Comments on: How other doctors (but not you, of course) are influenced by Big Pharma

By: Small Pharma

Small Pharma — Mon, 15 Aug 2016 16:58:24 +0000

I hope this isn’t about the USA – i know this post is from 2013 — but the states pharma and device companies have not been able to give out any freebies in almost 10 years. Difficult to cite a 2005 study in such a dynamic environment.

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By: Profiles in Medical Ethics

Profiles in Medical Ethics — Tue, 16 Feb 2016 19:11:29 +0000

[…] Writer Carolyn Thomas puts it this way in her blog Ethical Nag: […]

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By: epatientgr

epatientgr — Mon, 21 Jan 2013 23:54:57 +0000

Reblogged this on EpatientGR's Blog and commented: Στο παρακάτω άρθρο από το blog ethical.nag αντιγράφω το άρθρο “Πώς άλλοι γιατροί (όχι εσείς) επηρεάζεστε από τις μεγάλες φαρμακευτικές εταιρείες”. Η συγγραφέας, Carolyn Thomas, είναι επαγγελματίας των δημοσίων σχέσεων και της επικοινωνίας αλλά και γνωστή blogger του http://www.myheartsisters.org στο οποίο γράφει για την εμπειρία της με το έμφραγμα στις γυναίκες, και του http://www.ethicalnag.org στο οποίο γράφει για θέματα διαφάνειας στην κλινική πράξη, τα φάρμακα και θέματα δεοντολογίας.
Η διάθεση δωρεάν δειγμάτων στους γιατρούς από τις εταιρείες τα οποία οι γιατροί διανέμουν δωρεάν στους ασθενείς τους, είναι πρακτική που τούς ωθεί στη συνέχεια να συνταγογραφούν τα συγκεκριμένα φάρμακα;

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By: Carolyn Thomas

Carolyn Thomas — Mon, 21 Jan 2013 23:51:03 +0000

Thanks for sharing your perspective from Greece, Kathi. As in Greece, free drug samples here are the expensive brand name drugs. There’s just not enough money in making low-cost generics to warrant the expense of providing freebies!

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By: epatientgr

epatientgr — Mon, 21 Jan 2013 23:35:11 +0000

Hi Carolyn,
I read your post with great interest because as you might have read in the press the “medicines war” goes on in the economic crisis ridden countries, my country Greece among them.

Over-prescribing, directed prescribing and more accusations of doctors bad habits are the order of the day… The recently implemented e-prescribing is also conceived as a tool to put gates to prescribing by auditing the monthly medicines quotas of each doctor …

To my knowledge sampling is also here limited to selected branded medicines. As prescribing by drastic substance and not by trade mark is mandatory (unless the patient is willing to pay the price!), it is expected that big pharma will have every interest to convince doctors, and by their intermediary patients, that branded medicines are more effective than unknown generics…The tool in this case will be, you guess what, free samples…

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By: Carolyn Thomas

Carolyn Thomas — Sat, 12 Jan 2013 20:33:55 +0000

Hi Ed – very interesting about the voting analogy. Wonder if it’s because voters try to make sense of externa community indicators (billboards/lawn signs/TV ads) along with what results radio talk shows and water cooler conversations generally hint at? Docs on the other hand, are likely aware at some level of the pervasive influence Big Pharma has on “marketing-based medicine”, so they may be willing to acknowledge pharma’s ability to influence prescribing behaviour of their colleagues while being less willing to admit to the same influence personally.

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By: bunsen68

bunsen68 — Sun, 06 Jan 2013 02:52:33 +0000

Hi Carolyn,

The seeming disconnect between what doctors say they do and what they say others doctors will do reminds me of a finding from political science. As the economist Justin Wolfers at the University of Michigan has shown (among others), a very good predictor of who will win an election is not who people say *they* will vote for, but who they say *others* will vote for. Wolfers pointed this out before the recent US Presidential election, when there were (sometimes) conflicting data about whether Obama or Romney would (though the smart statisticians all had it right). And, indeed, at almost every point, the majority of Americans though that Obama would win, no matter who they intended to vote for.

It makes me wonder whether we shouldn’t start asking this question in more domains of human economic and political life. Sure, sure: *You* would never do X. But what do you think other people like you (voters, doctors, students) will do? If the phenomenon is widespread — and I suspect it is (there’s probably a vast literature I’m not familiar with) — it would suggest, oddly, that we’d better predictors of our own behavior by imagining the behavior of others under similar circumstances.

And then we might all stop and think, “Oh dear. Maybe I’m not as immune to these influences as I think I am.”

–Ed

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By: Carolyn Thomas

Carolyn Thomas — Sat, 05 Jan 2013 15:26:02 +0000

Hi Dr. Joe – patients like the notion of getting those ‘freebies’, too. At least in the beginning . . . There is no marketing advantage in offering free samples of unbranded off-patent drugs – I guess that’s why there are no samples.

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By: Dr. Joe Kosterich

Dr. Joe Kosterich — Sat, 05 Jan 2013 14:56:19 +0000

In cluttered markets like antihypertensives or antidepressants, samples may tilt the doctor to starting a patient on what is in the cupboard – as there is little difference between many drugs. Drugs out of patent are never sampled nor are those where there is little competition. Doctors also like the notion of giving patients a “freebie“. For what it is worth I stopped accepting samples 8 years ago and my patients are no worse off in my view.

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