Lunch money Pharma spends on physicians

Actually I’ll take a Ford Shelby GT500 Convertible, thank you very much …

Today’s stream of socially conscious thinking comes to you after having feasted on a tasty lunch paid for by a drug company (and no, it wasn’t Pfizer).

It has spurred me to contemplate the ever increasing scrutiny paid to the relationship between the pharmaceutical industry (a.k.a. Big Pharma) and physicians (a.k.a. Big Doc) by an increasingly suspicious public (henceforth referred to as Big Patient).

One of our friendly neighborhood (by neighborhood, I mean covering most of the state of Michigan) drug reps bought lunch for our office today, as another did last week, and possibly a different one may be doing in the coming days. They haven’t been doing this quite as often as they used to, there are fewer of them in the business due to cuts by the companies and consolidation in the industry as a whole. Today we were brought burgers from a local restaurant that is a favorite among our staff.

For years this symbiotic relationship was the norm. For the price of lunch at a local burger joint, Big Pharma got access to Big Doc and a chance to peddle their wares, citing various reasons why their drug is better than their competitors. Big Doc got some happily fed office staff, in addition to various bits of information that varied from highly informative to mildly useful to lightly febreezed bull droppings. In return for footing this bill, Big Patient got a Big Doc who was then better informed about the Big Pharmas that Big Doc was telling Big Patient to put into their bodies. And thus, was the manner of our glorious capitalist system of health care that was the envy of Canadians and kumbaya singing commies the world over. Or something like that.

For years, Big Patient thought that this was just the cost of doing business, and that the benefits to them outweighed the price paid in terms of any possible higher drug costs. But as the costs of peddling to Big Doc approaches the astronomical, and as patients see their own costs increasing, that sentiment, for better or worse, has changed.

In 2004, self reporting from Big Pharma put their expenditures for R&D at $29.6 billion, while it estimated it spent $27.7 billion on marketing. However, independent estimates put marketing expenditures by Big Pharma in 2004 from $47.9 billion to as high as $57.5 billion, far outpacing R&D spending that year. The number works out to a staggering $61,000 spent on marketing per physician in one year. Right now all of us as physicians are troubled with that figure and are wondering the same thing. Was the $50,000 spent on turndown service at the Heart Rhythm Society meeting deducted from my 61 grand, or was it somebody else’s?

This leads me to the point which I am trying to make here. Which is this, “hey guys, could I just get that $61,000 up front, please?” C’mon, lord knows with all the inhaler scripts I’ve written over the years, I must have moved your stock prices by at least a cent or two, right? So, I reiterate, let’s stop this silly dance, and cut out the middleman. I’ll take my Shelby GT500 Convertible in blue with white racing stripes. At an MSRP of $56 thousand, it will even save you a few grand, and you can pass those savings on to Big Patient, how’s that for value?

Deep Ramachandran is a pulmonary and critical care physician who blogs at CaduceusBlog.


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