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Is Pfizer Manipulating Your Doctor?

Recent events have many people who take statin drugs wondering if they or even their doctors are being manipulated by large drug companies and health insurance providers. One of the most common statin drugs is known by the brand name Lipitor; it’s used to lower cholesterol levels and reduce the risk of cardiovascular diseases. The tumult began this past year when pravastatin and simvastatin, the generic versions of Pravachol and Zorcal, entered the US pharmaceutical market. Their introduction meant new competition emerged for Pfizer, one of the world’s largest drug companies, and one of its best-selling brand-name drugs, Lipitor.

The generic drugs are cheaper for consumers and more attractive to health insurance companies. Pfizer stands to lose millions in profits if consumers either choose or are forced by their insurance plans to switch to other—cheaper—statin drugs. In response, Pfizer sent two letters to doctors (one to send to health care providers and another to pharmacists) that explained how switching to generic brands from Lipitor would “undermine the clinical judgment that went into the decision to prescribe Lipitor for this patient.”

From Pfizer’s perspective, it makes sense to try to have doctors on their side. Drug development is expensive—with the length of time it takes for a drug to make it into the market and be approved by the FDA, the cost can easily be in the billions. This is why drug companies are given a monopoly, albeit a short-lived one for some, so they can recoup their investment. But where does this leave the consumer?

How much influence do the drug companies really have?

Here is where it gets sticky. Medicine isn’t an exact science, it’s one of weighing probabilities and dealing with consensus, because it is rare that a drug will work exactly the same way in every person. All we have are statistics from a sample of the general population from which to base our opinions. So when does a patient need Lipitor and when could they utilize the generic brands and get similar results?

The answer to this question lies in why we go to doctors—to have them assess the risks and use their knowledge base to help us make sound decisions. Did Pfizer cross a line in sending these letters? The most popular sound bite from this story was stated by Sidney Wolfe, director of the Public Citizen Health Research Group. He posits that Pfizer is “using doctors as a human shield to protect them from losing business.” Which drug will work best is dependent on both the patient’s risk factors and goal amounts of cholesterol. These can only truly be determined by a medical professional—so in the end, it comes back to how much you trust your doctor.

The press suggests that doctors who received these letters from Pfizer have become unsuspecting pawns in the game of big drug companies. My response was to ask my computer screen, “Really?” Doctors help you make decisions about your health care—one of the most important factors in your life. Do you think they are easily manipulated? And, if so, why are you entrusting them with your health? I think it boils down to whom you think has your best interests at heart. For now I will continue to trust my family doctor over any large business or health care provider until someone proves to me that it’s a bad bet. What Pfizer has done is in bad taste, but I understand it from a business standpoint. Doctors can only be human shields if they decide to stand between their patients and the drug companies without voicing their opinions. In the event that you don’t know whether to trust your doctor, Consumer Reports Best Buy Drugs goes into some of the details of the pros and cons of each drug, according to their sources, allowing patients to ask their doctor tougher questions should they feel the need.

Stay healthy, and be a smart consumer,

Lara Belonogoff

Posted in: Editorials

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