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DOCTORS are being offered up to £1,500 a year
in return for letting drug industry sales reps into their surgeries, Scotland
on Sunday can reveal.
Under the controversial ‘cash-for-access’
scheme, GPs will be paid 15 each time they fill in an ‘appraisal’ of the
pharmaceutical firm representative who visited them. Critics say the move sidesteps
rules which ban drug companies from making direct payments to doctors for
agreeing to see their reps. It is expected to guarantee up to a third of a
million extra visits annually to GPs by reps who will plug the latest branded
drugs.
Concern is growing about the close links
between GPs and the pharmaceutical industry. The tendency of some doctors to
prescribe branded drugs where generic alternatives are available has left the
NHS with a multimillion-pound headache. NHS administrators estimate that questionable
tactics to protect branded drugs cost Scotland 14m a year, at a time when
prescribing budgets are spiralling out of control and health boards are in
financial deficit.
Greater Glasgow’s drug costs are currently
increasing by about 1m a month. The new internet-based service, GPreply.net,
was launched two weeks ago to provide "feedback" on marketing to
pharmaceutical companies. It has already recruited hundreds of doctors and has
a target of 3,000 GP members across the UK.
Doctors are being offered 15 each time they
send in their view about an individual visit from a drug rep. That information
will then be sold to drug companies who want to monitor the efficacy of their
field marketing. The catch is that doctors also have to agree to a minimum of
two appointments with a rep per month.
Advertising in the medical press points out
that sending an appraisal via computer should take no longer than three
minutes, equivalent to 300 an hour.
It also says "just two" appointments
every week will net a doctor 1,500 a year, which can be paid directly into
their individual bank account.
If GPreply.net reaches its target of 3,000 GPs,
and each of them agrees to see two reps per week, the total number of rep
visits generated will be 312,000 per year. The industry code of practice, drawn
up by the Association of the British Pharmaceutical Industry (ABPI), prohibits
manufacturers paying doctors to see reps.
Dr Des Spence, who has set up a lobby group
called No Free Lunch to campaign against undue incentives from drug companies
to doctors, said: "I am very uneasy about this. It seems from an
outsider’s point of view to be paying doctors to see reps." Spence, a GP
in Maryhill, Glasgow, said the industry’s marketing guidelines were being
"consistently bent or interpreted in their broadest sense".
He added: "This is how they [the industry]
wield their influence. But all this money is circular. It comes from the cost
of drugs, so that is then passed on to the NHS." Spence called for tighter
regulations on companies to curb abuses. Margaret Davidson, chief executive of
the Scotland Patients’ Association, said: "Blatantly trying to get into
doctors’ surgeries like this is wrong. Not only that, but if doctors see as
many reps as this how are they going to see enough patients? It’s ridiculous."
Shona Robison, the SNP’s health spokeswoman,
said: "I’m very concerned about this. Doctors should see reps from
pharmaceutical companies because they want to know more about the product. Any
financial incentives could raise concerns that the best interests of patients
are not the primary consideration."
The British Medical Association Scotland, which
represents the country’s GPs, declined to comment specifically on GPreply.net.
A spokeswoman said: "We would have no
fundamental objection to doctors taking part in market research or other
similar activities and being paid appropriate sums of money for their time.
"However, the important issue to be
addressed is whether or not GPs’ or any other doctors’ prescribing practices
are inappropriately influenced by pharmaceutical companies. It would not be
acceptable if this were the case."
SRMD Ltd, the company behind GPreply.net,
strongly denied it was aimed at anything other than market research.The firm,
based in Guildford, Surrey, is run by managing director Mike Hawthorne and
chairman Tony Norrington, who both have experience in the pharmaceutical
marketing industry.
Norrington said: "This is strictly a
market research tool. We definitely would not pay a doctor to see a rep because
it’s the feedback that’s important. Research has shown that doctors find seeing
medical reps a valuable source of information."
Norrington, who has worked as a rep in the
past, said the total number of visits to doctors produced by the new system was
"very small" and "absolutely miniscule" compared with the
millions made each year in the UK in total.
He said there had previously been a culture of
offering doctors "freebies", but added: "The profession and the
industry have decided those sorts of things have to stop."
Jim Eadie, director of the ABPI Scotland, said:
"The code of practice for the pharmaceutical industry prohibits company
representatives from paying or offering a fee for the grant of an interview.
Companies can conduct genuine market research in order to obtain feedback from
GPs."
Earlier this year, Scotland on Sunday revealed
that the number of times pharmaceutical companies have been caught breaking the
industry’s own marketing rules has risen by nearly 50% over the past two years.
The Prescription Medicines Code of Practice
Authority, an arm of the Association of the British Pharmaceutical Industry,
recorded 315 breaches of its code of practice in 2001, representing a rise of
48% from 213 in 1999.
Companies have also been accused of inventing
conditions, such as complications of diabetes and female sexual performance
problems, in order to promote new drugs as treatments.
MARKET FORCES
DRUG companies aim to protect their products
against competition from cheaper ‘generic’ alternatives. By law, a manufacturer
is allowed 10 years’ protection for a branded drug under a patent, during which
time competitors are not allowed to produce copies.
Shopping online with Boots the chemists, eight
Nurofen pain relief tablets currently cost 99p. Nurofen is a brand name for
tablets which contain ibuprofen, which is also sold generically. Boots’
own-brand ibuprofen costs 1.20 for 16 tablets. Clarityn, a branded hayfever
remedy containing loratidine costs 4.89 for seven tablets, compared with
own-brand loratidine tablets at 4.39. Prescription drugs show much more
variation. Prozac, the anti-depressant developed by US firm Eli Lilly, can cost
four times as much on the internet as its generic equivalent.
Generic drugs are estimated to save the NHS in
the UK 4.6bn per year. The average cost for a generic prescription is 4.07,
while the average cost of a branded ‘originator product’ prescription is 18.49.
However, manufacturers of brand-name drugs point out that they pioneer the
medicines and pay for years of research and development
.
P/S:
Citer kat atas ni kisah kat UK…. Masalahnya di Malaysia ne ada siapa tak yang pantau???
Jadi
lain kali anda jumpa Dokter tu pandai pandai dan hati hatilah ye..
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