Does the behavior of drug companies affect your Rx decisions?

[forwardlooking]

In light of the ongoing battle by optometrists to gain additional rights to perform surgery etc., I am curious:

If a major drug company appeared to favor optometrists in their lobbying actions, would you stop prescribing their drugs (given equal substitutes, obviously)?

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[PDT4CNV]

Here is a real and more important issue:

The Massachusetts Senate, in a unanimous 36-0 vote, passed health-care reform legislation that would ban drug and medical device companies from giving gifts of any value to physicians.

Violators would be fined $5,000 for each violation. The bill must be approved by the state House of Representatives and governor before it would take effect.

The bill also would mandate that health-insurance companies document annual cost increases and provide them to the general public, require the health-care industry to use computerized medical records, and necessitate state-iss...


Now, do you think that the lawyers and politicians are going to stop accepting gifts from lobbyists and corporations? Yea right. They are so hypocritical. Its amazing the power that just 3 years of law school grants a person. Personally, I think that pharmaceutical reps can be an excellent resource for information on new medications and diagnostic and surgical equipment. And, anybody who has used most EMR systems know that they are huge intial expense and are frought with problems. Using the government as their own bad example...the CPRS system at the VA (known for its excellent patient confidentiality, user friendliness, cost & time savings.....sarcasm).

 

[orbitsurgMD]

In light of the ongoing battle by optometrists to gain additional rights to perform surgery etc., I am curious:

If a major drug company appeared to favor optometrists in their lobbying actions, would you stop prescribing their drugs (given equal substitutes, obviously)?

It depends.

If a drug company supported legislation extending practice scope to include surgery to optometry, I would avoid supporting that company, all other things being equal.

 

[bucknut101]

Here is a real and more important issue:

The Massachusetts Senate, in a unanimous 36-0 vote, passed health-care reform legislation that would ban drug and medical device companies from giving gifts of any value to physicians.

Violators would be fined $5,000 for each violation. The bill must be approved by the state House of Representatives and governor before it would take effect.

The bill also would mandate that health-insurance companies document annual cost increases and provide them to the general public, require the health-care industry to use computerized medical records, and necessitate state-iss...


Now, do you think that the lawyers and politicians are going to stop accepting gifts from lobbyists and corporations? Yea right. They are so hypocritical. Its amazing the power that just 3 years of law school grants a person. Personally, I think that pharmaceutical reps can be an excellent resource for information on new medications and diagnostic and surgical equipment. And, anybody who has used most EMR systems know that they are huge intial expense and are frought with problems. Using the government as their own bad example...the CPRS system at the VA (known for its excellent patient confidentiality, user friendliness, cost & time savings.....sarcasm).

Curbing some gift giving to physicians isn't such a bad idea. Free steak dinners, vacations, and other lavish gifts are a bit much. I would never feel right receiving these kind of things in light of the fact that some of my patients are struggling to pay for the very eye drops some of these drug companies make.

But I do agree with PD4 that drug reps do provide an invaluable source of information and resources. Also not all gifts to physians are bad. When my class began our residency we recieved a small call bag with various drops, penlight, lid speculum and other handy things for call. I don't see any problems with gifts like this as they will be used for patient care.

Drug reps are also important for providing us with the free medication samples to give to patients. Some patients truly can't afford their medications and these samples can really help them out. And also one of our drug reps worked with our county hospital to set up a system where patients could recieve intravitreal injections of Avastin for a substantially reduced price.

I've also grown to learn just how out of touch hospital/clinic administrators, politicians, and other people in positions of power are regarding giving effective and efficient patient care. It seems that every month our VA or county hospital complains that we don't see enough patients yet adds some new rule that makes it more difficult to see patients efficiently or give proper care.

And speaking of hospital administration and medication samples, our county hospital forbids giving patients medication samples. This makes absolutely no sense as these are the uninsured patients that truly have trouble affording their eye drops. We actually keep a secret stash of gtts in our clinic to get by this for certain select patients. This is extra frustrating when I see my attendings in their private clinics giving out samples left and right to patients that can certainly afford them.

I was once called by one our glaucoma attendings private patients at 430 AM because he had run out of his Travatan. He also happened to be a physician at our university hospital (he openly volunteered this info). He actually proceeded to ask me if I could drive in to the clinic and give him a free sample, because he always recieved free samples from our glaucoma attending. I bluntly told him that I don't care who you are and there is no way I'm driving in to the clinic at this hour just to give you a medication sample. I'm sure you can afford Travatan on a physician's salary

 

[Oculomotor]

These drug companies ONLY care about making a profit. Alcon (one of the largest ophthalmic drug and device companies) a HUGE supporter of optometry. You wonder why? hmmmmmm 75% of the country's eye doctors are OD's----- alot of Vigamox, Travatan, and solution being prescribed by them. In my first year of optometry school they bought us lunch twice (gourmet italian and Thai), gave us presentations as to why their products are the BEST for our future patients, gave us an assortment of leather binders, pens, folders, etc..., and asserted their tremendous support of doctors of optometry. The only thing these drug companies care about is $$$$$$$$$$$$! Case in point there is an ad in Primary Care Optometry News stating that Vigamox is the number 1 prescribed anti-infective by optometrists. The same ad is in Eye Net stating that it is the number one prescribed anti-infective by ophthalmologists! Identical ads with just optometrist in place of ophthalmologists or vice versa. The ONLY consideration when prescribing for a patient should be the welfare of the patient and none of this political nonsense.

 

[KHE]

The ONLY consideration when prescribing for a patient should be the welfare of the patient and none of this political nonsense.

You will find once you get past the first year of optometry school that most ocular medications for most conditions that most patients have are virtually identical to each other in terms of their risk profile, efficacy and their side effects. As such, the "patient welfare" question becomes moot in most cases because in most cases, there isn't any clear cut choice.

As such, which company are you going to support?

 

[Oculomotor]

You have a good point KHE.......All things kept equal (no detriment to the patient) I would support the drug company that supported optometry. It makes sense.

 

[7ontheline]

Oculomotor, in this instance you are right as well - no company is likely to be so stupid as to support ODs vs. MDs or vice versa. They want business from both. What good would it do to antagonize one side?