Did you know . . .
April 4, 2005
Pharmaceutical company profits were 18.5 percent of their revenue in 2001, compared with 3.5 percent for all other Fortune 500 companies?
Since 1995, U.S. drug makers have actually cut their R&D staff by 2 percent, while increasing their marketing staff by 59 percent?
(So much for the argument that pharmaceutical companies can't afford to offer cheap AIDS drugs, or that it's worth paying exorbitant drug prices to keep the companies' R&D labs churning out important new drugs.)
These and other facts are on the No Free Lunch web site--www.nofreelunch.org-- aimed at doctors and med students. No Free Lunch deplores the marketing to--and wining and dining of--doctors, and it offers a wealth of links to reference material showing how bad the conflict of interest between health and profit really is. Among the most egregious examples: Doctors earn bonuses for pushing particular drugs--even if they're less safe and effective than drugs that don't enjoy an inside deal with the doctors' particular HMO.
The AMA generates $20 million a year by selling detailed personal data on U.S. doctors to the pharmaceutical industry.
No Free Lunch urges medical professionals to eschew gifts, meals, junkets, and, of course, those ubiquitous drug company pens. The site even has a "pen amnesty program" that offers to exchange its own anti-drug-pushing logo pens for the industry freebees.The group also encourages activism. "If you attend drug lunches, ask for evidence," it suggests. "If you must eat, avoid uncooked fish; and please, no pens. . . . Encourage residents to do the same. Your role-modeling--particularly regarding the non-acceptance and non-usage of gifts--can go a long way."
I found out about No Free Lunch by talking to Dr. Robert Factor, a psychiatrist on the medical school faculty at UW-Madison. Factor is among the small group of doctors who have signed the No Free Lunch pledge not to accept drug company perks. "If I wanted to eat for free at really nice restaurants, I could easily go to two drug company dinners a week," says Factor. At these dinners, in major and mid-sized cities all over the country, drug-company reps give "educational" talks pushing their products.
"People often say they can go to these things and not be influenced," Factor points out. "But now there are some really good studies [available on the No Free Lunch web site] that show that people's prescribing behavior does change" when they get drug company perks.
Worse, says Factor, he has colleagues--psychiatrists and other physicians--who are making a lot of money delivering the canned drug-company speeches at fancy dinners, and have grown "addicted"--both to the speaking fees and the free meals. It all adds up to an insidious perversion of good medical practice. The whole story--including full-text articles from medical journals--is available on the No Free Lunch site. Factor gives a talk at American Psychiatric Association meetings and other events urging colleagues to join the just-say-no movement.
He's an enthusiastic member, as are other medical professionals across the country. Bob Goodman, MD, of New York City, founded the group. It's encouraging to see nurses, physicians, pharmacists, dentists, and others standing up to the power of Big Pharm. "Overzealous promotional practices can lead to bad patient care," the group declares in its mission statement. "We believe that health care professionals, precisely because they are professionals, should not allow themselves to be bought." If patients and doctors can get on the same side of this issue, maybe they can bring some real political pressure to bear.