Pharma companies spend millions wooing doctors to prescribe ‘me-too’ drugs

Pharma companies spend millions wooing doctors to prescribe ‘me-too’ drugs

Xarelto package

Xarelto package

Is the drug you’re taking the safest and most effective one for your medical condition, or is it a “me-too” drug  — one that essentially duplicates the actions of an already existing drug, but at a higher price?

As a new investigative article from ProPublica reporters Charles Ornstein and Ryann Grochowski Jones points out, pharmaceutical companies spend millions of dollars wooing physicians to prescribe “me-too” drugs to their patients. They do this, in part, with free meals and educational gifts and by hiring physicians as consultants and promotional speakers. (And, yes, although most physicians will say that small gifts, such as free meals, have no influence on their prescribing preferences, research suggests otherwise. Pharmaceutical companies know this; that’s why they spend so much money on those gifts.)

In the last five months of 2013 alone, the manufacturers of just three new blood-thinning drugs (Pradaxa, Xarelto and Eliquis) spent almost $19.4 million on U.S. doctors to encourage them to prescribe one of those drugs rather than the much-older blood thinner Coumadin (warfarin), according to the ProPublica report.

Ornstein and Jones compiled that payment information from the Open Payments database, which has come into existence because of the Affordable Care Act. Their resulting investigation provides “the first comprehensive look at how much money drug and device companies have spent working with doctors,” the two reporters write. “What it shows is that the drugs most aggressively promoted to doctors typically aren’t cures or even big medical breakthroughs. Some are top sellers, but most are not. Instead, they are newer drugs that manufacturers hope will gain a foothold, sometimes after failing to meet Wall Street’s early expectations.”

“In almost all cases, older, cheaper products are available to treat the same conditions,” Ornstein and Jones add. “Companies typically try to differentiate the new drugs by claiming they are easier to use; carry fewer side effects; work faster than competitors; or have medical advantages.”

Top three

According to the ProPublica analysis, the drugs associated with the most payments ($9 million) to doctors during those five months in 2013 was Victoza, a diabetes medication made by Novo Nordisk.

“Victoza, through a once-a-day injection, helps lower blood sugar among diabetics, but researchers and advocacy groups have said drugs of its class carry an increased risk of thyroid cancer and pancreatitis,” write Ornstein and Jones. (A Novo Nordisk spokesperson told the reporters that the company had to spent that much money on doctors to address such safety concerns.)

Second and third on the list were Eliquis, the blood thinner (anticoagulant) co-marketed by Bristo-Myers Squibb and Pfizer ($8 million), and Brilinta, a blood thinner made by AstraZeneca.

Majority are new drugs

Among the 20 most-promoted drugs identified in this study, 14 were new drugs — approved by the Food and Drug Administration since 2010. Write Ornstein and Jones:

Some treat similar conditions, including diabetes, schizophrenia and chronic obstructive pulmonary disease, so the competition among them is fierce. “They’re fighting over the same doctors, I guarantee you,” said Rhonda Greenapple Simoff, founder of a consulting firm that advises pharmaceutical companies in Bernardsville, N.J.

Largely absent from the top of the list were drugs that cure disease, such as a new class of hepatitis C treatments, or those that significantly extend life, particularly for cancer patients. If a drug is either the first to treat a disease or is much better than existing drugs, said Dr. Sidney Wolfe, the founder and now senior adviser to Public Citizen’s Health Research Group, “they ‘sell themselves’ on the merits of their unique benefits.”

According to ProPublica’s analysis, a few of the most heavily promoted drugs, including Samsca, which treats low sodium levels in the blood, have serious side effects that came to light after their approval by the federal government. The manufacturers of several others, including Copaxone, Latuda, Xarelto, Daliresp and Humira, have been faulted by the F.D.A. for improper promotion.

For more information

You can read the full article on the ProPublica website. (It was co-published with the New York Times’ The Upshot.) The article includes a chart of the top 20 most-promoted drugs during the last five months of 2013.

In addition, you’ll find a useful app on the site that can help you see how much money is being spent on doctors (and teaching hospitals) to encourage them to promote a drug you are taking. ProPublica also has a “Dollars for Docs” tool that can help you determine if your physician has received payments from a drug or medical device company.

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John Macey

I was born, and principally educated, in the fields of biochemistry, and business management in the northeastern USA. However, my world-wide professional career has greatly expanded upon that US base to involve the many different segments of the Biotech / Life Science fields globally. – I have been dressed as a surgeon to view many, many surgical proceedures - The major players in the health care fields that I have worked for include: Johnson & Johnson, DuPont, Abbott Laboratories, and F. Hoffmann-La Roche. – Positions have included selling nuclear materials for both in-vivo & in-vitro (radio-pharmaceutical & radio-immunoassay) medical diagnostic purposes, in the four countries in Scandinavia, based south of Stockholm, to managing Ph. Ds at a global Swiss headquarters location. – At one time I held a position of Strategy Manager for Europe, Middle-East & Africa (EME&A) for a Chicago based company, but living in Germany. – I do speak fluent colloquial German. – In addition to having lived in multiple European countries, my professional career took me to Asia for well over a decade. There I had management control of Oceania, the Pacific Rim, Northern Asia, Japan, out to India. – Occasionally, management assignments have taken me to all of Latin America, and most of South America. – I am extremely culturally aware, a skilled negotiator, and a seasoned manager of men and science. – My one abiding passion has always been computing, data, and analysis. As such, my main computer operating system is Linux, and open-source computer applications. – I do also run Microsoft 7, and Mac OS X (all 3 operating systems on the same H-P Ultrabook). I hope you enjoy your time on the Blog, and should you have any comments / feedback please feel free to email me @, or visit my Linux Web Site @ (always evolving) – John J. Macey – AKA Adler, which in German means Eagle – Wildwood, New Jersey - Together, we can expand your global markets - with our partnerships. The partnerships are global utlizing multiple Law, Regulatory, Seasoned Management, Employment, M&A and buidlers of Business. Contact use.