Your Voice: Drug innovation should be applauded, not used to shame physicians

Every practicing physician with an ounce of integrity and common sense should read the “First Take” in the November 25th issue (“Stop suggesting physicians are ‘bought’ through pharma gifts”; bit.ly/docs-not-bought). You are saying exactly what honest physicians have been saying for years. The pharmaceutical companies do not unduly influence doctors’ prescribing habits or buy physicians’ loyalty and prescription pads by providing lunch, giving them scratch pads or pens or other perks. 

Pharmaceutical reps are salesman, and because they’re employed by Company XYZ, they are going to do their best to present their product in the most glowingly positive way possible. Don’t you (the critics) think we physicians know that? Do you think we’re stupid? Apparently, you do because of the decades of ridicule and abuse the pharmaceutical companies, and drug reps in particular, have taken.

From the tone of many studies and editorials, one would put drug reps on the list with Charles Manson, or better yet, Bernie Madoff. What crooks! How dare they promote their product by bringing me and my staff lunch to have ample time to apprise me of the benefits of their product! 

In 40 years of practice, I have learned so much from drug reps about the biochemistry of new drugs and the pathophysiology of diseases those drugs treat. When I went to medical school, statins, ACE inhibitors, ARBs, 3rd generation cephalosporins, inhaled corticosteroids and dozens of other drug classes did not exist. How do you think I first learned about drug therapy for hypercholesterolemia? It was in 1988 at a seminar sponsored by Merck that was touting the virtues of a new class of drugs called HMG-COA reductase inhibitors, i.e. statins, and the first one, Mevacor, was their baby.

Well, as I sat there fascinated, the last thing I thought was that evil Merck has brought me here to get me to prescribe their drug to fatten their pocketbooks. That’s BS and any honest person knows it. Statins and many, many other drugs have improved the quality of human life and reduced heart attacks, strokes and on and on. Sure, the drug companies have made money. That’s capitalism and it’s still the best economic system ever developed. American scientific ingenuity is amazing even if it happens to be subsidized by business and more power to them.

Those naysayers whose studies impugn the integrity of physicians and indict the pharmaceutical industry should thank their lucky stars that Eli Lilly made human insulin, that Merck made Lisinopril, Mevacor and Zocor, and Pfizer developed Viagra. And they should thank their physicians for knowing about and prescribing those drugs for them. That company-paid-for lunch may have been more influential than they realize.

William M. Gilkison, MD
Cave Creek, Arizona

Pharma accusations ‘a slap in the face’

I wanted to say thank you for the editorial on pharma guidelines and rep visits and their effect on prescribing patterns. I agree fully and felt all along it was a slap in the face that we had so little ethics as physicians that a pen or lunch would cause us to prescribe a drug. I do agree reps are the best way to learn about products and then make an educated decision on prescribing, but you are shunned if you accept them. I also help patients with samples for drugs they can’t afford. I’ve kept uninsured patients out of the hospital with asthma and COPD drugs which are pretty much all brand name. Thanks for bringing up the subject.

Deborah Winiger, MD
Vernon Hills, Illinois