Sch-Merck, When Combined, Would Make An[other] Awkward "Top Ten" List. . . .

Due largely to the timing of the publication, I imagine, it seems no one at the Center for Public Integrity thought to aggregate the historical Organon data, with the Schering-Plough data, and then add in the Merck data -- when calculating their "Top Ten List", at right.

So I've helped them out. Sch-Merck would be No. 8, or No. 10 (depending on whether one orders the list by number of sponsored trips, or aggregate dollar value of sponsored trips). They did catch the Pfizer/Wyeth combination, though. Cool.

This story speaks volumes about the need for health-care reform in the United States. To be fair, it appears that the bulk of this money was spent prior to mid-2007, when the toughened PhRMA Guidelines first really hit the radar screen -- with updated effectiveness, January 1, 2009. It is an important story, nonetheless -- so do go read it all. Kudos to publicintegrity.org (with an able assist from the Meddill School of Journalism at Northwestern University)!

Military Doctors, Pharmacists Took 8,700 Trips
By M.B. Pell, Aaron Mehta | June 09, 2009

. . . .These were among 8,700 trips by Department of Defense personnel paid for by the health care industry — at a cost of more than $10 million — from 1998 through 2007, according to an analysis by the Center for Public Integrity. In a joint project with Northwestern University’s Medill School of Journalism, the Center examined 22,000 travel disclosure forms filed by DOD personnel, and found that the medical industry was by far the biggest sponsor of free travel, accounting for about 40 percent of all trips. The sponsors included not only drug and device makers but also health foundations and trade groups often funded by those companies. . . .

. . . .Often physicians do not even realize the company is manipulating them.

"The return on dividends is phenomenal," [a former Lilly sales & marketing person] says. "If it costs them a thousand dollars for a dinner, that’s a [patient’s drug] payment for one month. If they fly you on the Concord to Paris for five grand, even if they get one patient out of it, it’s a lifetime of cash. . . ."


A $6 Billion Drug Market

Of special interest to the industry were DOD employees who prescribe, purchase, or recommend the use of drugs or medical equipment. Drug companies and device manufacturers spent about $1.7 million for more than 1,400 trips taken by DOD doctors, medical researchers, pharmacists, and other health care employees over the decade, creating relationships that pose serious conflict of interest issues, according to medical ethics experts. From 2000 to 2006, the DOD prescription drug budget ballooned from $1.6 billion to more than $6 billion a year. . . .

. . . .Ethics experts say the reason is obvious — gifts from drug companies affect the decisions of pharmacists. "They pay for them because it works," asserts Thomas Murray, president of the Hastings Center, a nonpartisan bioethics research institute. "Trust me, their marketing departments are paying very close attention to cost benefit analysis for these kinds of gifts. . . ."

Indeed -- from first-hand experiences, I can certainly affirm the above.