The subject came up this morning.

One side of the discussion insists that doctors get what amounts to a kick back from the pharma companies when they prescribe medications.

I know doctors get lots of "free samples" to hand out, but do they get a monetary consideration as well?

Not pointing fingers at doctors, just curious as I just discovered that a medication prescribed for me has known bad side effects, and I got them all.

There used to be free iPads, MacBooks trips to exotic place for 2 (just need 1 morning seminar attendance.) Then along came the Gov.
The Stark Law. Game over.

http://www.physicianspractice....our-medical-practice

This message has been edited. Last edited by: downtownv,

I'm a dentist, not an MD, but I can tell you I've received absolutely ZERO kickbacks from and sales rep or product manufacturer. They might pick up lunch once a year, but that's about it.

Then there's this:
https://www.celgene.com/about/...liance/sunshine-act/

as Drug reps would bring in lavish lunches for the whole office.
Studies showed that these freebies got a lot more scripts written.
As a result Pharma cut out the reps and doctors post "No Pharma reps allowed" signs.

I'm a pharmaceutical rep. I can assure you that doctors do not get kick backs for writing meds.

The old days were different though, they got trips, golf outings, fancy dinners.

Hell, I can't even give the doctor a pen with our company name on it without breaking compliance laws.

The "bribiest" things get are lunches/education In Services that I can hold with doctors and their offices to talk about our drug...I must be in attendence, no more than $15/$20 can be spent per person, and all names must be written down, receipts kept and disclosed to the government to remain in adherence of the Sunshine Act.

Did you let your doctor know?

When they have a patient that has bad side effects from a med, usually doctors inform their drug rep so the drug rep can report an "adverse event"...no names are used.

Btw, free samples are basically for the doctors to give to patients so the patient has a few days worth of meds on hand...Sometimes it takes a few days for meds to get filled due to insurance issues. Also helps the patient get a feel for the med without filling a full script and then having to go back and get an alternative from the doc due to issues.

If handing out free samples got docs to write more, I'd be the national champion. In my experiences, doctors absolutely want the best med for their patient and will write the best thing that they feel will help their patient get better...the only thing holding docs back is really insurance coverage of the patient.

Kickbacks!!! Depends on whether your doc is Republican or Demcrap.

You should read the drug instructions on side effects and report them to your doctor if you have a problem.

quote:

Originally posted by RAMIUS:
Did you let your doctor know?

When they have a patient that has bad side effects from a med, usually doctors inform their drug rep so the drug rep can report an "adverse event"...no names are used.

Not yet. Have an appointment on Wed. Been a couple of days now since that "man event" and still feel like I was run over by a tank.

But getting better!

quote:

Originally posted by Elk Hunter:
The subject came up this morning.

One side of the discussion insists that doctors get what amounts to a kick back from the pharma companies when they prescribe medications.

I know doctors get lots of "free samples" to hand out, but do they get a monetary consideration as well?

Not pointing fingers at doctors, just curious as I just discovered that a medication prescribed for me has known bad side effects, and I got them all.

I can only tell you what I do.

-"Free samples" are normally given to those who can't afford/in a bind.
-We never, ever, want or receive any "kickbacks".
-Whatever free samples that are given have zero influence on my prescribing patterns. I prescribe what evidence-based guidelines recommend, not what the drug companies want me to prescribe.

Any meds will have side effects. No two patients are alike. Not all patients will experience side effects identically. We cannot predict how a med will affect you, until you take it, unless you have taken it before and know its side effects.

Prescribing meds is a constant risk-benefit evaluation. As an example, you have acute bacterial sinus infection. The 1st line antibiotic (abx) to treat this is amoxicillin-clavulanate (trade name is Augmentin). This abx has a notorious and common side effect of giving you diarrhea. But, not everyone will experience it. Some will experience it but it's minor enough that they can tolerate. Then, there are those who experience bad cramps and diarrhea. The first 2 groups will receive the 1st line abx, while the last group will receive a second line drug.

How about chemotherapy drugs ???!!! God Bless

http://www.nbcnews.com/id/1494...-drugs/#.Wb63qmd5b8k

I am in Medical Device, not pharma.

But things have changed dramatically in the the last 10 years. As others above have stated - its much stricter.

Below is a link to a federal website - CMS is the Center for Medicare Services - where companies are required to submit payments to physicians. It is searchable by name, location, etc.

https://www.cms.gov/openpayments/

A law was passed a few years ago - generally referred to as the Physician Sunshine Act - which REQUIRES payments be reported.

-------------------------------------------

This is from Wiki:

The Sunshine Act requires manufacturers of drugs, medical devices, biological and medical supplies covered by the three federal health care programs Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP) to collect and track all financial relationships with physicians and teaching hospitals and to report these data to the Centers for Medicare and Medicaid Services (CMS). The goal of the law is to increase the transparency of financial relationships between health care providers and pharmaceutical manufacturers and to uncover potential conflicts of interest. The bill allows states to enact "additional requirements", as six states already had industry-pay disclosure laws.

On September 30, 2014, the Centers for Medicare and Medicaid Services reported payment information on its Open Payment Program website for the first time, the data from 2012.

--------------------

So to answer your question - do they receive payments? Yes it is possible. But the payments are not a quid pro quo for prescribing the med... They may be in the form of a free lunch to discuss the products, travel expenses to a medical conference, etc. And they must be reported so you can look them up. There is a lag time though as it takes time for the payment to get entered into the system (there is a dispute process for the doc...).

MDs can also enter into consulting agreements with manufacturers which is completely normal, above-board and highly beneficial. MDs help design and teach how to use products - for which they are compensated for their time. They serve on product design teams and meet with R&D engineers. But it must be disclosed. Their agreements must be 'market rate' and can not be inflated so as to inaccurately reflect the actual work performed by the MD.

Times are more transparent then a few years ago. Can it be abused? Like anything - its possible. But much more strict nowadays.

-------------------------------------

Of course they do, just ask Bernie Sanders. That is why doctors are so rich. Doctors and big pharma don't want to find cures for cancer either because they make too much money off of it.

I can tell you point blank....no kickbacks from pharm reps or drug company!!! All medicines from aspirin to chemotherapy have side effects. It is most unusual for a patient to get ALL of the known side effects.

Agree with responses of docs above. And yes, it used to be very different.
I attended a conference on pacemakers that was given at a luxury hotel in Kauai when I was practicing on Maui. It was a very serious medical education conference, but with free dinners, sushi, etc. The expenses had to be reported to the Feds with my name on it.
Other than that, "drug dinners" are still a thing, I occasionally attended those because they became actually useful lectures on new therapy.

However, years ago our organization stopped allowing drug reps to stop by the physician offices unless they had permission.

Based on what I've seen from patients in private practice, as opposed to our physician group model HMO, doctors often do prescribe the "latest and greatest" drugs, that is more expensive ones than equivalent generic drugs, and I attribute that to advertising and visits by drug reps, along with third party payment of pharmaceuticals. Changes in insurance with higher co-pays and drug formularies (lists of drugs the insurance company will pay for) have decreased these issues a lot.

quote:

Originally posted by MNSIG:
They might pick up lunch once a year, but that's about it.

I have personal knowledge of a practice in which pharmaceutical reps buy lunch for the entire office, both practitioners and clerical staff, at least once a week.

This is not hearsay or rumor; as I said, this is personal knowledge.

I am not a doctor, but my sister and BIL are both pharmecuetical reps and have been for 15-20 years each.

Bottom line is NO, they have never gotten cash kickbacks. They used to get a lot of free gifts from the pharmecuetical companies, such as the entire office taken to restaurants at $50 a plate, entire office catered with a nice lunch, tickets to ball games. Still has all stopped in the last few years and the government has REALLY clamped down on this. So none of these perks go on anymore. However they used to big time......like the same doctors entire office would get taken out twice a month.....etc. etc.

quote:

I have personal knowledge of a practice in which pharmaceutical reps buy lunch for the entire office, both practitioners and clerical staff, at least once a week.

This is not hearsay or rumor; as I said, this is personal knowledge.

Yep. Very true. You can share in the bounty if you are there around lunchtime. They always order extra food.

quote:

Originally posted by V-Tail:

quote:

Originally posted by MNSIG:
They might pick up lunch once a year, but that's about it.

I have personal knowledge of a practice in which pharmaceutical reps buy lunch for the entire office, both practitioners and clerical staff, at least once a week.

This is not hearsay or rumor; as I said, this is personal knowledge.

I do that all the time...having a lunch with the office is the only real way I can inform the entire office about the med I'm repping. It's called an educational in-service. It's not like the rep just called and sent lunch there...there are rules to how these things go and severe consequences for the drug rep, the company, and the doctor if it's not properly documented.

The general rule is that you can only spend $15-$20 per person in the office. They're not getting filet mignon, they're getting chik-FIL a...

I have around 20 breakfasts and lunches with doctors each and every week. Getting food for an office does not win scripts...trust me. Docs write what they feel is the best for their patients, which is how it should be.

Being a drug rep is fun btw, and you gotta watch what you eat...

My wife works at a cancer center and up until January, she never took or bought lunch. Every day was free lunch for everybody.

They shut it down and they don't even do it once a month.