Do Free Gifts Dictate Your Medical Care?

Some doctors say drug sales practices cross line. Do they affect patient care?

ByABC News
March 20, 2008, 2:12 PM

March 29, 2008— -- A peek into the office of Dr. Jeffrey Caren reveals he's not only a cardiologist, but also a collector of pop art.

Over the years, the Los Angeles doctor has amassed more than 1,000 pens given to him by pharmaceutical sales representatives who come to push their products. Displayed prominently in his office, Caren said his pillar of pens illustrates an institutional practice in which drug reps make the case for expensive, newer products that haven't been broadly tested, potentially risking patient health.

"I started collecting pens about six years ago when I noticed how many pens I was getting on a weekly basis," said Caren, a cardiologist at Cedars-Sinai Medical Center. "I think the purpose of the small gift is something that's in your hand all the time. And it's more subliminal. That, you know, I'm holding a Lipitor pen and I'm thinking 'Lipitor.'"

Watch Lisa Stark's report on pharmaceutical sales representatives tonight on "World News." Check your local listings for air time.

Doling out pens, coffee cups, clocks and free drug samples, drug companies spend about $7 billion a year to convince doctors to prescribe their medicines. The pharmaceutical industry says its sales reps arrive well-informed and with good intentions, but many doctors say the practice is dangerous and needs to stop.

"The information that drug representatives give to physicians is never objective," said Adriane Fugh-Berman, associate professor in the department of physiology and biophysics at Georgetown University. "Drug reps are trained to emphasize the benefits of their drugs, trivialize any risks, and to emphasize the shortcomings of competing drugs."

But representatives follow strict guidelines on gift giving and sales pitches, according to Marjorie Powell, senior assistant general counsel for the Pharmaceutical Research and Manufacturers of America.

"The pharmaceutical representative's job is to make sure the doctor knows what the medicine can be used for, when it should be used, and the patients for whom it should not be used," Powell said. "They are conveying medical and scientific information to the physicians and to the other people in the physician's office. And, yes, they are there to sell a product, but they do that by conveying medical information."