Drug Pushers

Herewith is an article entitled, No Free Lunch,written by a Capizeno which was distributed during the graduation ceremonies of the College of Medicine, University of the Philippines, Diliman, Quezon City, May 19, 2006. It's a good piece of work reflecting some insights on the high cost of medicines in Philippines...

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No Free Lunch
By Raoul A. Bermejo III, M.D.
Email comments to rabermejo@yahoo.com


I am writing this because I am bothered by the fact that our class graduation party was largely paid by a drug company. I heard they had foot the bill of P150,000 pesos for dinner.

Let us be honest and clear about it. It was a party. It was not a scientific meeting.. It was not a course of continuing medical education. People went there to eat, drink and be merry.

I am bothered that our class allowed it. It is patently a marketing scheme from the drug company and our class fell for it. Many feel that they are above the issue thinking they can personally resist being swayed by all these marketing schemes. I think it is quite naïve. Let us not be in denial. Drug companies utilize these schemes because they work. Clear evidence has shown that physicians’ behavior in prescribing medication is affected by these enticing efforts of drug companies.

Where is the marketing money of drug companies coming from? Let us also reflect on this question. Do you really think it is really out of their goodness in their heart? Or their fondness of physicians? Marketing costs are really passed on to the consumers; they are passed on to our patients. Costs from maintaining an army of cute and dapper medical representatives, and costs of cups of coffee, rounds of golf, lunches, tours and various freebies that physicians accept, these contribute to the high prices of medications in the country. While we enjoy freebies; let us reflect on the fact that they come from the pockets of our patients, many of them are poor and could hardly afford the complete course of medications we prescribe.

Drug prices in the country are as much as it is in Western Europe, the U.S. and Canada. Our country, having no real drug industry of its own, it is one of the favorite playgrounds of three big pharmaceutical firms. They are now challenging even the band-aid effort of our government to make essential drugs accessible to poor Filipinos though parallel drug importation.

Will making a stand now against an unethical practice really change the situation? Our small daily choices may seem minute to make a dent on what seems to be a much ingrained practice. But how do we expect the situation to change? Who will make that stand if not us now? Our collective stand will matter and will make a change.

There is no such thing as free lunch. Or a free graduation party.


Resist the temptation. Say NO to pharma freebies.

The issue of cost…

Ø Drug companies are spending more than twice as much on marketing, advertising, and
administration that they do on research and development
Ø Drug company profits, which are higher than all other industries, exceed research and development expenditures;
Ø Drug companies provide lavish compensation packages for their top executives.

The issue of ethics…

“Any gift accepted by physicians individually should primarily entail a benefit to patients and should not be a substantial value."
– AMA Council of Ethics and Judicial Affairs JAMA 1991; 261:501

Independent of any ethical repercussion, accepting gifts from drug companies has major effects:

1. Gifts cost money, and these costs are passed on to patients.
2. Physicians’ acceptance of gifts may contribute to the erosion of the image of the medical profession (and that it may be acting in other than the patient’s best interest)
3. Acceptance of gifts establishes a relationship between the giver and the receiver; acceptance of gifts creates a strong need for reciprocation on the part of the recipient. It is a from the latter that the conflict of interest arises.
Chren, et. al (JAMA, 1989; 262:3448-34451)

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"I, _____________________________ , am committed to practicing medicine in the best interest of my patients and on the basis of the best available evidence, rather than on the basis of advertising or promotion.

I therefore pledge to accept no money, gifts, or hospitality from the pharmaceutical industry; to seek unbiased sources of information and not rely on information disseminated by drug companies; and to avoid conflicts of interest in my practice, teaching, and/or research.”


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