Here is how Doctors are Bought

Discussion in 'Economics' started by spinn, Jun 15, 2009.

  1. spinn


    American DRs are among the biggest liars on the face of the earth. They are constantly prescribing medication that do not work, cover up symptoms, or drive people to suicide. That is in addition to bankrupting America.

    The below story tells how they are paid by drug companies to prescribe medications. The ironic thing is Xyrem is a good medication. This guy is being attacked because it works much better than any other sleep medication and they want it to disappear.

    Imagine how much DRs are paid to prescribe anti depressants?

    At first, Dr. Peter Gleason thought his arrest was a joke.

    Enlarge This Image

    Ozier Muhammad/The New York Times
    Dr. Peter Gleason, 53, promoted Xyrem for purposes other than those approved by the federal government and now faces charges.
    Side Effects
    Articles in this series are examining how money from drug and medical device companies can influence the ways doctors conduct business and practice medicine.
    In the early afternoon of Monday, March 6, half a dozen men in suits surrounded Dr. Gleason, a Maryland psychiatrist, at a train station on Long Island and handcuffed him.

    “I said, ‘Well, this is a gag,’ ” Dr. Gleason recalled in a recent interview. “They said, ‘No, this isn’t.’ ”

    Dr. Gleason, 53, was taken aback because he was arrested, and later charged, for doing something that has become common among doctors: promoting a drug for purposes other than those approved by the federal government.

    But prosecutors say that Dr. Gleason went too far. At hundreds of speeches and seminars where he was rewarded with generous fees, Dr. Gleason advised other physicians that a powerful drug for narcolepsy could be prescribed for depression and pain relief. In doing so, he conspired with the drug’s manufacturer to recommend it for potentially dangerous uses, the prosecutors claim.

    The case has put the spotlight on the murky financial relationships between drug companies and the physicians they use to promote their medicines. Companies cannot directly advertise drugs for purposes not approved by the Food and Drug Administration. But getting drugs prescribed for unapproved uses can increase a drug’s sales, so companies often skirt the rules by sponsoring seminars where doctors are paid to make presentations promoting their drugs, including the “off label” uses.

    For doctors, these and other payments they receive for discussing drugs can be very lucrative. Dr. Gleason acknowledges that he received more than $100,000 last year alone from Jazz Pharmaceuticals, which makes Xyrem, the narcolepsy drug he has promoted.

    His case could establish limits on what doctors can do to help companies sell their drugs. But any precedent could be complicated by the history of Xyrem, which differs in one important way from other drugs. Because the active ingredient in Xyrem is gamma hydroxybutyrate, or GHB, an illegal street drug with a history of use in date rape and of overdose hazards, Xyrem is listed as a federally controlled substance, with distribution tightly monitored.

    Some doctors who have researched Xyrem say that Dr. Gleason, in his enthusiasm for the drug, may have understated its very real risks. Still, at least one former F.D.A. official says that the government appears to be overreaching in going after Dr. Gleason and may chill a common and legitimate form of medical discussion. “This is a very, very scary development,” said Daniel E. Troy, a partner at Sidley Austin and the former chief counsel of the F.D.A.

    Dr. Steven Nissen, the interim chairman of cardiovascular medicine at the Cleveland Clinic, said the case could “have a chilling effect on physicians, because when we give lectures, we assume that giving an opinion about the use of a drug is not going to get us into legal difficulty.” The F.D.A. and federal lawyers, he said, need to restrict criminal prosecutions to especially egregious cases of off-label promotion.

    Continuing to Practice

    Dr. Gleason, who is now free on bail and continues to practice medicine, insists that he is not guilty of conspiracy. He says that he was charged only after he refused to help the government build a case against the drug’s maker, Jazz Pharmaceuticals — a sequence of events that court documents seem to support.

    Dr. Gleason freely acknowledges that in meetings with other doctors, he advocated Xyrem as a treatment for many conditions, including depression and fibromyalgia, a poorly understood pain disorder.

    In a news release about the indictment, an assistant F.B.I. director compared Dr. Gleason to a “carnival snake-oil salesman.”

    But the doctor says that based on his own experience giving Xyrem to patients, he believes everything he said about the drug and that his right to express his views are protected by both F.D.A. rules and the First Amendment.

    Some lawyers who have reviewed Dr. Gleason’s case, but are not representing him, say they agree.

    Dr. Gleason has been trapped in the complex rules that cover what doctors and drug manufacturers are allowed to say about prescription drugs, according to Harvey A. Silverglate, a lawyer in Boston who specializes in civil liberties cases.

    “What they are doing is criminalizing conduct that is not clearly criminal,” said Mr. Silverglate, who is not involved in Dr. Gleason’s defense.

    Neither the F.D.A. nor the United States attorney’s office in Brooklyn, which indicted Dr. Gleason, would comment on the case. Nor would David Loftus, a public defender who took over the case after Dr. Gleason determined he could not afford a private lawyer. Jazz Pharmaceuticals, which has not been charged, also declined to comment.

    F.D.A. rules allow doctors to prescribe federally approved drugs for any purpose, even if it is not indicated on the medicine’s label. But drug companies are tightly constrained in what they can say about their medicines. Companies can promote drugs only for their federally approved purposes — their so-called “on label” use.

    “Off label” promotion by drug companies is illegal, and since 2000 drug makers have paid large fines to settle federal criminal cases over off-label prescriptions.

    Pfizer, for example, paid $430 million in 2004 to settle allegations that it had promoted Neurontin, an anti-epilepsy medicine, for pain and bipolar disorder.
  2. promoting a drug for purposes other than those approved by the federal government.

    It is a good thing the FDA doesn't regulate duct tape.
  3. Don't give them any ideas.
  4. Read this book and you'll see how big a scam the entire U.S. Health System is (I'm serious, this book is not a 'conspiracy theory' - written by a physicians and a pharmaceutical executive):

  5. ba1


    GHB (Xyrem) is a "naturally-occurring substance found in the central nervous system, wine, beef, small citrus fruits, and almost all animals in small amounts. It is also a neuroprotective therapeutic nutrient..." (Wikipedia)

    It was available in health food stores in the 1980s for body building, chronic illness and stimulating growth hormone. Its use is complicated by abuse, high dose toxicology, and antidepressants including alcohol. Its character as a long known human nutrient and metaobolite especially raises constitutional issues.
  6. spinn


    I took Xyrem for about three years, at the maximum dose for most of that time. The only reason I stopped is because it has now been held hostage and sells for $1700 a month, usually not covered by insurance.

    It is the best sleep medicine I have ever used. Were it sold for what it costs to produce, about $8 a month, most, if not all prescription sleep meds would disappear in less than one year.
  7. Idiots began using this OTC version for a guaranteed lay with a skank, the media ran with the story and next thing you know a previously OTC supplement was labeled the "date rape drug" (as if alcohol isn't a the world's undisputed date rape champion) and is now considered as bad as crack or heroin if found in your possession. It was a typical knee jerk reaction from a bloated government trying to protect us from ourselves.

  8. Couldn't have said it better myself.

    Face it - Big Pharma is probably in the top 3 most powerful lobbies in the world.

    They will get their monopoly or oligopoly pricing, or they will take their ball home with them and ensure that no one plays.

    This includes the ban on approving generic biosimilar drugs and also their sinister attempts (successful, so far) to patent DNA and molecules.

    And if it grows in nature and they can't patent it, they will ensure it's never harvested properly, processed properly, easy to sell, easy to market, and they will run interference at every step of the way towards blocking it from being marketed, sold and they'll smear it.

    They want profitable, long-term exclusive licenses on drugs they can charge monopoly profits for, and that don't 'cure' anyone, but treat them for life - it's far more financially beneficial.

    And they want every American, even young kids, on as many meds as possible.
  9. MattF


    There are too few doctors out there who can recommend second, third opinions on medicine that can help to cure or alleviate the problem.

    There are also too few people who think of taking said opinions and instead just brainlessly listening to the doctor they have and "trusting" them.

    I had asthma as a kid for years...still do. Took the old machine-type treatment because the pediatrician said to and my parents listened. Didn't do shit except make my stomach turn...don't even remember what inhaler was used. Knew there had to be something else.

    Fast forward many years...ended up with a different doctor. Took one look based on symptoms and said it's allergic reactions...take a combo. of these and it'll be controlled in a day or two.

    Sure enough; exactly what happened. Best cure I ever got in both time and results. Now I barely use the stuff to this day; maybe once or twice a year at most.

    He moved on a short time later, but that told me immediately if you get something prescribed, irregardless, always find and seek other opinions.
  10. MattF


    There is plenty of stuff that works out there and can have other uses...but God forbid that happens.

    I mean, it's only chemicals and shit...sometimes it can have different and useful effects for something else.

    No, we must create a separate product.

    [/end sarcasm]
    #10     Jun 16, 2009