1. Doctors’ Ties to Drug Makers Are Put On Close View

2. From 1997 -2005 5,500 doctors, nurses and health care professionals were paid by drug makers in the state of Minnesota (Over 20% of the states doctors). They were paid over $57 million dollars to give speeches to doctors regarding drugs, to sit on committees that develop guidelines for doctors to follow for medication use, to finance research

3. There are arguments both for and again this close relationship and the exchange of money

4. For: health care professionals + trained pharmaceutical research company reps = proper use of medication + better care for patient

5. Against: It creates a conflict of interests that can affect a doctor’s clinical judgement Health care professionals + trained pharmaceutical research company reps = more prescriptions of newer and pricier drugs (due to vested interest in pharmaceutical company) -proven by research Former Drug Reps say that doctors are hired in an attempt to alter their prescribing behavior

6. Dr Allan Collins Extremely influential kidney specialist in the USA – President of the National Kidney Foundation – Director of a research center on kidney disease Criticized for receiving large amounts of money from Amgen ($25,800 personally in 2005, 1.9 million to research/education he led)

7. Payments… $1000 per consultation on average, some as high as $100,000 Dr Grimm made over $798,000 between 1997 and 2005 from drug companies, $231,000 from Pfizer alone in 2003 10 doctors and 1 dentist in Minnesota were paid $500,000 Psychiatrists earn more from drug makers than any other specialty (6.7 million was earned by 250 psychiatrists) Internal Medicine is 2 nd, Cardiologists 3 rd, Endocrinologists 4 th and Neurologists 5 th.

8. Public Opinion Most patients don’t know 85% of people polled say that it is not acceptable for doctors to earn money from drug makers as they feel it would influence their prescription decisions

9. Minnesota Vermont Main West Virginia California The District of Columbia now require some disclosure of these payments

10. Tips to Seducing the doctors… Take them on a paid vacation to learn about a drug Try a Silent Quid Pro Que – Example: have a doctor give a drug talk – his name gets out there, he gets more patient referrals, he gets paid for the talk – he now owes you a favor, he gives more prescriptions for your drug.

11. Is this problem increasing? Between 1998 and 2006 the number of doctors giving drug presentations in the USA more than tripled In 2002, 80% of doctors on panels writing guidelines for clinical practice were connected financially to drug companies