Last week whistle-blowers from the government and the pharmaceutical industry met in Washington, D.C., at a meeting sponsored by, PLoS and the Government Accountability Project to discuss the pharmaceutical industry's influence on doctors.

I read an article this morning:
Spin Doctored: How drug companies keep tabs on physicians.
By Shannon Brownlee and Jeanne Lenzer
Posted Tuesday, May 31, 2005, at 3:13 AM PT

Unbeknownst to most doctors, the drug companies have been using prescribed reports (weekly lists of every prescription written by each of the 600,000 doctors in the United States) to profile physicians. The prescriber reports are the pharmacy records with information containing the exact medication, dosages, and physician ID numbers for every prescription filled in the United States. The drug companies buy lists that match the ID numbers to doctors' names from the federal government or the American Medical Association, (earns about $20 million a year selling its "physician master file" database).

These reports allow drug reps to identify and rank doctors into tiers (based on how much they prescribe), market to top prescribers and monitor the effectiveness of their tactics. According to the article the drug reps change tactics based on doctor's prescribing behavior and personality. If one doctor prescribes more after certain perks then more perks are given. If a doctor likes to be swayed by published articles, then the doctor is inundated with articles. Of course the articles given to the doctor are the ones that are the most favorable, not necessarily those with best medical evidence. The article mentions that despite the revelation of one study published in the New England Journal of Medicine in 2001 that Vioxx could be more harmful than the generic drug, Vioxx drug's sales continued to rise. It was discovered that Merck taught sales reps how to deflect doctors' questions about its safety, by handing out pamphlets referencing studies less powerful than the NEJM study to make it look as if Vioxx was associated with fewer heart attacks rather than more. "Merck code-named its marketing blitz 'Offense' and 'XXceleration."

It is an interesting and scary article. I wonder what percentage of prescriptions I have taken over the years have been driven by the drug companies. I used to always get excited when my doctor handed me free samples of a drug. Now I am not so sure I feel too great about that. While this article specifically talks about medical doctors, what about eye doctors?! I just went to the ophthalmologist Friday and was switched to a new brand of contacts, because according to the doctor they were "better" for me. It just so happens that they are also the most expensive brand and back on the market after a generic patent battle. I would like to believe that the doctor "believes" they are better for me, but now I have got to wonder when was the last time the Bausch and Lomb rep visited.