Dr. Arnold Kassanoff says the best gift he ever got from a drug company was a trip to Monaco for him and his wife in 1982.
"We were told in advance that there would be, you know, everything was covered except gambling,” says Kassanoff. “All your meals. No tipping allowed. Nothing. And just enjoy yourself.”
What did he think they wanted from him in exchange for the trip?
“Well, I knew that they had come up with a breakthrough drug,” says Kassanoff. And it was a drug that the company wanted him to prescribe to his patients.
Kassanoff says the gifts from drug companies — usually small items such as bags, pens and meals — start in medical school. "From that point on you are indoctrinated," he says.
In recent years, the American Medical Association and U.S. drug manufacturers have agreed to cut back on the big trips offered to doctors, although Kassanoff says he can still get a free dinner almost any night for listening to a sales pitch.
"If you look hard enough you might get a trip to Hawaii," he says.
The gifts have never been illegal, but Kassanoff wonders about the long-term effect on his practice.
"When you pick up your prescription pad, you write something out. … It has to do with psychology and the whole marketing business,” he says.
Today there are 88,000 drug salespeople for the 600,000 practicing doctors in the United States. Six or seven visit Kassanoff's small practice every week, offering souvenirs and free lunch for the staff.
“Very, very bright, attractive people who've got good people skills,” says Kassanoff.
Dr. Jerome Kasserir, former editor of the New England Journal of Medicine and author of a new book on drug companies, says the sales people drive up health care costs.
"They're always marketing the newest drugs and the most expensive drugs and the idea is to get the doctors to use these more expensive drugs instead of the drugs that may be just as good but are not as expensive,” says Kasserir.
Pharmaceutical manufacturers say the sales efforts are critical to educate doctors, but after practicing medicine for 40 years, Kassanoff is worried about the education they provide.
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