Starting today the pharmaceutical industry has agreed to stop handing out the prescription-drug-branded trinkets you see in doctor's offices. No more flimsy Lipitor pens, no more Zithromax children's games, no more Viagra soap dispensers. However, drug companies will not change their policies concerning taking doctors out for "educational" dinners that turn into lavish events.
As drug companies have lose other avenues for advertising to doctors, these lush evenings will become one of the few ways the companies will still be able to try to manipulate doctors into prescribing their products.
The marketing people at Novartis bought me dinner recently. For those of you who can't enter this by-invitation-only world, here's your chance to learn what happens at these events.
(Ordinarily I avoid drug dinners. Receiving free stuff from drug companies feels like graft to me. Due to social entanglements, I felt obliged to attend this particular dinner. Call me a modern-day George Washington Plunkitt, but I value loyalty toward my friends over most principles, and this loyalty pushed me to attend.)
Three drug company representatives set up some tables in a back room in the chic sushi restaurant Bond Street. Two were attractive, blond, twentysomething women whose main job appeared to involve setting up a gizmo that would project a PowerPoint presentation onto a screen. The third was a friendly woman who frequently comes around my department in the hospital. Seeing how frequently she appears in my life, I suppose that she's in charge of getting me to prescribe Novartis drugs more often.
The wait staff came by to offer us free drinks, and I promptly downed two.
NYU hypertension specialist Howard Weintraub gave a presentation about the drug, a blood pressure medication called Tekturna. He filled his talk with "doctor jokes," quips that require extensive background in medical knowledge and patient treatment before you can "get" them.
There is no evidence that this drug makes people live longer or feel better. Sure, there's evidence that it lowers blood pressure. However, lots of treatments lower blood pressure while worsening health. He went over the useless evidence on its effect of blood pressure, peppering his talk with these doctor jokes. Many of these jokes expressed sympathy with his co-physicians for the forces that make our lives difficult; most had some element that flattered the intelligence of the audience. His speaking style fell somewhere between Rodney Dangerfield and stereotypical-car-salesman.
I tried to pay attention to evidence he could provide that this drug makes people live longer or feel better. Paying attention was difficult: My spot at the table kept me angled away from the screen that displayed his presentation. The booze did not help: Before he started speaking I had already become tipsy.
(Thank you, Novartis! Thank you, patients who pay out-of-pocket for Novartis drugs! Thank you, taxpayers and insurance buyers who put money into a health care system that spends money on Novartis products. Cheers! Who cares if we don't get any more crap-tastic pens if we keep getting this?)
Hey, cute blondes, come talk to me! Another time when I ended up at one of these events, a medical device company's beautiful young representative kept asking me questions and pretending to be interested in me and my life for about an hour. With the benefit of hindsight and sobriety I feel sorry for her-how dull!-and ashamed of myself. It feels pathetic to spend much time with people who are paid to act friendly with you. I wonder how my colleagues feel when the drug cuties feign interest in them. This night's blondes never approached me, and, with me wedged into the corner and blotto, going to them seemed insurmountably difficult.
At one point the speaker admitted that nobody knows whether the drug extends life, but that they were doing a study to investigate this. The world already has several blood pressure medications that do make people live longer. Several of these drugs have a long safety record and a low price. Does Novartis think that I'll start prescribing their new, expensive, possibly useless drug instead?
Maybe.
Coming eventually: A blog entry on My Colleagues Who Prescribe Expensive Untested Drugs When Inexpensive and Effective Alternatives Exist. Later, you might also get an entry on the hypocrisy of accepting a meal from a drug company, then writing a snarky blog entry about the ethics of the whole practice.
