An attendee at the Drug Companies event alluded to an article in the NY Times regarding a psychiatrists experience working for Wyeth Pharmaceuticals marketing their drug Effexor. It is a fascinating read, describing a sympathetic doctor who compromises his professional integrity ever so slowly until he is too deep in the pockets of Wyeth. Rarely do ever see such a strong narrative from a scientist.
Quick synopsis - Daniel gets hired to give short talks to other doctors and present data on Effexor. He is subtly influenced to hide damaging data as he slowly becomes aware that the drug doesn’t live up to the claims (it increases hypertension risk in many). The drug reps are ruthless in their monitoring of his performance, making him more and more uneasy. After making roughly 30K over 1 year, he gets fed up and quits.
One of the most telling points of the story:
At my next Lunch and Learn, I mentioned toward the end of my presentation that data in support of Effexor were mainly short-term, and that there was a possibility that S.S.R.I.’s were just as effective. I felt reckless, but I left the office with a restored sense of integrity.
Several days later, I was visited by the same district manager who first offered me the speaking job. Pleasant as always, he said: “My reps told me that you weren’t as enthusiastic about our product at your last talk. I told them that even Dr. Carlat can’t hit a home run every time. Have you been sick?”
At that moment, I decided my career as an industry-sponsored speaker was over. The manager’s message couldn’t be clearer: I was being paid to enthusiastically endorse their drug. Once I stopped doing that, I was of little value to them, no matter how much “medical education” I provided.
It was clear that Daniel has turned a corner on the drug’s effectiveness and his willingness to discuss that openly (something he struggles with earlier). And who is waiting there for him? The drug company, tracking him, ready to dismiss him at the slightest sign of rebellion. You have to admire the ruthlessness.
Over the course of the year, he made 30K. Not a whole lot for the number of doctors he potentially influenced.
Takeaway
Your doctor’s integrity is the only protection you have as a patient. Patients aren’t educated on the drugs, not equipped to analyze/provided with the data. So I humbly ask, how much do you trust your doctor?
More Info
The Nytimes Article
