incentive based medicine: the money shot.

This week the ABC radio show Background Briefing takes a look at the practice of drug companies paying senior doctors to promote specific drugs. It’s not only the drug reps themselves that can make wad loads of money getting patients to take a certain type of drug.

Doctors known in the business as ‘key opinion leaders’ are actively groomed by the reps and then offered money ( up to $1,500 per presentation) and other incentives to champion the drug to their colleagues. In fact the reps spend a considerable amount of time building up ‘dossiers’ on individual doctors so that the best recruitment leverage can be applied.

Petra Helesic, who worked in the pharmaceutical industry for over 10 years, says Australian specialists were offered free trips to international conferences and paid to deliver presentations that often used drug company slides.

But the Australian Medical Association (AMA) has strongly defended doctors who accept hospitality or speaking fees from drug companies.

It says it is strongly opposed to publicly naming doctors who attend drug company-funded events or accept fees for promoting pharmaceuticals.

AMA president Dr Steve Hambleton told Radio National’s Background Briefing a registry could jeopardise the reputations of the doctors who are on it.

“It’s not a secrecy issue, it’s really a matter of being realistic about looking after the rights of both the patients but also the rights of the doctors. I guess there’s concern that just because you’re on a register that somehow that besmirches your reputation,” he said.
:: ABC news::

Many doctors would be very quick to point out that they know exactly what these drug companies are up to, and that they use the resources that are offered (such as drug company funded meetings and educational sessions)  for their own agendas without being biased or influenced by these marketing strategies.

But there is a great deal of research and psychological science at play here. These are very smart¹  and powerful organisations.
If there was no evidence that their strategies were in fact able to influence prescribing habits to a (financially) significant extent, they would not be wasting their time nor their money doing it.

You can find the entire show Background Briefing show available to listen to, or in transcript form here.

1. that’s smart as in smarty pants, not smart as in wise. [↩]