(If pharma companies can deduce which brands are prescribed by which doctors, then perhaps there lies a problem we can easily solve.)
How about buying technology? You've never been treated to lunch or drinks or something by a vendor? "You aren't buying a product, we are forming a relationship, you'll be a partner in the future of <widget>". Did you guys buy it?
Most doctors are reasonably intelligent on paper, they all have advanced degrees and all their friends think and tell them they are smart... But why would the ratio of great to bad be different than in tech? I'd think that you could "hide" more easily in medicine, there are all sorts of ways to make a big pay check without doctoring, like selling medical marijuana cards or simply selling prescriptions for big pharma, people will actually come in and ask for certain drugs because they saw an ad. Fact is, most sicknesses are defeated by your immune system, not some pills. Cultivate the right practice and they can simply be legal drug dealers, get paid and their customers will be happy. And nobody wants to think their doctor is bad, but before anything substantial or chronic treatment (like you need this drug forever) you should always seek some additional opinions.
Glad to see that the data is so boring.
That said, speaker engagements are a bit of a hot button in the industry right now. Speaker engagements are when pharma pays a physician to speak to other physicians. They typically present material that is authored by the pharmaceutical company. The doctor that presents tend to be pretty high profile and leaders in their field of study.
GSK has decided they will not be doing speaker engagements any longer due to the appearance of using money to influence clinical decisions. They're getting a decent amount of flak from other companies about it (i.e. "it will only hurt them"), but we'll see how it goes. It might cause a change in the industry. GSK will now have their own employees present the material (will it be as effective as a outside physician doing it?).
Years ago being a drug company speaker was a pretty good gig. The presenter was expected to more or less stick to the script, but back then there was a fair amount of leeway and speakers often made the subject more lively by inserting anecdotes or clinical "pearls" from their own experience. Sadly that's no longer allowed to happen.
In the 90's and early 00's intermittent I was a speaker for several pharma companies. Besides the pay it was a lot of fun interacting with colleagues, and getting to be the "expert" on the drug. There were other benefits too, paid travel to speaker and consultant meetings at venues I'd never be able to afford to frequent on my own.
But those days are gone forever. In the current environment the pharma companies don't even hand out ballpoint pens anymore, let alone put speakers up at 5-star resorts.
Haven't worked for any of the firms for nearly 15 years. It's a very different thing now. Once in a great while I'll still attend a dinner presentation, but mostly it's a waste of time.
The drug companies have become virtually paranoid about incurring regulatory or public scorn. Speakers are strictly constrained to say only what's FDA approved, the same info provided in the package insert which I can easily read on my own (and most of the time I already have read it). Why bother going over it again?
So I suspect if companies are terminating speaker programs it's because attendance has fallen off even when "high profile leaders" are presenting. Kind of a shame to see traditions fade away, but the message is clear, "drug dinners" and other ways to market pharmaceuticals will soon be relegated to the dustbin of history.
Thanks for sharing your experience. I'm only familiar with how it is today and yes, companies are absolutely paranoid about following the rules (which is a good thing). Not that surprising considering some of the monster fines these companies have paid.
And what the graph doesn't show is how these companies are related. Who owns who? Who's independent and who isn't?
This is a decent site, but it has a tendency to overstate the significance of some of the 'payments'.
First, it doesn't seem to be properly distinguishing between multiple doctors in a given private practice. That's a hard problem, and I don't fault them for it, but then it's a bit misleading to attribute a payment to a particular doctor's name when it could very well be a gift accepted by someone else in the same practice.
It's also including transfer of money that's associated with conferences. Physicians are required to perform continuing education in order to keep their skills up-to-date (which is a good thing!). Because of this, pharmaceutical companies have a really strong incentive to get themselves financially integrated into this process - and they've succeeded. This is certainly an unfortunate aspect of the medical field, but it's not really something that's possible to avoid, particularly in certain specialties. Personally, I'd rather have a physician who's up-to-date in their knowledge and practice than one who's not. It'd be great if this process were easily separable from pharmaceutical money, but in fields like oncology and psychiatry, it's near impossible.
The descriptions are a bit misleading too. For example, the tooltip for 'Food & Beverage' gives as an example, 'a salesperson asks a doctor if they can talk about a drug over a meal... and the salesperson pays for the meal'. This also includes gifts that are sent to the physicians (e.g., they send the office for the practice a bottle of wine, which was signed for by the receptionist, etc.).
Granted, if you see that your physician received $50,000 in payments for the very drug he/she wants to prescribe you, yes, that's definitely something to ask him/her about. But the data on this site, as it stands, is a lot less indicting than it first seems - it's really best used as a conversation starter between you and your physician rather than a condemnation of individual physicians or even the industry at large.
Anecdotal, I know, however I have a family member that shows up on the site. His number is low—less than a couple of hundred dollars—but I asked him about it when I first heard of the site from Last Week Tonight. His response was that they were medical device manufacturers taking his team out for meals to discuss devices they were either already using regularly or were in the process of trialing. I can't imagine anyone can find fault in such a thing.
Perhaps the conferences would end up being in less glamorous locations, but that would have little impact on their educational benefit.
Well, I work for a Hadoop distribution, so I may have some biases showing through in my setup. I like to use spark in conjunction with Hadoop; I've never actually used it stand-alone before, honestly. For relational data, I'll ingest into Hive as that allows me to pivot to the right tool for the kind of analysis that I need to do whether it be simple SQL via Hive, something more suited for Pig via HCatalog or Spark via SparkSQL. I'll often do my analysis on a Hortonworks Sandbox for small data like this.
For larger data and a more professional setting, I like to do prototyping/ad hoc investigation/etc in python with pyspark inside of jupyter. Generally that transitions either to Java or just plain python (depending on the degree to which it's difficult to transition).
Anyway, hope that helps! Happy to answer any other questions you might have too. :)
Or maybe doctors generally know what they're doing and can, on average, perform their profession better than a random guy on the internet.
> a product of the Sunshine Act, part of the Affordable Care Act.
> Why does this database exist? Basically because of the incentives created by industry being able to pay doctors to work on things that will ultimately help industry–like new drugs or medical devices. The hope is that more transparency will reduce any harmful influence that industry could have on medical research, education, and clinical decision making.
The idea that the major source of graft in medicine is Pharma is a red herring the other actors keep flogging so no one asks who's really skimming.
Orthopedists often take off-the-books kickbacks from physiotherapy clinics they recommend, Dermatologists take kickbacks from handling pharmacies for custom "hydrating lotions", and so on.
The worst case is the field of orthopedic prosthesis: it is controlled by a mob, the same gangsters control other surgical materials like the stents used for coronary angioplasty. A congressional committee investigated the issue and indicted 10 people from 16 companies:
* Empresas Oscar Iskin
* Totalmedic
* Life X
* Orcime
* IOL
* Brumed
* Strehl
* Intelimed
* Prohosp
* Tellus Rio Comércio e Importação e Exportação Ltda
* Elfa Produtos Hospitalares
* Atma Produtos Hospitalares
* Osteocare Serviços Médicos, Locação e Representação Ltda
* Signus do Brasil Comércio de Materiais Hospitalares Ltda
* Biotronik Comercial Médica Ltda
* Biomet
* Intraview
My email is lane (at) myire dot com