With revenues in excess of $314 billion, the complexity of the United States pharmaceutical market has exploded. With specialty products, generics and developing therapies, consumers have access to countless medicines that curb appetite, reduce pain, lower cholesterol and even improve sexual virility; however, navigating this environment has changed as commercials and websites have been overshadowed by an unexpected drug world pitchman - the white-coated and familiar medical doctor. For generations, we have been taught to trust the advice of doctors, but a recent ProPublica report warns us to proceed with caution.
In October 2010, Pulitzer-winning ProPublica examined the role, and more specifically the payrolls, of several physicians hired by drug companies to promote specific products. These doctors, referred to as the white-coat sales force, are allegedly respected specialists, who educate others on the benefits, use and risks of particular offerings from their Big Pharma sponsors.
ProPublica uncovered several concerning facts about these doctors. First, the investigative group discovered that many of the pharmaceutical giants, including Merck, Pfizer, Johnson and Johnson and Lilly, have paid $257 million since 2009 for speaking, lecturing, consulting and other unspecified duties. Second, ProPublica revealed that many of these pill pitchmen have been sanctioned by professional organizations, cited by the Food and Drug Administration, and/or have been cited for professional misconduct.
Many pharmaceutical companies employ hundreds of doctors, according to the ProPublica investigation. Rheumatologist James I. McMillan is one of them. Over 18 months, Dr. McMillan has been paid more than $200,000 to speak with physicians about various drugs. This same McMillan was ordered by the FDA to cease "false and misleading promotions," for promoting unapproved uses and minimizing risks of Celebrex. Besides McMillan, the report showcases various others for falsifying records, inappropriate sexual behaviors and performing unnecessary tests and excessive invasive procedures.
While the ProPublica report sheds light on the marketing techniques of pharmaceutical companies, their report also exposes a real problem in patient care and safety. With trusted doctors on payroll or receiving incentives, who is potentially liable when a patient suffers adverse affects? And, who stands with patients to prove the wrongdoing?