I just got back from the doctor's office, and witnessed another . . . what to call it? Visitation? Haunting? Bout? Infestation?
They dress in the finest business couture
, sporting expensive accessories and finely-coifed hair. From a cursory appraisal only, some bear the looks of further, more surgical enhancements. They are happy to pick up bits of fallen crap in the waiting room, or help move file boxes behind the counter. They always smile. You can see this last duty can sometimes hurt their faces. They always come bearing gifts. Always.
They are the Pharma-Barbies.
Pharma-Barbies (and the lesser-seen male version Pharma-Kens) work as local representatives for large pharmaceutical companies extolling the virtues of the various unguents, polstices, compounds, capsules, pills, and et cetera ad infinitum ad nauseum
produced by pharma large and small. They make mostly weekly rounds, driving within their clearly defined boundaries and chatting up doctors at local offices, promoting, begging, wheedling, doing anything necessary to somehow convince the docs to prescribe goodies found exclusively in the company's pharmacological cornucopia. Since the only way behind the counter is through the reception desk, they never treat receptionist with anything but cheery goodness, bringing coffees, lunch coupons for the whole office, tickets to dinners (provided the doctor also attend), even dropping (and I witnessed this twice, once today and once yesterday) gift-wrapped designer chocolates right on the desk alongside the sample stacks. These same samples, given freely to doctors without obligation, in some cases cost needy, uninsured patients hundreds of dollars a month.
You see, Dear Readers, pharmaceutical companies have a dirty secret. Remember the health care dog-and-pony shows the senate or the house or something conducted a few years ago investigating the staggering cost of prescriptions? Remember the various representatives of "big pharma" testifying as to the astronomical costs involved in developing any given drug, "from a low of $800 million to nearly $2 billion per drug
?" Well, perhaps those "development costs" should be clarified. "Development" includes the cost of developing the market for a drug
That's right, folks. Every new drug budget includes advertising and marketing costs, everything from the money paid to inundate the airwaves for the latest purple, boner or hair-growing pill, to the snacks, treats, goodies and other effluvia flooding doctors far and wide.
Things used to be worse, according to a little chat I had with my doctor today. (He's chatty and easy-going. We talk about his college days working on halibut boats and mine on more local craft, about the news, the weather, whatever. He's pretty cool.) Doctors in high-volume and high-end offices (read: lots of money-bearing patients) used to get all-expenses-paid Caribean vacations sponsored by Big Pharma. When the gov clamped down on this more obvious graft, they shifted to sponsoring "continuing education seminars," meetings where doctors could listen to experts in various medical fields talk about their research. I "attended" several of these myself when I captained and crewed passenger boats. These seminars most often featured generous buffets and open bars. They tucked the speaker in a corner with a mike so those actually interested in what he or she had to say wouldn't get in the way of the free Pharma party -- always, always, always hosted by a smiling, convivial, and very well-proportioned Pharma Barbie.
How wide-spread is this high-heeled boots on the ground marketing system? A few years ago, I accompanied my wife to our doctor's office and waited for her to finish her appointment. I saw three different representatives go in and out of the office in the hour and a half I warmed the waiting room chair. At one point I nearly lost my lid when the receptionist informed a rep that she was the second PhB to visit that week
. (One rep usually visits once a week, a limit established by the docs themselves.) Imagine, if you will, the money needed to:
Buy PhB outfits;
Pay for a PhB convertible;
Pay for a PhB Dreamhouse;
Pay for the Starbucks and Godiva presented at every visit;
Pay for the lunches, dinners, picnics, cruises and other goodies;
Pay for the coffee cups, note pads, post-its, pens and other swag dumped on the receptionists, all emblazoned with the Pharma logo and Pill of the Week;
TIMES TWO!!! PER DOCTOR!!!
I got so worked up and mad mentally compiling this figure, staring at the (in this case) overlapping Pharma-Ken in his expensive suit who was at that moment sucking up to the receptionist by picking up toys a waiting child had scattered . . . I freaked out one of the doctors. He walked into my wife's exam room and mentioned there was some evil-looking and threatening bus driver (I was still in uniform) in the waiting room, and that he was thinking about calling the cops. I guess I have an expressive face.
I guess I'm not the only one steamed at the system. You see, pharma supply drugs to the local drug stores. The stores pass on information about which doc writes each prescription. This info is passed down to the reps along with a goal for those reps to improve those sales figures. Reps are paid by commission, so the more pills they can push through the docs, the more they get paid. . . no matter whether the drug is needed or not
. Today the doc told me they (my doc and the other doc at the same practice) sometimes have to ban individual reps that get too pleading, clinging and whiney. A few years ago they banned reps altogether. They allowed them back only because the free samples are awfully handy. Doctors can give a couple different drugs to patients without charge so the patients can see which drug -- each from a competing pharma company and pushed by a different PhB -- works best for them.
He also mentioned he and about 90% of his colleagues would love
a nationalized health care system. It would eliminate the swarms of PhBs, the hassles he has fighting with insurance companies, the ensuing paperwork generated by those hassles, the whole nine yards. He could actually spend his time at the office doctoring
. What a concept.
Until then, however, be aware, Gentle Readers, of the tricks Big Pharma has to inflate their "development" dollars. Remember the bevy of bouncing, er, personalities, and the treats they bear paid for by these "development" dollars, and think of how much less you might have to spend on pills or -- if you are so blessed -- the insurance necessary to get said pills. Do as I do, if you have a mind, and tell your doctor that you will not swallow any non-generic drug (generics are older drugs whose patent protections have expired, and are therefore not promoted in marketing).
Or go further. Pressure congress to pass legislation. Perhaps they can strengthen HIPA legislation and forbid drug stores from revealing which doctors actually write prescriptions. This double-blindness would greatly reduce the pressure individual docs currently receive. Also, laws could require Pharma to specify how "development" costs are spent, itemizing every line on the budget and publishing that info. I would be very curious to know exactly what portion of the billions spent yearly go to television ads I have to skim through or receptionist chocolates doled by Those That March In High Heals. I must assume that many folks out there are completely unaware of this loophole and would be equally galled to know the real dollar amount of crap wrapped in the cost of every capsule we must swallow.