It was doctors' night out last June at the world-renowned Museum of Modern Art in New York City, and the Saturday night party, put on by Pfizer Inc., was lavish.
The event was strictly private, closed to reporters, as the pharmaceutical company entertained a very select list of doctors and their guests. But Primetime's undercover cameras saw the kind of big-money splurge that some say drives up the cost of prescription drugs and corrupts the practice of medicine.
Further investigation into the $6 billion spent by drug companies for what they say is a way to educate doctors showed that tactics like lavish gifts and trips are surprisingly common.
"It's embarrassing, it's extravagant and it's unethical," said Dr. Arnold Relman, a Harvard Medical School professor and the former editor of the New England Journal of Medicine. "It makes the doctor feel beholden … it suborns the judgment of the doctor."
But doctors seemed thrilled to have been invited for a weekend in New York City with some seminars along the way, with all expenses paid by Pfizer on behalf of one of its drugs, Viagra.
One Small-Town Doctor: $10,000 in Goodies
Few doctors were willing to talk publicly about their relationships with pharmaceutical companies, but one upstate New York doctor was willing to come forward.
"It's very tempting and they just keep anteing it up. And it's getting harder to say no," said Dr. Rudy Mueller. "I feel in some ways it's kind of like bribery."
Disgusted by how the free gifts and trips add to the high price of medicine, and moved by the plight of patients forced to skip needed medication, Mueller agreed to provide Primetime with a rare glimpse of the astounding number of drug company freebies he was offered by various drug companies in a four-month period.
He was presented with an estimated $10,000 worth, including an all-expenses-paid trip to a resort in Florida, dinner cruises, hockey game tickets, a ski trip for the family, Omaha steaks, a day at a spa and free computer equipment.
"It changes your prescribing behavior. You just sort of get caught up in it," said Mueller, who said he was offered a cash payment of $2,000 for putting four patients on the latest drug for high cholesterol. The company called this a clinical study; Mueller called it a bounty.
"I've never been offered money before," he said. "I don't remember that 10, 15 years ago."
Though Mueller normally declines the offers, he agreed to attend a dinner, which Primetime secretly taped. Not only were the doctors wined and dined, but each was also offered a payment of $150 for just showing up to listen to a pitch for a new asthma treatment for children.
The company called it "an honorarium," but Mueller saw it differently. "Again, it's bribery," he said. "This is very effective marketing."
There's a wide range in value of the free gifts offered to doctors — from lavish trips to free Mother's Day flower bouquets for doctors willing to hear a pitch about a new osteoporosis medicine.
In the latter example, when asked whether a floral shop was the most effective place for a discussion on pharmaceuticals, one of the representatives said, "I'm sorry, we're not allowed to comment on anything."
The goodies are dispensed by an army of drug company representatives known as detail men and women, of whom there are 82,000 nationwide.
It's the job of the detail people to quietly befriend doctors, keeping close track of which doctors take the free gifts and then determining which drugs the doctors later prescribe.
"I think it's sleaze," said Relman. "Anybody who's been in that position knows that yes, those gifts, $60, $100, $40, again and again, do influence your attitude about that company … and will influence the prescriptions that you write."
And the multibillion-dollar drug company blitz extends throughout the profession, even at the yearly gathering of one of the most prestigious medical groups, the American College of Physicians. It was like a carnival: Doctors could be seen taking free massages, free food, free portraits, free Walkman players, free basketballs, and from one company pushing a new antacid drug, free fire extinguishers.
Many doctors say it's no different than any other business or convention, and that it doesn't affect their medical judgment. But that's not the view of the new president of the American College of Physicians, Dr. William Hall, who says anything beyond a pen or a mug could have an impact.
"Whether we like it or not, it can cloud our clinical judgment," he said. "Unequivocally, I would say that."
So why are some of the very practices Hall publicly criticizes permitted at his group's supposedly scholarly convention? "I think there it's a situation where every physician is going to have to balance what's right or wrong," said Hall.
"We are concerned about it.," he added, saying that at some point the system may be changed.
But right now, Hall's group receives $2 million a year from the drug companies to have their exhibition booths at the convention, yet another example of how the big drug companies spend billions to influence doctors in this country.
"The basic mistake we're making with our health-care system now is that we regard it as just another business. And it's clearly not just another business. Patients, sick patients and worried patients, are not like ordinary consumers," said Relman. "Doctors ought to be incorruptible … That's the doctor's sacred obligation. They're being corrupted and undermined by this kind of salesmanship."