During the period July 1, 2007, through June 30, 2008, drug makers spent close to $3 million on consulting and speaker fees, travel expenses, gifts, and other payments to or for physicians, hospitals, universities and others authorized to prescribe or dispense pharmaceutical products in Vermont, according to the annual report, “Pharmaceutical Marketing Disclosures,” by the state’s Attorney General, William Sorrell.
“The greatest amount of expenditures went to psychiatrists as a group, totaling nearly half a million dollars; one psychiatrist received over $112,000, the greatest amount of pharmaceutical marketing dollars spent on any single person,” the report states.
“The monies came from four pharmaceutical companies, with nearly 92% from one company, nearly 93% in the form of cash or check, and over 90% for speaker fees or payments,” according to the report.
Eleven shrinks made the top 100 recipient list with an average payment total of $43,473. Shrinks also received the highest pay in 2007. Eleven earned a total of $626,379, or about 20% of the total payments made, according to last year’s report.
Keep in mind that Vermont has a population of less than 609,000, according to the US Census Bureau and the disclosures in the report do not include the money spent by drug makers on advertising in TV, radio, or print media.
The top five spenders were Eli Lilly, Pfizer, Novartis, Merck and Forest Pharmaceuticals. Lilly has held the top spender position for 3 years. The report shows that $242,730 was spent on promoting drugs for depression and $217,983 on drugs used for ADHD.
Under current law, the specific amount spent on individual drugs cannot be listed unless the drug maker agrees. But a list in the report shows the top marketing dollars went for Lilly’s ADHD drug Strattera and its antidepressant Cymbalta second. Forest‘s Lexapro ranked fifth and Pfizer’s atypical antipsychotic Geodon held the thirteenth position.
The current prices of these drugs at a middle dose on DrugStore.com are $427 for 100 capsules of Strattera, Cymbalta costs $391 for ninety capsules, Lexapro runs $258 for 90 tablets, and Geodon costs $787 per hundred capsules.
These days, psych drugs are almost always doled out in 2- or 3- drug cocktails under the guise of treating “co-occurring” disorders like maybe ADHD and “treatment resistant” depression, for which antipsychotics are being promoted as an add-on to antidepressants.
A patient diagnosed with ADHD and treatment resistant depression might easily end up taking Strattera, Cymbalta and Geodon. The grand total for a year of these three drugs would bring Lilly and Pfizer roughly $19,260 per patient.
More than 80% of the expenditures analyzed for the Vermont report were designated “trade secret” by the drug companies, making it illegal to release the specific information to the public, according to a press release by the Attorney General.
Thirty-seven of the 78 drug companies making disclosures requested that some or all of their data be listed as “trade secretâ€. The total of payments made by these companies “is $2,427,594.00, which represents 83% of the total payments made during this reporting period,” the report points out.
The Vermont legislature is considering a bill that would eliminate the practice of drug makers claiming payments to or on behalf of specific doctors, or for specific drugs, are protected from disclosure through the “trade secret” loophole.
“Our report could be so much more useful if legislative changes are made,” Attorney General Sorrell said in the press release. “It makes sense that Vermonters be able to see how much, if any, individual doctors are receiving in cash payments and from the manufacturers of which particular drugs.â€
If the law is passed, consumers would be able to look up their doctors and find out what kind of benefits they are receiving and to what extent a drug maker is promoting a certain drug to prescribers. Analysts would also have access to information to help assess whether marketing expenditures are influencing prescribing habits, the press release points out.
The law would ban most gifts to doctors and other health care professionals. Free drug samples, certain scholarships, and payments for academic or scientific articles and journals would not be banned under the bill.
Whether a ban on food will be included is still being debated. In the year covered in the 2008 report, more than 11% of the recipients received over $1000 in free food with one recipient receiving more than $15,000 in free food.
On another front, in April 2009, a federal court upheld Vermont’s Pharmaceutical Data Mining Law as constitutional, against a challenge by data miners IMS Health Inc, Verispan, LLC, and Source Healthcare Analytics, Inc, and the pharmaceutical industry’s trade association, PhRMA.
The lawsuit alleged that the new law violated the right of free speech. The law in part prohibits “regulated entities from selling or using prescriber-identifiable data for marketing or promoting prescription drugs unless the prescriber consents”.
The prescriber-identifiable data (PI) obtained from pharmacies contains details about physicians’ prescribing patterns in terms of the number of prescriptions written and the tendency to prescribe certain drugs. Once the data is compiled by data mining firms, the information is sold to drug companies so that sales representatives can use it as a marketing tool to target individual doctors in promoting new drugs.
“Pharmaceutical manufacturers are essentially the only paying customers of the data vendor industry,” the court states in its opinion. “Put simply, if PI data did not help sell new drugs, pharmaceutical companies would not buy it.”
The Vermont Legislature found that, coincident with the phenomenon of data mining, spending on direct marketing to doctors by the pharmaceutical industry increased by over 275%, the court pointed out.
“Pharmaceutical manufacturers collectively spend close to $8 billion a year to market drugs directly to prescribers, employing thousands of sales representatives,” the opinion notes. The estimated total cost of marketing to “Vermont prescribers approximates $10 million, not including samples or direct-to-consumer advertising,” the court states.
Vermont’s goal in enacting the new law was to contain prescription costs by ensuring that doctors focused on generic alternatives when appropriate. “The Vermont Legislature determined that targeted marketing by sales representatives armed with PI data leads to increased prescriptions for new drugs despite the availability of safe and effective cheaper alternatives,” the opinion notes.
“The Legislature seeks to limit the overprescription of new drugs to lower prescription drug costs and protect patients from unknown risks and side effects,” the court wrote. The Attorney General’s arguments cited in the opinion were that:
“(1) new drugs are not necessarily better than older drugs but are usually more expensive and may pose unknown risks and side effects; (2) detailing is only done for new drugs; (3) PI data is a marketing tool used to make detailing more effective and leads to the over-prescription of costly new drugs; and (4) the law’s restriction on the use of PI data will reduce the influence of marketing leading to reduced prescriptions for new drugs, thereby trimming spending on prescription drugs and promoting public health.”
Dr Meredith Rosenthal testified that “a 1% decrease in prescriptions of new patented drugs that do not yet have a generic bioequivalent, but that do have an adequate generic alternative, would lead to a $2 million cost savings to Vermont,” the court points out.
I should have made the link to your article since Codex Alimentarius eliminates the use of inexpensive natural supplements and is designed by the pharmaceutical industry. In the EU, bottles of supplements now cost hundreds of dollars and contain miniscule amounts of nutrients so no one can afford to buy vitamin E to get any real value from it.
Are you aware of the “food safety” bills in congress which are not at all about “food safety”?
HR 875, HR 814, HR 759, HR 1332 SR 510, and SR 425
They contain the implementation of Codex Alimentarius.
Comment from a reader of one bill:
Well, I’ve gone through the whole bill now [HR 875], and wrote notes totaling 12 pages…
This bill scares the hell out of me.
“The bill is monstrous on level after level – the power it would give to Monsanto, the criminalization of seed banking, the prison terms and confiscatory fines for farmers, the 24 hours GPS tracking of their animals, the easements on their property to allow for warrantless government entry, the stripping away of their property rights, the imposition by the filthy, greedy industrial side of anti-farming international “industrial” standards to independent farms – the only part of our food system that still works, the planned elimination of farmers through all these means.”
Considering the author of the bill, this author’s fear is entirely valid …
Everything that he’s saying is entirely possible, and probable, but in order to get serious attention, his tone should change. It needs to change, because the truth of the first line in the paragraph above goes waaaaaay beyond the surface he’s scratched.
Yes – this bill would be devastating to small farms, and an enormous boon to both Monsanto and Stanley Greenburg. Even if he’s not appointed as the “Administrator of Food Safety,” and someone who didn’t introduce rBGH was installed for political reasons, the bill provides for the hiring of “Experts and Consultants” who receive both a salary and ALL expenses covered while in the Agency’s employ, and the creation of “advisory committees that consist of representatives of scientific expert bodies, academics, industry specialists, and consumers.”
Either of these positions could create a figurehead situation like the Bush/Cheney relationship, leading to Monsanto’s continued growth and influence, and the continued push toward a world where all food is patented. These things are all probable, but unsubstantiated in the language of the bill.
The really scary stuff is in the text of the bill itself, and goes beyond peddling influence to Monsanto.
The really scary stuff is the direct paraphrasing of Codex Alimentarius initiatives opportunistically wedged between seemingly rational improved safeguards for the general public in food production and distribution that will be readily accepted by a populace scared to death by their peanut butter and baby formula. These provisions are dissected into a form that most people won’t have the time or patience to digest, due to incomprehensibility that one gifted in legalese can create when they want certain negative specifics overlooked in deference to the overall facade they wish to be seen.
The most drastic change this bill tries to impose is the re-definition and restructuring of the “Food and Drug Administration,” the FDA.
in the bill’s own words:
“Renaming and Reservation of Agency Identity- The Food and Drug Administration in the Department of Health and Human Services is hereby renamed the Federal Drug and Device Administration and may be referred to as ‘FDA’.”
I find it pretty sinister, completely revamping the direction of a well known agency, yet keeping the acronym exactly the same, leaving unwitting people to assume that nothing’s changed…
there’s also a provision that automatically transfers previously registered food related businesses under a recognized, long-standing code of law to the restrictions and responsibilities of this bill:
“(C )Transitional Provision- During the 6-month period following the date of the enactment of
this Act, a food establishment is deemed to be registered in accordance with this section if
the establishment is registered under section 415 of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 350d).”
So this bill, if passed, automatically registers unwitting farmers and processors to its provisions without notice – there’s got to be something illegal in that – basically shifting restrictions and responsibilties from one contract to another without consent.
…This change brings all kinds of new areas under their jurisdiction, from surveillance of businesses and livestock, to the main crux of the fear of Codex standards being implemented – a complete and total revamping of what can be labeled as a “contaminant.”
Previously, dietary supplements, such as vitamins and minerals, couldn’t be regulated by the FDA. Under this bill, a food-borne illness outbreak is defined as:
“the occurrence of 2 or more cases of a similar illness resulting from the ingestion of a common food.”
Now, those things that cause an “outbreak” are considered “contaminants.”
both vitamin c and magnesium can cause diarrhea in some people at currently acceptable dosage levels. Magnesium will do it to almost anyone if they take the entire current RDA (500 mg.) at the same time. If two people get diarrhea from either of these substances, their status as “contaminants” will be cemented, putting them under the regulation of these agencies under DHHS.
More on the contaminant thing…
The bill states that the Administrator of Food Safety only has to come up with a list of “contaminants” they will regulate SIX MOTHS AFTER enactment of the bill. This means that congress will have a bill in front of them that every fan of peanut butter will want passed from its name alone, yet not have any idea what this person, (be they an employee of Monsanto, or a pharmaceutical company, or a tobacco executive, or a health-food guru,) intends to regulate or outlaw. Codex specialists insist that codex will eventually implement a Napoleonic code of what we’ll be allowed to consume. This sure sounds like a beginning of that to me.
back to the “outbreak” issue…
the bill constantly focuses on what it calls “specific categories of consumers” like in this section:
“(B ) Comprehensive Analysis- The program shall be based on a comprehensive analysis of the
hazards associated with different food and with the processing of different food, including
the identification and evaluation of–
(1) the severity of the potential health risks;
(2) the sources of potentially hazardous contamination or practices extending from the farm
or ranch to the consumer that may increase the risk of food-borne illness;
(3) the potential for persistence, multiplication, or concentration of naturally occurring
or added contaminants in food;
(4) the potential for hazardous contamination to have cumulative toxic effects,
multigenerational effects, or effects on specific categories of consumers;
(5) opportunities across the food production, processing, distribution, and retail system to
reduce potential health risks; and
(6) opportunities for intentional contamination of food or food ingredients”
now earlier in the bill they refer to a few “specific categories of consumer” as babies, the old, or the infirmed, (I’m assuming here that “infirmed” encompasses the immuno-compromised.)
so if any two people in these groups are negatively affected by any “ingestion of a common food” that product, and anything in it becomes a potential “contaminant” subject to regulation or dis-allowance.
so if two AIDS patients drink raw milk from the local Amish farm, and get sick, everyone at the farm is now liable both civilly (crushing their livelihood) and criminally – punishable with up to five years in a non-mortal case, and ten in a case where someone were to die. Not only that, but then raw milk would be federally regulated (kind of like a controlled substance,) or outright outlawed.
This bill, as the author of the article above states, can mandate treatments for crops and livestock that it deems necessary to prevent contamination, such as mandating which products are acceptable to do so – I’m sure DOW lobbyists are squeeling with delight for the prospects of the new toxic pesticides they’re developing…
You may think that all this regulation and oversight may pertain solely to those who distribute food as a business, but no – this pertains to your home garden. There’s a provision that demands:
“a comparison of the safety of commercial processing with the health hazards associated with food that is harvested for recreational or subsistence purposes and prepared noncommercially…”
so at some point in the near future, if you grow your own food, you may be required by law to spray it with round-up.
All in all, I haven’t seen a more devastating attempt at infringement on an individual’s personal way of life than the USAPATRIOT act. This must be stopped… at all costs.
Mostly opinion if you ask me
Sorry, typo..I do NOT use pesticides…I like to use baking soda a lot along with vinegar. It cleans and shines most everything, deoderizes and kills bacteria. I use it to wash my fruits and vegetables too..it's excellent for keeping drains open, and smelling clean. I don't think I've ever had to call a plumber or use any of the harmful drain cleaners to unclog a drain.If you've never tried it, just shake some baking soda into the drain, pour a cupful or so of vinegar on top and watch the volcano erupt..my grandkids think it's fun to watch..lol..I repeat this until the foam is not dingy looking and rinse with clear water.
Hi Peggy,
Thanks for your comments–and I'm with you on the vinegar and baking soda. Definitely look into the bill and let us know your thoughts. Since you talk about food supply (following reader Carl's comments), you may want to check some of the foodborne illness stories on lawyersandsettlements.com as well.
I heard something about this on NPR (I think it was that channel) but now that I’ve read the above post I will definitely check into the Bill myself, form my own opinion & if I find that a major company ( Monsanto) is bscking the bill and do not like what I read, you can believe I will yell it out to my email pals, my Reps, as well as the Whitehouse and Pres Obama.
We do not need big businesses running our country!! Especially when I do use pesticides, do not like the harm they are doing to our beloved country, world actually, and can see nothing but harm come to all of us if a company that is all about toxic chemicals is left in charge of our food supply. We all need to start paying closer attention to what is going on in Washington and speak up when there is a need.