMS) to negotiate the price of drugs paid for under Medicare Part D.
As the first woman from the State of Michigan elected to the United States Senate, Senator Stabenow was inspired to first run for office by the closing of a local nursing home. She was elected to the Ingham County Board of Commissioners in 1974 and was the youngest person and first woman to chair the Board (1977-78). She was elected to the Michigan House of Representatives where she served for twelve years (1979-90) and rose in leadership, becoming the first woman to preside over the House. She served in the State Senate for four years (1991-94). Elected to Congress in 1996 representing Michigan’s Eighth Congressional District, she won election to the U.S. Senate four years later.
We are honored to be able to highlight these two important leaders with our first annual Blockbuster Awards.
As we head into 2008 (with one-twelfth of it already done), we here at PAL want to take an opportunity to look back and fondly recall our favority Prescription Access Litigation blog posts of 2007. 2007was an exciting year for those of us committed to fighting drug company greed. We had some major successes and some set-backs, but you can always count on us to continue fighting to lower the cost of prescription drugs and challenge illegal drug industry schemes.
Drugs that you can buy without a prescription are called Over-the-Counter (OTC) drugs. There are hundreds of different drugs that are OTC – cough and cold medications, pain relievers (aspirin, ibuprofen, etc), heartburn drugs, and many others. Many of these drugs have been available for a very long time, and have long track records for safety. Others are newer, and often started out as prescription drugs.
In recent years, drug companies have often tried to preserve their profits and market share on a blockbuster prescription drug by switching it from prescription-only to OTC. Pharmie explained how drug companies benefit from this switch and whether it’s necessarily a good thing for consumers.
Click Here to read more about OTC drugs, and the entire Ask Pharmie series!
June was a great month for PAL and the consumers and health plans we fight for. First, we announced a major victory in our Average Wholesale Price (AWP) case. A federal judge ruled that Astra Zeneca, Bristol-Myers Squibb and Warrick acted “Unfairly and Deceptively” by inflating the “Average Wholesale Prices” of a number of their physician-administered drugs. The Court found that these three defendants caused the publication of false and inflated Average Wholesale Prices for seven drugs:
• Astra Zeneca: Zoladex
• Bristol Myers Squibb: Taxol, Vepesid, Cytoxan, Blenoxane and Rubex
• Warrick: albuterol sulfate
“Today’s decision rights a great wrong that was done by these three companies against some of our society’s sickest and most vulnerable patients,” said Alex Sugerman-Brozan, director of Prescription Access Litigation. “What could be more outrageous than taking advantage of cancer patients in the name of profits?”
The second major announcement we made in June was that a federal judge allowed our case against the maker of Zyprexa to move forward. In a 14 page ruling the Judge stated that the courts are “in the strongest position” to protect the public from fraudulent drug marketing. The case alleges that Zyprexa was fraudulently marketed for uses not approved by the FDA, and that important safety information was withheld. Click Here for the full story!
In July, we highlighted how the withdrawal of the Irritable Bowel Syndrome (IBS) drug Zelnorm from the marketillustrates the dangers of aggressive prescription drug marketing, and the absurdity of marketing questionable or overinclusive “syndromes.” Zelnorm was voluntarily withdrawn from the market by the manufacturer due to a study that showed patients on Zelnorm had an increased risk of heart problems.
These ads, and the overall promotional campaign of which they were a part, didn’t just market Zelnorm — they also marketed ‘Irritable Bowel Syndrome’ (IBS) as a condition, working to convince millions of viewers that they have ‘IBS,’ rather than more conventional occasional and symptomatic digestive problems. By the time Novartis voluntarily withdrew Zelnorm from the market in March 2007, millions of people had taken it.
On August 17th we reported on an AP story that the Pharmaceutical Research and Manufacturers of America (PhRMA) spent $10.7 million in the first half of 2007 to lobby the federal government. PhRMA is headed by the former member of Congress, Billy Tauzin. While in office, Rep. Tauzin was one of the main proponents of the passage of the legislation that created Medicare Part D, which is widely regarded as an enormous giveaway to the pharmaceutical industry. Click here to read more about this report.
This September Breast Cancer Action urged our readers to “Think Before You Pink,” a campaign that encourages consumers to ask critical questions about the hundreds of pink ribbon products and promotions that are marketed every October in honor of Breast Cancer Awareness Month (BCA calls it Breast Cancer Industry Month). This year’s campaign focused on “pinkwashing” — the practice of companies that increase sales by putting pink ribbons on their products, even though these products contribute to the breast cancer epidemic.
October brought us a spooky surprise when we learned that according to The Government Accountibility Office seniors’ drug trials fail to involve enough seniors!
As the election season heated up this fall we decided to examine John Edward’s proposals to rein in the drug industry’s excesses. Does he go far enough?
And finally, an October surprise! Our beloved Red Sox (PAL is based in Boston) won the World Series.
In November we featured an alert issued by Consumer Reports about the overhyping of drugs for “Restless Leg Syndrome.” The Restless Leg Syndrome Foundation, which happens to be significantly funded by GlaxoSmithKLine, which makes drugs for RLS, was not happy about the Consumer Reports alert.
Also in November we gave you one more reasonnot to buy Nexium, you know, the purple pill. At PAL, we’ve long contested that Nexium is just a dressed up version of Prilosec. You can put lipstick on a pig but…
As the holiday season came into swing this December we thought it was a good idea to highlight a report that reminded people to remember that certain foods can cause negative reactions when mixed with prescription drugs.Take a look at the list of the most common drugs and their accompanying “no no” foods.
Then we told you about Montell William’s outburst at a college student who was asking him about prescription drug prices. Williams is a paid spokeperson for PHrMA and the Partnership for Prescription Assistance. Click here to watch the video clip!
Finally, in December PAL joined a “friend of the court” brief supporting new patent rules that would curtail abusive behavior by patent applicants and improve patent quality. Click here for the details.
There you have it – The PAL Blog 2007 Year in Review! Since its start in May, our blog has been growing every day, but we’d still love your help. Please tell your friends and colleagues about this blog, and contact us if you’re interested in exchanging links to a related blog. Of course, we always encourage comments. Let us know in the comments here – what do you want us to report on in 2008?What did you particularly like – or dislike – on the PAL blog in 2007? What are your predictions for the industry in 2008?
Thank you so much for your readership, and have a wonderful (rest of) 2008!
The director of Prescription Access Litigation (PAL) appears in a documentary called “Money Talks: Profits Before Patient Safety”. The film focuses on the questionable marketing tactics of the pharmaceutical industry. A trailer is below:
It shares this honor with a number of other distinguished documenatries, including “Jesus Camp,” “Maxed Out,” and Spike Lee’s “When the Levees Broke.”
We here at PAL are honored to have been part of this project and applaud the filmmakers, Kathleen Slattery-Moschkau (director of “Side Effects,” an independent feature film on drug marketing starring Grey’s Anatomy’s Katherine Heigl) and Holly Mosher, of Be Well Media. To learn more, go to www.moneytalksthemovie.com. The filmmakers’ press release is below:
Madison, WI (PRWEB) January 24, 2008 — The American Library Association Video Round Table Committee has announced their top picks for the “2008 list of Notable Videos for Adults.” Among the committee’s 15 choices was the award-winning and timely documentary Money Talks: Profits Before Patient Safety by critically acclaimed filmmakers Kathleen Slattery-Moschkau and Holly Mosher. The film offers compelling insight into the questionable marketing tactics of the pharmaceutical industry.
“Money Talks presents a wealth of unsettling information and forward-looking ideas about one of the most urgent issues facing our country today. This film should be required viewing for anyone concerned about the complexities and failings of the American health care system,” said Meghann Matwichuk, University of Delaware, Media Librarian / Video Round Table Notable Videos for Adults Committee Member.
Each year the committee selects top educational and instructional titles based on criteria that include expanding the viewers’ knowledge, clarifying a difficult topic, and contributing to the solution.
The 50-minute documentary explores the pervasiveness of drug industry influence through featured interviews with medical community heavy-hitters, including Harvard’s Dr. John Abramson, author of Overdo$ed America; Columbia University’s Dr. Bob Goodman, founder of the ‘No Free Lunch’ program; Alex Sugerman-Brozan, director of Prescription Access Litigation; and Dr. Jerome Hoffman of UCLA Medical School.
Money Talks: Profits Before Patient Safety is Slattery-Moschkau’s and Mosher’s second film about the issues within the pharmaceutical industry. Their internationally acclaimed debut film Side Effects, starring Katherine Heigl, was a fictional look at writer/director Slattery-Moschkau’s decade working as a sales rep for two of the nation’s top drug companies.
Most recently, the two outspoken consumer health advocates launched Be Well Media, a nonprofit media production and promotion company focused on healthcare education via entertainment.
Money Talks: Profits Before Patient Safety is available on DVD, or as part of an educational viewing package at www.moneytalksthemovie.com.
Yesterday two CBS affiliates aired PAL Director Alex Sugerman-Brozan’s counter argument to drug industry cronies in a segment about Rx coupons. Watch a clip here!
PAL has called on the FDA to ban the use of coupons to promote brand name drugs because we believe it is just another one of the many tactics the drug companies use to lure people away from cheaper generic drugs. Click here to read the Los Angeles Times article (published in December) that features PAL’s efforts, and learn more about why Rx coupons should be banned.
In 2006, New Hampshire became the first state to prohibit pharmacies from selling information about what drugs doctors prescribe. Pharmacies routinely collect and sell information on what drugs individual doctors write prescriptions for, and sell it to companies like IMS Health and Verispan. Those companies then sell that data to drug companies. Drug company salespeople use that information to tailor the sales pitch that they make to doctors during visits to doctors’ offices. IMS Health sued the state of New Hampshire, arguing that the new law violated the company’s “free speech” rights.
Prescription Access Litigation’s parent organization, Community Catalyst joined AARP, AFL-CIO, AFSCME, Center for Medical Consumers, Community Catalyst, National Women’s Health Network, and New Hampshire Citizens Alliance in submitting a “friend of the Court” (amicus curiae) brief in support of the law. Unfortunately, the U.S. District Court for the District of New Hampshire struck down the law. The state of New Hampshire appealed, and last week, there was a hearing at the U.S. Court of Appeals for the First Circuit, in Boston, MA.
Sean Flynn, Associate Director of the Program on Intellectual Property at Washington College of Law at American University, was there and argued on behalf of a number of “amici curiae.” Sean reports on that hearing, in the PAL Blog’s first-ever “guest blogger” post. Here’s his dispatch from the hearing:
On Wednesday, the First Circuit heard arguments in IMS v. Ayotte, involving New Hampshire’s appeal of a district court ruling striking down a first-in-the-nation law prohibiting prescription data mining.
Prescription data mining occurs through “health information companies” like IMS purchasing information from pharmacies on what drugs were prescribed by whom. This information, which is provided without the consent of either the doctor or the patient, is sold to pharmaceutical companies who use it to tailor the marketing of drugs to physicians. Using prescription information identifying prescribers enables drug companies to send a salesperson into a doctor’s office with an individually tailored pitch as well as to identify and reward their best prescribers with gifts, paid consultancies, prestigious board appointments, expense paid “educational” trips and other perks.
According to some estimates, drug companies spend as much as $34 billion a year marketing to doctors. Evidence in the case showed that the average physician sees at least five drug company reps a day.
In 2006, New Hampshire became the first state to outlaw prescription data mining for marketing, and was immediately challenged in court by the major drug information companies. Last May, the law was overturned by the a U.S. District Court, which agreed with the companies that the law violated the First Amendment guarantee of free speech because it “limits both the use and disclosure of prescriber-identifiable data for commercial purposes.”
At the hearing before the First Circuit on Wednesday, the judges appeared very critical of the data mining industry’s assertion that collecting and selling prescription records amounted to protected speech under the First Amendment. Judge Selya, who wrote an important opinion holding that advertising consulting services between companies are not 1st Amendment speech, asked the New Hampshire attorney “if there is any effect on commercial speech, isn’t it just incidental?”
All of the Judge’s questions were focused on the degree to which states can regulate economic conduct with an ‘incidental effect’ on commercial speech rather than whether the law itself was narrowly tailored. The court never asked either side for detailed arguments on whether the law was ‘narrowly tailored’ to meet its objectives, a possible indication that they believe that the law does not regulate protected speech.
The judges were much more critical of IMS’s argument. Judge Lipez asked skeptically whether NH had to have a “Turner record” (three years of congressional hearings used to justify regulating cable speech) for this law. The IMS attorney seemed not to take the hint, responding that NH needed more because this law was akin to regulating the core of the 1st Amendment and therefore required strict scrutiny.
I gave the rebuttal argument on behalf of the public interest amici in the case. The core of my argument was that the First Amendment’s commercial speech doctrine is about protecting the rights of companies to speak to consumers about their products. It does not protect any right of companies to monitor their consumers to see whether their pitches are successful. This law, like many others, regulates the latter by cutting off access to identifying information rather than regulating the substance of what marketers say. It is thus similar in particulars to
• Driver Privacy Protection Act (upheld by Reno v. Condon)
• Video Privacy Protection Act (video rental information)
• Stored Communications Act (internet)
• Electronic Communications Privacy Act
• Fair Credit Reporting Act (upheld by Trans Union v. FTC)
The DPPA is particularly relevant since that law was passed in part to cut down on harassing sales tactics by lawyers searching accident records for potential clients.
We argued that a gift ban would not meet the state’s interests because the monitoring of prescriptions is used to target a host of reinforcements of favored prescribing behavior — including consultancies, educational seminar invitations, prestigious board appointments and even targeted expressions of appreciation — that are difficult or impossible to regulate under gift bans.
I am optimistic about the chances for a favorable ruling. If the First Circuit overturns the ruling striking down New Hampshire’s first in the nation law regulating prescription data mining, several states and the District of Columbia are expected to quickly enact similar laws. Washington State and New York look primed to move soon, possibly without waiting for the ruling. The First Circuit’s ruling will also affect current litigation in Vermont and Maine that passed data mining restrictions soon after New Hampshire.
Pfizer’s commercials for Lipitor featuring Dr. Robert Jarvik, “inventor of the artificial heart,” are probably among the most recognized drug ads on TV today. The ads rely on us viewers assuming that because Dr. Jarvik supposedly invented the artificial heart, he must be an authority on cholesterol… Right? The ad above has Dr. Jarvik saying “Just because I’m a doctor doesn’t mean I don’t worry about my cholesterol.”
Hmmm… What if the ads also said that Dr. Jarvik never actually practiced medicine, and in fact never even got licensed to practice medicine? Suddenly, he doesn’t seem like that much of an authority, does he?
Well, apparently that is the case. The Energy and Commerce Committee of the US House of Representatives is investigating “the use of celebrity endorsements of prescription medications in direct-to-consumer advertising, specific to Dr. Robert Jarvik’s appearance in Pfizer’s Lipitor Commercials,” according to the Committee’s press release:
Washington, D.C. – Reps. John D. Dingell (D-MI), Chairman of the Committee on Energy and Commerce, and Bart Stupak (D-MI), Chairman of the Subcommittee on Oversight and Investigations, announced today that they are opening an investigation into the use of celebrity endorsements of prescription medications in direct-to-consumer advertising, specific to Dr. Robert Jarvik’s appearance in Pfizer’s Lipitor Commercials.
“We are concerned that consumers might be misled by Pfizer’s television ads for Lipitor starring Dr. Jarvik,” said Dingell. “In the ads, Dr. Jarvik appears to be giving medical advice, but apparently, he has never obtained a license to practice or prescribe medicine.”
“Dr. Jarvik’s appearance in the ads could influence consumers into taking the medical advice of someone who may not be licensed to practice medicine in the United States,” said Stupak. “Americans with heart disease should make medical decisions based on consultations with their doctors, not on paid advertisements during a commercial break.”
It’s not surprising that Pfizer chose Dr. Jarvik as its spokesperson. In the past three years, we’ve seen a stampede of white coats in drug ads — either actual doctors or actors dressed up like doctors. The white coat conveys authority and gravity to the ads.
But there’s something very bothersome about using a “Doctor” who has no license to practice medicine, and who in fact apparently has never done so, to advertise Lipitor. And that is the fact that particularly when it comes to cholesterol medications, the prescribing details matter. The decision of whether to prescribe a statin (such as Lipitor, Crestor, Zocor, Pravachol, etc.) and which statin to prescribe are ones that require a fair amount of knowledge and experience on the part of the doctor — different patients need different statins, different statins have different side effects. So who should use Lipitor -versus another statin or even versus just changes to diet and exercise – are complicated questions requiring doctors to know a fair amount. Yet Pfizer has Dr. Jarvik, who can’t even practice medicine, advising consumers to take Lipitor!
It’s a measure of what Pfizer thinks of us lowly consumers that they use a celebrity doctor spokesperson who can’t even prescribe the product they’re endorsing.
What with the recent flap over Montel Williams, PhRMA’s patient assistance spokesperson, threatening to “blow up” a high school student, and now the revelation about “Doctor” Jarvik, it makes us wonder whether celebrities are the best choice for drug ads…
A new study conducted by Harvard University researchers at Cambridge Health Alliance bucks an important piece of conventional wisdom about prescription drug samples: They don’t primarily go to low-income and uninsured people — in fact the study found the opposite: “Most free drug samples go to wealthy and insured patients and are not used to ease the burden of the poorest nor the uninsured,” said the press release on the study (below).
Most doctors and even most patients think of drug samples as benign, and even beneficial. After all, what’s wrong with getting your prescription drug, even the first few days’ or a month’s supply, for free? But this ignores several key facts:
Drug samples are almost always for the newest, most expensive brand-name drugs. They are a way to introduce doctors to these newer, costlier drugs, even if they don’t offer any advantage over older, less expensive drugs, especially generics. Newer drugs have less of an established record of safety than older drugs – One of the authors of the study says in the press release below “we found that the most widely distributed sample in 2002 was Vioxx, with Celebrex being number 3. These drugs turned out to have lethal side effects. While many doctors still view samples as a safety net for their neediest patients, our study shows that samples are potentially dangerous, and do little for the needy.”
Drug samples are primarily a marketing tool. They are part and parcel of the overall sales pitch aimed at doctors — a pitch delivered by the same drug salespeople who drop off the samples, provide free lunches for the staff, invite the doctor to a “continuing medical education seminar” at a fancy restaurant, and ply the doctor with reprints of medical journal articles casting the company’s drug in the most positive light possible.
Drug samples affect prescribing. Doctors tend to continue patients on drugs that are working for them. If the patient starts on Expensive Brand Name Drug X because that’s the sample that was in the Doctor’s cabinet, and it works for them, then they’re likely to continue on that drug, even if Inexpensive Generic Drug Y would have worked just as well. Brand-name drug companies know this, and that’s why they spend billions a year providing samples to doctor’s offices. It’s not feasible for generic drug companies to provide samples, because they can’t guarantee that the patient would get their particular version of the generic when they later fill a prescription at a pharmacy. So drug samples lead to overuse of expensive brand-name drugs and millions in unnecessary spending.
Doctors often justify allow drug salespeople into their offices because of drug samples, and justify accepting drug samples on the notion that they help their needy or uninsured patients. Today’s study undermines that justification, at least on an aggregate basis.
Interestingly, the study pointed to differences in health access and insurance coverage to explain why wealthier and insured patients get more drug samples:
“Free sample receipt was consistently higher among those with better access to medical care. Non-Hispanics, English-speakers and Whites were all more likely to receive free samples than were members of ethnic, linguistic or racial minorities. Receiving medical care in an office and taking more medications also increased an individual’s chances of receiving free drug samples.”
NPR did a story on the study today, and interviewed a representative from PhRMA, the brand-name drug industry’s trade association. That PhRMA rep was quick to point out that drug companies don’t consider samples to be a way to help low-income or uninsured patients — and instead pointed to drug company patient assistance programs as serving that purpose.
There are some moves afoot to put generics on a more equal footing with brand-name drugs at the doctor’s office. More and more health plans are charging their members zero copayments for generics. In our 2006 Bitter Pill Awards, we gave a “Real Deal Award” to MedVantx, a company that places “generic sample cabinets” in doctors’ offices. Doctors are able to give a patient an initial supply of a generic drug, and thus have an alternative to the marketing-oriented brand-name samples that drug companies ply.
Most Free Drug Samples go to the Wealthy and Insured
-First of its Kind Study from Harvard Medical School Researchers at Cambridge Health Alliance Finds Few Samples Distributed to Poor and Uninsured-
Cambridge, MA……Most free drug samples go to wealthy and insured patients and are not used to ease the burden of the poorest nor the uninsured, according to a study by physicians from Cambridge Health Alliance and Harvard Medical School. The study, which is the first to look at free drug samples nationally, will appear in the February 2008 issue of the American Journal of Public Health.
The study found that use of free prescription drug samples is widespread. More than one out of every ten Americans received one or more free drug samples in 2003. Among Americans who take at least one prescription drug, nearly one out of five got free samples.
Few free samples went to the needy. Insured Americans and those with higher incomes were more likely to report receiving at least one free sample. More than four-fifths of sample recipients were insured all year. Conversely, less than one-fifth were uninsured for all or part of 2003, and less than one-third had low family incomes (under $37,000 for a family of four).
Free sample receipt was consistently higher among those with better access to medical care. Non-Hispanics, English-speakers and Whites were all more likely to receive free samples than were members of ethnic, linguistic or racial minorities. Receiving medical care in an office and taking more medications also increased an individual’s chances of receiving free drug samples.
Author Sarah Cutrona, a physician at Cambridge Health Alliance and an Instructor of Medicine at Harvard commented: “The distribution of free samples has become very controversial. Evidence shows that free samples may influence physicians’ prescribing behavior and cause safety problems. For instance, we found that the most widely distributed sample in 2002 was Vioxx, with Celebrex being number 3. These drugs turned out to have lethal side effects. While many doctors still view samples as a safety net for their neediest patients, our study shows that samples are potentially dangerous, and do little for the needy.”
Dr. David Himmelstein, senior author of the study, a physician at Cambridge Health Alliance and an Associate Professor of Medicine at Harvard adds: “We know that many doctors try to get free samples to needy patients when those patients come into the office. We found that such efforts do not counter society-wide factors that determine access to care and selectively direct free samples to the affluent. Our findings strongly suggest that free drug samples serve as a marketing tool, not as a safety net.”
“Free drug samples are not the solution to the disproportionately low amount of health care resources going to the poor and uninsured; they are part of the problem,” said Dr. Steffie Woolhandler, a physician at Cambridge Health Alliance, Associate Professor of Medicine at Harvard, and study co-author.
The study used data on 32,681 US residents from the Medical Expenditure Panel Survey (MEPS), an annual federal survey. Dr. Cutrona’s work on the study was supported under a National Research Service Award.
Recipients of Free Prescription Drug Samples: A Nationally Representative Analysis published in American Journal of Public Health http://www.ajph.org/ February 2008, Vol 98, No. 2. Authors: Sarah L. Cutrona, MD, MPH, Steffie Woolhandler, MD, MPH, Karen E. Lasser, MD, MPH, David H. Bor, MD, Danny McCormick, MD, MPH, and David U. Himmelstein, MD.
Our friends over at PostScript, the blog of the Prescription Project, got in to the holiday spirit last week with a Christmas Carol about the joys of drug sales people pitching their drugs to Doctors, with the aid of data and information sold to them by the American Medical Association (AMA). Here it is. Enjoy!
Here in PostScript country, we’re up to the shins in snow and to the gills with yuletide spirit, so we thought we’d turn all that merriment toward something else that’s on our minds…
A Data-Mining Carol
[to the tune of Jingle Bells]
Dashing through the wards, with a briefcase in his hand,
The rep signs in and waits, then shakes the doctor’s hand
But this is no plain pitch,
He knows just what to say,
Because he knows just how much Doc wrote
Of Seroquel last May
Data sells, the reps can tell
How well their free lunch pays
But docs don’t know how much is shown
On a rep’s handheld display, hey
Prescriptions filled, providers billed,
The rep calls it a day,
Oh how tough his job would be
Without the AMA!