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Study shows most doctors endorsing drugs on X are paid to do so

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Re: Study shows most doctors endorsing drugs on X are paid to do so

#71

Doctors who fail to disclose an interest should lose their license. The SEC doesn't tolerate such shenanigans for finance, why should the FDA permit it for drugs?

Isn't the very fact a doctor is on social media saying how great a drug is a giant flashing sign that they are being paid to do it?

Re: Study shows most doctors endorsing drugs on X are paid to do so

#72
post #67

Earlier quoted context omitted.

This is the bad kind of statistic, because it doesn't actually tell us anything interesting about the impact on individual doctors (but does sound scary / impressive!). A Google search says the US has 1 million doctors, so $12B over 10 years is $12k/doctor/year on average - nice, but not wow... The linked article did actually have something useful to say on a per-doctor basis:"The analysis showed that more than half…

Does one not suppose that a fair bit of this is the trial and starter doses that they give to doctors? Surely the drug company values them at list price for purposes of a business expense.

Free samples aren't include. Look up the Sunshine Act, it's only direct payments to doctors.

But this can include things all the way from doctor getting $250 for spending 60 min consulting for a company (i.e. answering questions about how they treat a disease, what they look for in a new drug) to a doctor leading multiple speaking engagements throughout the year and making tens of thousands.

Re: Study shows most doctors endorsing drugs on X are paid to do so

#73
I'm confused that people have at the same time deep suspicion and also unwavering trust of drugs companies, depending on the story.

In most cases people are suspicious of pharma corruption & recklessness. Yet in a few contexts, for example with vaccines and psych meds , any criticism is deeply stigmatized. Critics are even slandered as backwards.

Why the paradox? I think a healthy dose of suspicion all around is warranted given their track record, plummeting healthfulness and the stakes at hand.

Re: Study shows most doctors endorsing drugs on X are paid to do so

#74
post #15

Earlier quoted context omitted.

You can search the database they used: https://openpaymentsdata.cms.gov/ I can’t find Huberman, but it does look like Peter Attia [1] was payed $300k by Dexcom for consulting services. Dexcom makes continuous glucose monitors that Attia has repeatedly mentioned on the show. It looks like there’s even an episode where he interviews the CEO, although this happened before the payment [2]. This website [3] links his NPI…

It’s worth highlighting that Peter starts every podcast by stating that his conflicts of interest can be found on his disclosures page: https://peterattiamd.com/disclosures/ He’s done so since the start of his podcast. In checking, Dexcom is clearly listed as a company he advised during the period listed on Open Payments.

Right I guess this didn't require sleuthing. This does display how large the payments were tho, if that makes any difference to someone.

Re: Study shows most doctors endorsing drugs on X are paid to do so

#75

Earlier quoted context omitted.

...are drugs and surgeries not healthcare?

Eating right is health care. Exercise is health care. Decent housing is health care. Drugs and surgeries are medical care and I grew up with the weird idea that it's crisis management, not your first line of defense while acting like diet and lifestyle are annoying details you can stop worrying about if you can get the right prescription.

The idea that if we had a safe drug that made people lose weight (we don't) we shouldn't immediately give it to all fat people without a lecture, borders on a religious belief about virtue. That case could be made for not giving insulin to diabetics or bronchodilators to asthmatics.

If there were a safe drug that can make people lose weight and put on muscle, I'd be actively telling people not to exercise unless they enjoy it. It's bad for the joints.

Re: Study shows most doctors endorsing drugs on X are paid to do so

#76
post #45

While non-disclosure by doctors prescribing drugs they profit from is unethical, I would be interested to know if doctors change which drugs they prescribe if when paid by different pharma companies ie are doctors recommending the drugs because they are being paid or are they just being paid because they recommend the drugs.

Yes, physician behavior is influenced by pharmaceutical sales/marketing. https://www.pewtrusts.org/en/research-and-analysis/fact-shee...

Considering "marketing" extends all the way down to "hey, did you know our drug just got approved to treat disease XYZ", I'm hardly surprised it influences behavior.

You'd be surprised at how many doctors there are that know very little about newly approved medicines and pretty much rely on sales people for information.

Re: Study shows most doctors endorsing drugs on X are paid to do so

#77
post #41

There was a recent HN post about a weight-loss drug where I bit my tongue and did not try to "rebut" stuff there with a comment about diet and lifestyle . Methinks this problem runs deeper than paying doctors to promote drugs. Americans fundamentally seem to see drugs and surgeries as "health care" in a way I find concerning.

This is hardly an American thing; you see the same in Europe, and presumably other places. This is why antibiotics resistance is a problem in many parts of the world. I once overheard a coworker give a doctor a right bollocking over the phone because he wouldn't prescribe antibiotics for her daughter who had the flu, and she then proceeded to tell rant how ridiculous that doctor was. I've rarely had to spend more eff…

> This is why antibiotics resistance is a problem in many parts of the world.

Antibiotic-resistant bacteria are more of an agriculturally-induced problem than a non-farmer-human-induced problem. Almost all commercial livestock are pumped full of antibiotics to make them fat, according to estimates ~2x the amount of antibiotics are used for animals as for humans.

Re: Study shows most doctors endorsing drugs on X are paid to do so

#78
post #45

While non-disclosure by doctors prescribing drugs they profit from is unethical, I would be interested to know if doctors change which drugs they prescribe if when paid by different pharma companies ie are doctors recommending the drugs because they are being paid or are they just being paid because they recommend the drugs.

Yes, physician behavior is influenced by pharmaceutical sales/marketing. https://www.pewtrusts.org/en/research-and-analysis/fact-shee...

So is patient behavior. How many drug ads for X include the line "ask your doctor about X" as if the patient has any clue whether that drug would be appropriate. Then they run to the doctor asking for X and the doctor says "eh, it's easier than trying (again) to get them to change diet and exercise habits" and they write it.

I don't actually know how often doctors do the last part but I would think that in some cases it happens.

I think drug ads are almost always completely out of place in consumer media and it's something that is really uncommon or totally banned in other countries.

Re: Study shows most doctors endorsing drugs on X are paid to do so

#80
post #63

Earlier quoted context omitted.

If you believe this you should vote for RFK Jr. He’s the only presidential candidate that has actually taken on industry. The VO has pledged to open up all the data in the FDA and CDC for transparency. We need this.

US Gov't FDA and CDC can already be FOI'd. Records from neither department will cover ongoing "bribery" of regular doctors by Pharma reps, so it's unclear how "we need this" to address that.

They can be FOIA'd, for all the good that will do you. They apparently have, according to the news, employees dedicated to deleting records before they can be FOIA'd, they use burner phones and private email accounts, and when caught the agency boss will say "I don't know who my personal assistant was working for when he did that" in front of Congress.

And get away with it.

In a matter that regarded some two million or so deaths in the US.

[0]: "Fauci concedes wrongdoing at NIAID, just not by him": '“That was wrong and inappropriate and violated policy,” Fauci said of Morens’s scheme to “disappear” problematic emails. “He should not have done that.”

Fauci’s chief of staff was in on the scheme. Emails show that Gregory Folkers intentionally misspelled the name of Kristian Andersen, a tactic Morens suggested to avoid FOIA, after Andersen received an $8.9 million NIAID grant, which came two months after he authored a paper arguing that it was “improbable” that COVID-19 had a lab origin.'

[1]: It's an image of an email from Gerald Keusch, who worked at NIAID.

[0]: https://www.washingtonexaminer.com/restoring-america/fairnes...

[1]: https://x.com/gdemaneuf/status/1797494390535160205

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