The following is from an oncologist and PJ reader:
I am an oncologist & I feel our specialty (likely due to the very expensive drugs we use) are frequently pressured by high pressure sales pitches & also by financial inducements.
Examples: 1. Lunches for staff 2-4 X/wk. If my staff is to continue getting this perk, I must listen to the pitch. 2. Multiple fax, email & telephone invitations to be on "advisory boards", complete surveys, attend meetings, or just listen to propaganda for $100 - $1500 per pop. I refuse them all. 3. Lavish parties at our society meetings which make me feel dirty so I turn them down. 4. Drug samples which obviously have value for our poor patients but induce us to become familiar with their product. When was the last time a drug rep filled your cabinet with a generic? 4. Lastly, guarantees from the companies that if we use their drug off label, and experience reinbursement issues, they will refund us. While on the surface this seems entirely altruistic, it has other subtle influences: It gets you familiar with using their drug,. We all like to use treatments with which we are familiar. It also encourages you to use expensive treatments before data has established that drug as standard of care.
I see this as a huge concern when Oncologists could bankrupt the entire health care system by ourselves due to the irapid development of effective but enourmously expensive pharmaceutical options; ie. growth factor inhibitors. Example: Erlotinib (Tarceva) has a 15-18% partial responce rate in "selected" lung cancer patients at a cost of ~$2500/mo. The impact of this expense could be devastating if we are not careful & are influenced in which pts we select.
See the recent action take by Stanford:
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