BMJ  2004;329:10 (3 July), doi:10.1136/bmj.329.7456.10-a

News

Drug marketing practices come under scrutiny

Florida

Federal prosecutors have issued subpoenas to several drug makers, including Johnson and Johnson, Wyeth, and Bristol-Myers Squibb, as part of an investigation from Boston, Massachusetts, into a pattern of financial incentives that the major drug makers have used to persuade doctors to favour their drugs.

The action comes after a number of doctors revealed the ploys allegedly adopted by the various companies.

One doctor—who wishes to remain anonymous because he wants to avoid involvement in a federal probe of major drug companies—said he threw away an unsolicited cheque for $10000 (£5500; 8200) from Schering-Plough. The doctor said the cheque arrived in the mail from the company in exchange for an attached "consulting" agreement that required the doctor's commitment to prescribe the company's products.

Schering-Plough paid doctors between $1000 and $1500 for each patient for prescribing its drug Intron A (interferon alfa-2b, recombinant) for hepatitis C. A one month course of treatment of the drug costs approximately $500. In return for the payments doctors were expected to collect data on their patients' progress.

Six specialists in liver disease said Schering-Plough paid "consulting fees" to doctors to keep them loyal to the company's products. The letter accompanying a cheque for $10000 explained that the money was for consulting services that were detailed on an accompanying "Schedule A," said a doctor who also insisted on anonymity. But when the doctor turned to the attached sheet, he said, "Schedule A" were the only words printed on an otherwise blank sheet of paper.

Two top executives at Schering declined to comment, but Fred Hassan, chief executive officer since April 2003, said Schering has overhauled its marketing to eliminate inducements.

Experts on the drug industry say the federal enquiries into Schering-Plough and other big drug makers have led some companies to adopt major changes in the way they market drugs to doctors.

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