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Doctors and Prescriptions

Old 02-15-06, 10:30 AM
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Doctors and Prescriptions

Question. Do doctors get kickbacks from pharmaceutical companies? For instance, why do doctors prescribe Crestor and not Lipitor (or vice versa)? If a doctor prescribes Crestor, do they get anything from Astra-Zeneca?
Old 02-15-06, 10:39 AM
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That'd be quite illegal. Nowadays they've cleaned the business up a bit, but there are pharma company sponsored dinners, sponsored retreats, ski trips, "conferences" etc...
Old 02-15-06, 11:23 AM
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That is illegal -- choosing Crestor between Lipitor has more to do with published studies that used Lipitor and not Crestor to show improvement against placebo or older cholesterol-lowering medications.

Pharmaceutical companies are now restricted from gift-giving over a certain amount and who can receive the gifts -- gone is the "Golden/Dark Age" where doctors and their families were invited to resorts or were given tickets to sporting events, concerts, etc. Most of what represenatives dish out now are branded office supplies, reference books -- the cheap ones -- for residents, and lunches. However, in conjunction with continuing education-type lectures/conferences, I think pharmaceutical companies get away with a little more like dinners at a fancy restaurant. I have never worked with a doctor who was offered a trip of any sort, but I wouldn't be surprised if it still exists.
Old 02-15-06, 01:55 PM
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Surely everyone's heard of the Pharmaceutical Rep?
Old 02-15-06, 07:48 PM
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OK. My doctor was awfully quick to prescribe Crestor for me even though I am relatively young and my cholesterol wasn't THAT high. Around 165. Now its around 120.
Old 02-15-06, 08:04 PM
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The ones that get kickbacks will go to jail. What I prescribe has more to do with published studies, safety profile, patient characteristics, and what is on a certain insurance company's formulary.
Pharmaceutical companies and medical equipment manufacturers can sponser conferences and seminars but there is full disclosure(the continuing medical education statement will have who is sponsoring it and if the lecturer has any ties to the industry). Not only that, we get to rate the conference to see if there is any bias or 'pushing' of medication or equipment. I usually go to 2-3 conferences a year and honestly, I've never seen that sort of bias in the lectures. Sometimes a physician in one of those seminars(esp. live procedure conferences) will give a preference as to which catheter they prefer but will take pains to say that there are no studies that show its superiority if there aren't any.
Old 02-15-06, 08:10 PM
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Admit, bhk -- it's all about the free pens and desk calanders for you.

Doctors must do relatively well on office supplies compared to comparable professions, because every time I go to my doctor, he's using a pen from Lipitor to make notes on a chart that he keeps on a Zoloft clipboard and he consults a pocket calendar from Prilosec. Of course, they have other expenses, so I guess it all evens out.
Old 02-15-06, 08:11 PM
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Originally Posted by bhk
What I prescribe has more to do with published studies, safety profile, patient characteristics, and what is on a certain insurance company's formulary.
Ditto.
Old 02-15-06, 09:40 PM
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Why would you need a prescription for cholesterol medicine if your cholesterol was 165???
Old 02-15-06, 09:44 PM
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I visit my doctor to get the freebie stuff - it often pays for the visit.

(on cholesterol and blood pressure meds) - and my doctor prescribes lipitor
Old 02-15-06, 10:24 PM
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Originally Posted by bhk
The ones that get kickbacks will go to jail. What I prescribe has more to do with published studies, safety profile, patient characteristics, and what is on a certain insurance company's formulary.
Pharmaceutical companies and medical equipment manufacturers can sponser conferences and seminars but there is full disclosure(the continuing medical education statement will have who is sponsoring it and if the lecturer has any ties to the industry). Not only that, we get to rate the conference to see if there is any bias or 'pushing' of medication or equipment. I usually go to 2-3 conferences a year and honestly, I've never seen that sort of bias in the lectures. Sometimes a physician in one of those seminars(esp. live procedure conferences) will give a preference as to which catheter they prefer but will take pains to say that there are no studies that show its superiority if there aren't any.
what bhk said.
Old 02-16-06, 09:14 AM
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Originally Posted by FantasticVSDoom
Why would you need a prescription for cholesterol medicine if your cholesterol was 165???
He said that studies now indicate that your cholesterol should be below 100.

Thats why I started this thread.
Old 02-16-06, 09:19 AM
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I know my doctor has often given me samples of prescription medication if he didn't feel the need to prescribe a full amount.
Old 02-16-06, 09:22 AM
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Originally Posted by CRM114
"What would I do? I'd shut it down and give the money back to the shareholders."
- Michael Dell in 1997 when asked how he would fix Apple Computer.
Nine years later (2006) Apple surpasses Dell in market valuation.
Offtopic and don't mean to hijack but Apple's valuation is currently $15 billion dollars below Dell's, barely a month after Steve Jobs sent out the email "proving" Dell wrong.

Note: I don't own anything by Apple or Dell, so I'm not a fan either way.
Old 02-16-06, 09:28 AM
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Originally Posted by CRM114
He said that studies now indicate that your cholesterol should be below 100.

Thats why I started this thread.
I'm a lawyer, not a doctor... but there's no way in hell that's true. AFAIK (and even the websites for the drugs like Lipitor still say this, and you think they'd be quick to jump on something that could help them sell more pills), 200 is borderline and 240 is high. If cholestorol of 100 was high, 99% of Americans would have to be on the cholestorol lowering drugs.

(mine is 150 as of a few months ago)
Old 02-16-06, 10:17 AM
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Originally Posted by CRM114
He said that studies now indicate that your cholesterol should be below 100.

Thats why I started this thread.

according to the NHLBI (the national heart lung blood institute) your low density lipoprotein (or LDL) cholesterol should be below 100. your total cholesterol should be below 200. through the links at this site you should be able to find the results of the ALLHAT study which looked at statin use and heart attack prevention, IIRC.
Old 02-16-06, 11:00 AM
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Originally Posted by CRM114
He said that studies now indicate that your cholesterol should be below 100.

Thats why I started this thread.
Im not sure that is humanly possible...He must be referring to your LDL. 165 is a great total score.
Old 02-16-06, 11:40 AM
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The wining and dining though is really apparent if you wait in office long you alway seem to see some rep giving out free stuff or making a dinner date.
Old 02-16-06, 12:14 PM
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Originally Posted by madara
The wining and dining though is really apparent if you wait in office long you alway seem to see some rep giving out free stuff or making a dinner date.

The last hospital I worked at, my friend in HR had a good friend that was a drug rep, and she would take us out to lunch all the time and write it off to one of our doctors.
Old 02-16-06, 05:41 PM
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I was speaking of LDL Cholesterol ... the "bad" cholesterol. According to the NHLIB site above, my doctor is correct. Below 100 is optimal. My LDL was at 165 which they list as "high." I am now at 124 LDL which is listed as "Near optimal."
Old 02-16-06, 05:46 PM
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What's your HDL?(if you don't mind saying)
Old 02-16-06, 05:46 PM
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Originally Posted by The Bus
Offtopic and don't mean to hijack but Apple's valuation is currently $15 billion dollars below Dell's, barely a month after Steve Jobs sent out the email "proving" Dell wrong.

Note: I don't own anything by Apple or Dell, so I'm not a fan either way.
Dell grew by 15 billion dollars in a month?
Old 02-16-06, 05:57 PM
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Originally Posted by CRM114
Dell grew by 15 billion dollars in a month?
Current Dell stock price: $31.96/share
Current Dell Market Cap: $75.22 billion

Current Apple stock price: $70.57/share
Current Apple market cap: $59.89 billion
Old 02-16-06, 06:41 PM
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Originally Posted by CRM114
Dell grew by 15 billion dollars in a month?
fluctuations in stock price probably resulted in the change (see wildcatLH's post). but, dell did bail on their mp3 player .
Old 02-16-06, 08:21 PM
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Yeah, I see Apple's share price dropped like $15 over the last month. Just a selloff of the massive rewards. (I'm not selling - yet.)

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