NYTimes: Drug industry speaking fees, etc. flowing to the docs who prescribe

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In a five-reporter blitz over the last two days the NY Times has shown what earnest shoe work and paper-trail-pursuit can do to find out how big-money industries can prime their markets. The target here is big pharma. The topic is the many ways by which drug makers get extra money to the docs who prescribe their products.

First out, Wednesday May 9, was “Doctors Reap Millions for Anemia Drugs� by Alex Berenson and Andrew Pollack on the front page and jumping to the Business Section. Many of the uses, regulators tell them, are at doses higher than those usually considered safe. Technically legal, the hundreds of millions of dollars in extra physician income is now under scrutiny by an FDA advisory panel.

Today, Thur May 10, also on the front page comes a piece on a practice with a similar odor. Gardiner Harris, Benedict Carey, and Janet Roberts have “Psychiatrists, Troubled Children and Drug Industry’s Role.� It concerns the striking, but not surprising, statistical correlation between how much drug money docs receive and the number of off-label prescriptions they write for costly new “atypical antipsychotics.� The patients are youngsters with various behavior difficulties. And, again, the fees may in the end prove legal — such as lecture fees in continuing education programs by doctors who encourage the drugs’ use.

Writing up such investigations is difficult to get right. These instances do well. They don’t hide uncertainty. It is very plausible that the fees corrupt the physicians’ judgment. It also is plausible — similar to how campaign contributions work — that most of the extra money is going to docs who would use the drugs anyway. It’s the difference betweeen buying a friend who had been disinterested, and rewarding someone who is already a friend and is eager to help you make more friends. The reporters may not have found fire (ie something actionable on its face). But there is smoke all over the place. This is not so much about science as business practice. But the accounts are well-written illustration — with vignette and drama — of where the medical and drug beats can take aggressive, diligent reporters.
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