APA Under the Influence

APA Under the Influence of PhaRma

June 5, 2002

FYI

Reporters who attended the 2002 annual convention of the American Association of Psychiatry / PhaRma have had a rude awakening about the scope of industry’s influence. Essentially, psychiatrists are drug marketers for industry, helping to create blockbuster sales:  

Even doctors who say they understand marketing are uncomfortable with the amount. Galen Stahle, a Minneapolis-area psychiatrist who said he writes millions of dollars’ worth of prescriptions each year, said he was offered a trip to Hawaii after one APA convention. “It’s getting pretty corrupt, I think,” he said. “I don’t know if it’s short of bribery or if it is bribery.”

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May. 23, 2002

Drug companies attend psychiatrists’ meeting in hopes of doing big business

<spanstyle=’font-size:11.0pt;font-family:Arial’>BY STACEY BURLING

<spanstyle=’font-size:11.0pt;font-family:Arial’>Knight Ridder Newspapers

<spanstyle=’font-size:11.0pt;font-family:Arial’>PHILADELPHIA – (KRT) – The American Psychiatric Association convention drew 14,000 doctors to Philadelphia this week.

<spanstyle=’font-size:11.0pt;font-family:Arial’>It also attracted about 4,000 representatives from pharmaceutical companies.

<spanstyle=’font-size:11.0pt;font-family:Arial’>With slick exhibits, parties and posters, the drug companies made the most of the chance to market their wares directly to the doctors who write the prescriptions that sell the drugs.

<spanstyle=’font-size:11.0pt;font-family:Arial’>Jeffrey Bedrick, a psychiatrist at Mount Sinai Medical Center in New York City, said he turns down pricey dinners offered by the drug companies but attends some lectures they sponsor because he finds them interesting. He believes he can see the bias and the attempts to influence, but he also has a nagging doubt voiced by several convention-goers: There has to be a reason the drug companies spend so much money at these meetings.

<spanstyle=’font-size:11.0pt;font-family:Arial’>”I’m convinced I can filter it out,” he said wryly, “but apparently, they’re convinced I can’t.”

<spanstyle=’font-size:11.0pt;font-family:Arial’>Signs of the intense competition for psychiatrists’ attention were everywhere. Eli Lilly & Co. welcomed the doctors to town with billboards at 30th Street Station and the airport. “Our hometown, the birthplace of modern psychiatry,” proclaimed an ad for Paxil near the tolls on the Admiral Wilson Boulevard in Camden. A Phlash bus carried another ad for the same antidepressant. Bristol-Myers Squibb advertised on a Greyhound bus collecting passengers at the Convention Center.

<spanstyle=’font-size:11.0pt;font-family:Arial’>Inside the center, an army of young, attractive, well-dressed and well-trained sales reps roamed the Exhibit Hall, which was filled with discreetly labeled freebies – your picture on a blues CD (Forest Laboratories), your picture with the founding fathers (Wyeth Pharmaceuticals) – and sleek, expensive exhibits. Three drug companies offered high-tech ways to experience schizophrenia. There were 3D stereoscopic visions of bipolar disorder and depression, a 3D film on what it’s like to be an insomniac, and the “ADHD virtual challenge.”

<spanstyle=’font-size:11.0pt;font-family:Arial’>The gray shoulder bags given to all conventioneers carried the GlaxoSmithKline logo. Television monitors were tuned to APA News Net. “Watch it in your room,” the signs said. “Brought to you by Wyeth, maker of venlafaxine (Effexor).”

<spanstyle=’font-size:11.0pt;font-family:Arial’>Drug companies sponsored well-attended breakfast and dinner symposiums on treatments. They bused conventioneers to the Art Museum, the Kimmel Center, and Electric Factory concerts. AstraZeneca sponsored a speech Tuesday by Tipper Gore.

<spanstyle=’font-size:11.0pt;font-family:Arial’>Such drug-company visibility is not unusual at a medical meeting. Psychiatrists, who used to rely primarily on talk therapy but now frequently use a wide variety of drugs, have mixed feelings about pharmaceutical marketing.

<spanstyle=’font-size:11.0pt;font-family:Arial’>Several at the meeting said the drug companies produce high-quality information they and their patients find useful. They felt competent to ignore the spin and focus on the facts.

<spanstyle=’font-size:11.0pt;font-family:Arial’>Jodi Star, a graduating psychiatric resident from the University of Cincinnati who attended the meeting as an “AstraZeneca fellow,” said her schooling has emphasized how to “analytically review an article.”

<spanstyle=’font-size:11.0pt;font-family:Arial’>”Because we’ve learned these skills, I can take everything they say with a grain of salt,” said Star, who said she appreciates free samples companies give her for indigent patients.

<spanstyle=’font-size:11.0pt;font-family:Arial’>Even doctors who say they understand marketing are uncomfortable with the amount. Galen Stahle, a Minneapolis-area psychiatrist who said he writes millions of dollars’ worth of prescriptions each year, said he was offered a trip to Hawaii after one APA convention. “It’s getting pretty corrupt, I think,” he said. “I don’t know if it’s short of bribery or if it is bribery.”

<spanstyle=’font-size:11.0pt;font-family:Arial’>In response to the concerns, the APA labels drug company-sponsored events and segregates them at the beginning and end of each day. In its program, it ran 12 pages in small type listing presenters with connections to drug companies.

<spanstyle=’font-size:11.0pt;font-family:Arial’>All presentations are peer-reviewed for bias and scientific merit, said Philip Muskin, chair of the scientific program committee. Paid monitors attend all the industry-sponsored symposia and rate them. Speakers are required to disclose their company connections.

<spanstyle=’font-size:11.0pt;font-family:Arial’>Whatever the qualms some may have had, the Exhibit Hall was often crowded this week. Long lines snaked through the Pfizer area to meet Sylvia Nasar, author of “A Beautiful Mind, and receive a free, signed, hardback copy of her book. Pfizer also brought in Kathy Cronkite to sign her book on depression and John Bayley to give away his book – “Elegy for Iris” – on his wife, the writer Iris Murdoch, and her descent into Alzheimer’s disease.

<spanstyle=’font-size:11.0pt;font-family:Arial’>Some of the drug-company exhibits were unquestionably interesting. A high point was “The Bus Ride,” a chance to feel schizophrenic for four minutes, offered by Janssen Pharmaceutica, maker of Risperdal, a drug for treating schizophrenia. The “bus” is four yellow pyramid-shaped modules. The multimedia program that participants see was designed with the help of a group of people who suffer from schizophrenia. “Riders” sit alone on a bus seat in the module and watch screens showing the front and side windows and the driver’s rearview mirror. They are on a trip to – where else? – the pharmacy. Unfortunately, they’ve gone too long without their medication.

<spanstyle=’font-size:11.0pt;font-family:Arial’>As the bus begins to move, the rider hears voices from all around. It’s difficult to separate one voice from the others. A biker appears beside the bus and says, “Hey, you, get off the bus now.” The driver loudly says, “You have God-given rights,” then morphs into a young woman who says, “Hi. Welcome back. Are you having a nice ride today, Your Highness?” The bus appears to veer and the street looks distorted. Eventually, it arrives at the rider’s stop. “Hey, you don’t look so good,” the driver says. “Maybe you should have gone to that pharmacy sooner.”

<spanstyle=’font-size:11.0pt;font-family:Arial’>Lilly’s competing “Journey of Hope” takes one through a tunnel with different stops in a young schizophrenic’s life. The tunnel, which works in English, French, German, Italian, Japanese and Spanish, shows the man’s growing paranoia and estrangement. At the end, though, he’s doing much better, after forming a “therapeutic alliance” with the doctor who prescribed Zyprexa, Lilly’s drug.

<spanstyle=’font-size:11.0pt;font-family:Arial’>Is this is what it takes to stand out from the competition? Marni Lemons, a Lilly spokesperson, said: “Certainly, we’re aware that we have a number of other companies here at the APA with whom we compete for a share of voice, but we’re just interested in doctors having a chance to get a real feel for what it’s like to have schizophrenia.”

<spanstyle=’font-size:11.0pt;font-family:Arial’>—

<spanstyle=’font-size:11.0pt;font-family:Arial’>© 2002, The Philadelphia Inquirer.

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