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Biotech / Medical : Pharma News Only (pfe,mrk,wla, sgp, ahp, bmy, lly) -- Ignore unavailable to you. Want to Upgrade?

To: Anthony Wong who wrote (1468)	2/22/1999 8:40:00 PM
From: Anthony Wong	Read Replies (1) \| Respond to of 1722

Drug company's bouquet comes with ethical thorns Pens and Needles February 21, 1999 By Mark Somerson An item in the pile of mail waiting for me Monday morning caught my attention. It was a flier sent by a reader announcing a "Flower & Flee'' promotion sponsored for doctors by TAP Pharmaceuticals, the makers of the popular prescription antacid Prevacid. The flier was apparently an invitation to area doctors to attend a brief presentation about Prevacid on Feb. 9, just before Valentine's Day. "You are cordially invited to join your Prevacid representatives for a short detail at (an area flower shop),'' it read. "Afterward, choose a flower arrangement or a gift certificate to be used later.'' A few months ago, I wouldn't have even received this mail. But I wrote a story last month about the often-sticky relationship between doctors and pharmaceutical companies. Medical ethicists say questionable promotions that benefit doctors more than patients are a growing problem. This is going on despite rules for doctors created by the American Medical Association nearly a decade ago to deal with gifts. Critics cite a resurgence of incentives that teeter on an ever-narrowing ethical tightrope. "Now, before they will even see a pharmaceutical representative, some physicians expect something in return,'' said Dr. Victoria Ruff, a critical- care specialist at Riverside Methodist Hospitals and a member of the medical association's Council on Ethical and Judicial Affairs. Walk into nearly any physician's office, and you'll find wall clocks, notepads, pens and paperweights bearing the names of Prozac, Viagra, Claritin or Meridia. According to the AMA, these small tokens are fine. It's the biggies that bother the association. And these biggies are growing even larger, officials say. They include golf excursions, scarce Broadway show tickets, trips to Hawaii and $1,000 honorariums to attend an all-expenses-paid weekend conference in Florida. "Gifts should not have a significant value and should have a benefit to patients,'' said Dr. Robert M. Tenery, a Dallas ophthalmologist and chairman of the ethics council. "These companies are simply buying access to that doctor.'' Because of changes in managed care, doctors say they are busier than ever, seeing double the number of patients they saw years ago to make the same money. All this makes the pharmaceutical companies work even harder to get the physicians' attention. Most drug companies voluntarily follow the AMA ethics rules, but some don't. One Westerville dermatologist got an offer in December from a company promising a free Beanie Baby for every prescription he'd write for its drugs. "Doctors on the whole are good judges of what is appropriate and what is not,'' Tenery said. "But there is a lot going on out there that is questionable.'' Tenery said the ethics council is considering creating a task force to re-examine the issue. Ruff said most of the small gifts are fine. "For the most part, we are talking about things under $50,'' she said. "The council doesn't want to be hysterical. But while a Beanie Baby doesn't sound like much, when do you stop? It can become absurd.'' The pharmaceutical industry spends billions of dollars every year promoting its drugs to doctors and now patients through direct advertising. It also spends billions researching and developing life-saving drugs. But who pays for marketing and promotions? Chances are the consumer does. As for the Prevacid/Valentine's promotion, I called a woman listed on the TAP Pharmaceuticals flier. She wasn't eager to talk. "I was within AMA guidelines,'' the rep said. "We didn't even come close to spending $100 per doctor.'' Mark D. Somerson is medical reporter for The Dispatch. He can be reached at or 461-8521. dispatch.com