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Old 11-03-2008, 09:23 AM   #1 (permalink)
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Does anyone think prescribing physicians get a kickback from pharmaceutical companies

Is this me being paranoid?
I know pharmacueticals are big business.
I've seen the reps with their cases and how our doctor spent lots of time
with the reps.
It seemed like our doctor was overprescribing and I could never figure any good REASON for it.
Why would a doctor prescribe so much oxycontin AND ms-contin for
breakthrough pain?
Why would a doctor prescribe an antidepressant AND benzos for breakthrough anxiety?
Does anybody know of incentives doctors may be receiving from the pharma companies?

What do YOU think? All input appreciated.
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Old 11-03-2008, 10:00 AM   #2 (permalink)
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Some definitely do, no question about that. Though one's definition of a "kick-back" may differ.

I do not think that a doctor get's a check from a drug company just for writing scripts. But there are definitely other incentives.

Though when it comes to oxy's and other opiate pain relievers...

Those have been around a long time. And there aren't really any brand name opiates any longer. Plus they are really inexpensive for the legitimate purchaser.

When I think of incentives, it's more the case with the really expensive, newer brand name drugs out there.
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Old 11-03-2008, 10:01 AM   #3 (permalink)
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I do believe that they do.

I just saw a new ad for a migraine med. It is Imitrex with Naproxen (Aleve) in it. They are going to charge an arm and a leg for it, insurances won't pay, people in pain won't get the relief they need because their Dr. doesn't think...why won't we just perscribe Imitrex and tell the patient to take X amount of Aleve that they buy OTC. /end rant.

I always tell people to talk to their pharmacist about the medications they are perscribed. Pharmacists often know of cheaper/better alternatives that save a patient all kinds of money.

I don't think it is just about narcotics but about all medications.

I know why benzos are perscribed with an antidepressant and why extra pain meds are perscribed. I have a friend with a very painful chronic condition and she is on a lot of pain meds and breakthrough meds. This condition is slowly killing her and her quality of life is very important. That is why they have those meds, for people like her.

Anti-depressants can take up to a month to work and often benzos are perscribed until the antidepressants kick in.
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Old 11-04-2008, 09:28 AM   #4 (permalink)
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Absolutely!

It is absolutely true that physicians receive incentives to prescribe drugs to patients. It is well documented that pharmaceutical companies provide doctors with a number of different forms of payment to prescribe their meds. Whether we are talking about doctors being paid as supposed consultants to large pharmaceutical companies when a new drug is on the market or whether you want to discuss the trips paid for by these giants supposedly to educate doctors on the use of these drugs. Educational seminars that many doctors don't even attend but rather a smoke screen payoff system for these doctors that provides vacations for their families or whatever. What about that new trial drug where the doctor (mostly in the mental health industry) must monitor your use over the course of 6 - 12 months which means regular visits to physicians with guaranteed payment from the insurance companies. Many of these visits you actually see your doctor for under a couple minutes as they continue the use of the drug. This is the stuff that goes on ABOVE BOARD ... I am sick when I think about the things that happen below the radar screen. These pharmaceutical companies are WAY TOO BIG and too powerful and get away with literally ... MURDER!!!

They stay within budget to get a certain drug out to circulation based on the projected profits this new wonder drug will provide regardless in some cases, of what tests have shown. They have brought to court numerous times for behaviors such as this ... A $600 Million judgment against the makers of Zyprexa a year ago, Merck just finally made the first payment in their lawsuit concerning the drug Vioxx a $4.85 Billion settlement ... but the scary thing is that just recently our own government is looking to pass protection to these irresponsible companies that don't warn people in a timely manner about side effects of certain drugs. Hmmmm ... imagine that, capitalism at is finest. If you have the money you can buy your own form of protection to abuse your power even more.

Here we are on a site where the majority of people here are trying to find solutions to their out of control substance abuse and you read countless of posts from people talking about their prescribed drugs that are suppose to be helping them stop using drugs ... the irony of it all.
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Old 11-05-2008, 12:44 PM   #5 (permalink)
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Thank you!

Purdue Pharma admitted in federal court last year that their sales reps lied to the doctors they supplied about the addictive nature of oxycontin.
Now anyone with a little savvy would see it and say well duh. Oxycodone, not addictive, riiiiiight. So how can a doctor not have that reaction.
Why did this happen, how could the doctors say they didn't know and wtf about the whole thing. Prolly to cover their arses when people turned up addicts who they didn't know what to do with to avoid potential lawsuit issues.

PP was ordered to pay 634 MILLION in fines and much of it to fund drug task force units etc. Who go around busting the dealers who are addicted to this garbage and find it so easy to get huge scripts from unscrupulous doctors.

Argh.

And yeah it kills me when doctors who we are supposed to trust just keep the vicious cycle of drug dependency and addiction going instead of rehab or addiction treatment.

Argh.



**I am NOT talking about legitimate drug scripts here for people who really need them.**
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Old 11-05-2008, 12:54 PM   #6 (permalink)
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again, with everone else, YES! I know so.

Many industries receive incentives, my SIL who works in auto insurance receives gift cards for gasoline. Between she and her husband, they enjoy free travel, bottled water, you would not believe all the kinds of things the are given!!!
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Old 11-06-2008, 10:19 AM   #7 (permalink)
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I'm a paramedic and have worked in a few doctor offices over the years....

None of the physicians I have ever worked for have received a "kick back" for prescribing any type of medication whatsoever; be it for diabetes, heart, cholesterol, pain, menopause, etc. Drug reps stop by doctor offices to give the doctor/staff information about the medications they represent, any updates on these meds and information on upcoming meds.

As far as the "addictive" meds; doctors aren't snowballed by the "it's not addictive" jargon. Generally, most good doctors give patients the benefit of the doubt and try to help their patients pain. Sadly, doctors who don't understand addiction don't realize how easy it is for some of us to get addicted to these meds. Then, we want more because that dose isn't helping...most narcotics will only "satisfy" a person for so long before it becomes not as effective.

I have seen a lot of patients who are legitimately on enormous amounts of narcotics...do I agree with it, not exactly. Within reason. However, it is quite easy to see those persons who are addicted to the meds and use them wrongly.

I will never forget when I got caught up on percocet after a severe back injury (from work). I was on valium for 3 weeks and the following 6 months or so, on percocet. The first 5ish months I used my meds as they were prescribed...however, I didn't wait for my scripts to run out...I refilled them as soon as I could... On the percocets, my pain was "gone" of sorts, I still had some pain, but NOTHING like it was without them....then I started noticing the euphoria when I took 1 or 2 more than I was suppose to take. Then I noticed my patience level, gone...continued to take a "few more" here and there, until I was popping 10 or more at a time. When the script ran out I KNEW I had to be done...or else....

I'm a recovering alcoholic, been sober (at that time for 13+ years). I knew I was getting really close to losing everything if I continued. I was getting scared. My depression from my injury was unbearable (ended my career) and the physical pain was horrific; but I didn't get a refill, in fact, my first day without percocets I went back to my ortho doc and I admitted what I had done. I told him I wanted to detox off it and see where I stood. I was going to PT at the time and confessed to my therapist also. He tried helping me with pain relief as much as he could too. After a week and a half of hell, I went back to my doctor, humbled, and begged for something to help relieve the pain...and he worked with me.

I now have a pain relief course that helps. It doesn't make the pain go away, but it makes it bearable to endure life daily. Been on it now for 4 years. No euphoria. No desire to take more than I'm suppose too. I have learned a lot from going through that experience and have been able to talk with our patients that I felt were having the same problem. It also helped me a lot, when I got sober I was 17....I'm now 34 and for me the hell of addiction was far out of mind...it's really clear again and I used that experience to also quit smoking. Which was worse...I think it was the percocets definitely physically and emotionally, though I had smoked for over 1/2 of my life, averaging 2+ packs per day...

Sorry for the long share...felt I needed to "qualify" myself...
Blessings,
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Old 11-06-2008, 10:27 AM   #8 (permalink)
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Jen... what a powerful story. I'm glad you had such good care providers.
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