Diabetes Self-Management Blog

If you have diabetes, chances are you take at least one and possibly several prescription drugs. Naturally, people with or without diabetes expect their doctors to prescribe what is best for their condition based on science, without any commercial bias. Yet a report released last week suggests that current gift-giving practices by pharmaceutical companies make impartiality impossible.

The report, entitled “Conflict of Interest in Medical Research, Education, and Practice,” was issued by the Institute of Medicine (IOM). It recommends ending many common pharmaceutical company practices used to promote drugs to doctors, as well as requiring full disclosure of payments given to doctors hired to give presentations on drugs. According to an article in The New York Times on the report, pharmaceutical companies currently spend more money on services for doctors — such as free drug samples for patients, meals, and medical “refresher” courses — than they do on research or on consumer advertising. A 2007 survey of doctors found that more than 75% accepted meals or drug samples and that more than 25% were paid for giving drug-promotion lectures or enrolling patients in drug trials.

The IOM report recommends that pharmaceutical companies not be allowed to pay for doctors’ meals or for medical “refresher” courses. It also asks that doctors give the free drug samples they receive only to patients with limited income, and only when they can continue to provide the drug for free.

How do you feel about these recommendations? Who, ideally, should pay to educate doctors on the latest drugs and treatments? And what effect, if any, do you think drug promotion to doctors has had on your own prescriptions? Leave a comment below!

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Comments
  1. I am and have been a diabetic for many years and
    know this drug pushing and Doctor wineing and dining to be a definite fact. You will find your doctor has in his office many drugs samples . And doctors will start prescribing them for things for what ever signs he sees in your tests even
    tho the signs are marginal or even no consequence nor threat to a patient’s health . They do this for drug firms kick backs beyond any doubt.

    Posted by vern |
  2. Doctors should take a fresh look at their hypocratic oath, “first, do no harm”. I believe doctors have lost sight of the fact that most pharmaceuticals, have side effects, and they should, most of the time be considered “harm”. Many pharmaceuticals, when given, require careful monitoring, or they can do harm. I believe that doctors should be required to become expert in nutriceuticals, which help the body cure itself, and have relatively no side effects. Becoming familiar with neutriceuticals will allow doctors to fulfill their adherence to their oath.

    Posted by George |
  3. Off-label use of many drugs is simply “testing by public” and it is permitted, encouraged in fact, by the FDA and other government agencies. Added to the time-pressure with patients and the practice of “free rewards”, our current system is untenable. Few physicians get into medicine to exploit their patients, but this cannot be said for “big pharma”. By business definition these corporations exsist to make money from those who are ill. Making profits by any means possible shows NO sense of corporate responsibility–only greed. Recouping R&D expenses, the greed defense, was weak when first uttered years ago by industry flacks. Now it is just insulting. Doctors need to evaluate their own sense of morality, and decide which side of the debate they want to be counted on.

    Posted by miserhill |
  4. I am a biabetic type 2 and I enjoy getting
    the reipes you all send out.

    W.J.Saturley

    Posted by W.J.Saturley |
  5. Physician “wining and dining” is indeed a perk but does not influence my prescribing practices - I continue to prescribe what is most appropriate and best for my patient and their condition. Drug sampling is, however, a very important and useful tool in our treatment. It allows us to provide at least partial treatment to those patients who can not afford expensive medications and to allow others to trial a medication before investing in an expensive prescription.

    Posted by Dr. W |
  6. I HAVE ALWAYS THOUGHT THIS WAS TRUE CONCERNING ALL DOCTORS. WHATEVER HAPPENED TO DOCTORS WANTING TO HELP THEIR PATIENTS MORE THAN THEMSELVES. SO VERY SAD TO KNOW THAT IT IS TRUE.

    Posted by MARY |
  7. I am happy to see someone interested to speak out about this very situation that has troubled me for a very long time. Of course, not being able to speak out has forced me to learn all about the natural avenue for helping with issues that normally would be taken care of by yet another drug. Some doctors just automatically prescribe a medication (drug), when we know very well they have other knowledge about natural helps that would avoid many unnecessary deaths. It is a real problem in hospitals - wrong meds given to a patient, or a doctor writes a prescription without knowing exactly what is wrong with the patient. And, we are helpless against it most times. Thanks for allowing me to “vent” a bit about this old, but continuing life and death problem.
    Em from AZ.

    Posted by Emogene Crawford |
  8. I worked for a MD in the ’60’s. The same thing was going on then. It scares the hell out of me.

    Posted by Sara |
  9. As a newly diagnosed diabetic, I thought my doc was doing me a favor when he gave me Actos Plus Met from his sample cabinet. But the next time he gave me samples, he gave me a different dose because he was out of the first one. Then the next time, he was completely out of both and wrote me an Rx for it! OUCH! without insurance that was a huge blow at over $220. a month.
    I wasn’t entirely comfortable with what I read at the Actos site either.
    So I changed doctors. Now I take Metformin, costs me $10.00 for a three month supply and my BS stays around 110 - 120. My new doctor doesn’t get all the samples that the previous one did, he’s not wooed by the drug reps. He’s much more thoughtful about what he prescribes considering no insurance, the severity of my conditions and the effectiveness of the drugs.
    For long term maintenance drugs, please, no more ‘free’ samples. I can understand if it’s short term or a trial, but as long as I can find $10.00 every 90 days, no thanks, keep your samples.

    Posted by LuvARiddle |
  10. Yes,indeed it is scarey being a patient and hoping that the attending physician is truely dedicated. So far I have been blessed with a physician who takes time to study my chart and labs. He put me on metformen and it works well so far at a Diabetic type 11. He also put me on Byetta that is injected twice daily once before breakfast and once before dinner. My only concern now is the FDA is questioning the drug and I have not heard anything from my doctor so will contact him. I think sometimes physicians are much too busy to take off for added education so the easy access to “drug reps” seems handy. I believe honesty should be on both sides and not gain riches from sick patients.

    Suzanne Seager May 9,2009

    Posted by Mclarenkayack |
  11. Lecture dinners sponsored by pharmaceutical companies about the use of insulin and other medication are generally given by nationally known physicians researchers about pharmaceuticals that they have published research on. Dinners serve as a knowledge exchange forum and continuing education mechanism in a less formal structure than a national meeting. Many family practice doctors, internists and family nurse practitioners who care for people with diabetes may not go to ADA scientific sessions where they would hear this cutting edge information about how to use new medications effectively. Dinners also allow question and answer time with visiting guest lecturers and allow for networking. Careful thought needs to be given about too much control of pharmacuetical house attempts to disseminate information even though issues that weigh into drug costs have to be examined.

    Posted by K Patterson RN, MSN, CDE |
  12. I’m an Internist in South Carolina. Yeah I go to some of those but not as much as I used to. They repeat the SAME things with the SAME speakers all the time! In years past in New York they had Liberty Cruises around NY harbor “eat and run” with NO lecture or took us to the harness races!

    And the reps are all “Ken” and “Barbies” look like the supporting cast to the defunct “Boston Legal” not chosen for their Organic Chemistry knowledge. LOL

    When drugs go off patent they change one atom of a molecule make a “me too copycat” and charge hundreds a month when a similar med can be had for four bucks at Walmart

    Posted by Thaddeus Buttmunch MD |

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