Drug companies, already under fire for selling medications that don't work, are bribing doctors to prescribe pills you don't need.
Behind the headlines about the safety of the painkillers Vioxx and Celebrex and antidepressants use by children, lurks a secretive world in which drug salespeople lavish doctors with gifts and free travel. Doctors charge Medicare the full price for drugs they get at a discount. The result? Patients pay more for medications they may not need and that may actually have harmful side effects.

Check YOUR pills here: WORST PILLS

Bad Medicine
by Michael Blanding
From the February 2005 issue.

Under normal circumstances, Dr. Joseph Gerstein wouldn't have taken the call. His assistant knew that the Tufts Health Plan administrator didn't approve of so-called "detailers" -- pharmaceutical-company representatives who ply doctors with free samples and high-priced dinners to get them to prescribe particular drugs. She was under strict orders not to put them through.

On this day, though, Gerstein's regular assistant was away, and a temp transferred the call from TAP Pharmaceutical Products. Gerstein, medical director of the plan's pharmacy program, listened as the detailer on the other end said TAP would pay the HMO $20,000 in an unrestricted "educational grant" if it would provide patients with the prostate-cancer-fighting medication Lupron instead of Zoladex.

"That scandalized me," says Gerstein, who had supervised three years of study that concluded Lupron was no better than Zoladex, even though it cost $100 more per dose. The "grant" seemed to him nothing more than an illegal kickback to the hospital for which its patients would ultimately pay.

Gerstein contacted the U.S. Attorney's Office to report the offer (which was later increased to $65,000). That proved to be just the tip of the iceberg. A whistleblower from TAP told investigators that sales reps offered all kinds of incentives to urologists to switch their patients to Lupron, including free VCRs and trips to resorts for supposed medical seminars.

Charged with fraud, TAP pleaded guilty to illegal marketing and agreed to settle the case by paying $875 million -- the largest settlement of a medical-fraud case in U.S. history. In November, a judge approved a $150 million settlement in a class-action suit brought by Lupron patients, pushing the potential total the company will pay to more than $1 billion.

Behind the headlines about the safety of the painkillers Vioxx and Celebrex and antidepressant use by children lurks a secretive world in which drug salespeople lavish doctors with gifts and free travel, and doctors charge Medicare the full price for drugs they get at a discount. The result? Patients pay more for medications they may not need and that may actually have harmful side effects.