
Another Study Finds Link Between Pharma Money and Brand-name Prescribing - acsillag
https://www.propublica.org/article/another-study-finds-link-between-pharma-money-and-brand-name-prescribing
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qaq
That's partially BS generics are not always the same as brand name drugs. The
manufacturing facilities are not the same the suppliers of active ingredients
and the degree to which they are purified are not the same. So if insurance is
covering brand name drug it's actually better it be prescribed vs generic.

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hartror
> degree to which they are purified are not the same

Got a source for that?

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ArtDev
In this story, I learned that generic drugs are never exactly the same:
[http://fortune.com/2013/05/15/dirty-
medicine/](http://fortune.com/2013/05/15/dirty-medicine/)

This company was fraudulently claiming that the drug profile of their generics
was identical. Thanks to a whistle-blower the company was fined $500m by the
FDA, after years of legal wranglings.

More background: [https://www.propublica.org/article/fda-let-drugs-approved-
on...](https://www.propublica.org/article/fda-let-drugs-approved-on-
fraudulent-research-stay-on-the-market)

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Spooky23
Obviously marketing works, and sales reps can help physicians by pushing
research and information at the as part of their outreach -- just like any
other relationship based salesperson.

The other equation missing is the impact of pharma sales practices with
respect to the gatekeeper pharmacy managers. Who is taking the CVS/Caremark
guy out for steak dinner and what is the rebate or consideration that the
insurance company gets for choosing one drug over another.

In my case, my insurance company standardized on a drug in a broader class of
medications that wasn't as effective for me -- I had some minor side effects
and the metrics changed for the worse.

So my doctor switched me back to a non-preferred drug. His mousepad was
provided by that drug maker. Is that an ethical issue?

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refurb
_increased by 0.1 percent for every $1,000 in industry money received_

I'd love to know what the confidence interval is for this analysis.
Prescribing varies wildly across physicians, so if a doc is receiving $10K in
pharma money, is a 1% increase in prescribing relevant?

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napoleoncomplex
Here's a figure from the article posted by Eric Topol on twitter:
[https://twitter.com/EricTopol/status/729688822053670912](https://twitter.com/EricTopol/status/729688822053670912)

Combined with the stat you mentioned, it's a strange one. Maybe I'm looking at
it wrong, but there's barely any physicians receiving above $50k in payments,
so the biggest impact pharma payments have made is around a 5 % difference in
prescribing. Looking at the variation at around $0-$10k, 5 % seems like a tiny
change, since you have docs prescribing anywhere from 0 % and 80 %. Something
else is driving it, my guess would be good personal relationships with sales
reps? In that case, focusing on limiting that would have a much better impact
on fixing the issue.

The big variation could also be something completely innocent like trust in a
specific brand due to experience in the clinic, etc. Perhaps someone more
knowledgeable can chime in.

~~~
refurb
Nothing quite like extrapolating a line across your entire data set when 99%
of the data points are in the bottom 5% of the range.

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mwsherman
As I mentioned in another comment, the incentives here draw from the
protections that derive from several levels of prohibition:
[https://news.ycombinator.com/item?id=11650108](https://news.ycombinator.com/item?id=11650108)

