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Doctors and drugs
Aug 18, 2004

I know this site is sponsored heavily by drug companies so I do not know how truthful the reply to my question will be. How much does the relationship between the particular doctor and the drug companies affect the choice of drug treatments the Doc recommends to a patient?

Secondly what kick backs are doctors getting from drug companies?

Finally why are HIV drugs so expensive, how in Gods name do you expect the average person to afford these medicines?

Response from Dr. Pierone

These are all good questions and deserve honest answers, so here goes.

The interactions and relationship between a particular doctor and the drug companies do affect the choice of drug treatments. If this were not the case drug companies would not spend vast sums of money on marketing and educational programs for physicians. Can a drug company convince a doctor to prescribe an inferior agent through a slick marketing campaign? Sometimes they can, especially physicians with weaker analytical skills and less time or interest in keeping up advances in scientific literature. Generally though, the better physicians see through the marketing hype and make the best choices for their patients.

A "kick back" implies a doctor gets some cash amount (or cash equivalent) from a pharmaceutical doctor in return for writing prescriptions for their products. Many years ago this practice did sometimes occur (and still goes on in parts of the world), but is illegal and I have never personally seen this situation in my years of HIV medicine.

Drug companies do sponsor educational meetings in fancy hotels, resorts, and restaurants, and invite doctors in an attempt to influence them to prescribe their own product and not the competitor. But over recent years and as a result of new government guidelines these meetings are more tilted towards education over entertainment. The information presented is also less biased and more balanced. The doctor still needs to contend with the pharmaceutical industry spin and objectively look at and interpret the data.

Finally, HIV drugs are so expensive because that is what the market can bear and will pay for life-saving drugs. Generally, individuals don't pay for these medications. We pay for them collectively as a society through insurance premiums and government programs for people that don't have private insurance.



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