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Study shows most doctors endorsing drugs on X are paid to do so
- chuckadams 2y agoDoctors 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?
- ClassyJacket 2y agoDoctors who are paid to endorse a drug should lose their licence
- s1artibartfast 2y agoWhy is that? Surely you mean without proper disclosure.
- nkrisc 2y agoBecause it conflicts with their duty to their patients. Patients should be able to trust their doctor and not have to look for fine print disclosures in the middle of receiving treatment which may or may not impair them cognitively or emotionally.
- gamepsys 2y agoPatients are often in a vulnerable position and we use laws to protect the vulnerable. Not only is the patient often impaired, but there is a massive information asymmetry naturally between an expert with years of post graduate education on a specific topic and a general member of the public. Many other fields that require similar amounts of training have strict codes of ethics regarding who they may take compensation from and how that is disclosed.
- s1artibartfast 2y agoI agree, but i take it that this isn't about advertising to patients, but the general public. Some doctors don't even have patients. Some work in drug development itself.
- llamaimperative 2y agoI think you can assume based on context that GP is referring to practicing physicians, not to research doctors. You can tell because one has a clear conflict of interest and one does not.
- redwall_hp 2y agoDrug company employees who attempt to bribe a doctor should be imprisoned.
- blindriver 2y agoIf 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.
- aaomidi 2y agoYeah but then you’re voting for RFK.
- defrost 2y agoUS 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.
- cheaprentalyeti 2y agoThey 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/fairness-justice/3027219/fauci-concedes-wrongdoing-niaid-not-by-him/ https://www.washingtonexaminer.com/restoring-america/fairnes... [1]: https://x.com/gdemaneuf/status/1797494390535160205 https://x.com/gdemaneuf/status/1797494390535160205
- SayMyName 2y agoAs of their latest reporting I could find on the fda site, 3.3B out of their 7.2B budget comes from "user fees", so the more drugs are sold, the more they get back in user fees.
- llamaimperative 2y agoPretty sure user fees are tied to new drug applications, not to sales. As in FDA validating your trial results is obscenely expensive and they make the companies who consume those services pay for them.
- s1artibartfast 2y agoThis is correct. It isn't validation or technical series. It is purely review.
- deleted 2y ago[deleted]
- refurb 2y agoIsn'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?
- harry8 2y agoLots of doctors from reputable places eg Mayo on X. Weighing in on things with media coverage like whether cholesterol drugs are a good treatment option. Possibly they're countering quakery from charlatans with good, measured opinion. That opinion could also be influenced by paying for their conference attendance, or just plain cash. Undisclosed, such payments would be far from obvious and radically change one's opinion on how convincing their case is or isn't. The new weight loss drugs. Are they good? How serious are the side effects? How often are there problems? Is the risk low and benefits high? Are they good for cancer? Are they good to help alcoholism? Are they scary? Should I take them? Much legit debate there and I'd rather know who is being paid for their opinion faced with the choice when trying to weigh probability in the face of imperfect information.
- idle_zealot 2y agoThe Doctor could conceivably be a passionate professional who wants to share health information with a wider audience. You know, as opposed to a shithead shill. The fact that being a corporate mouthpiece is apparently the default assumed state is a condemnation of our current medical standards.
- SilverBirch 2y agoIt's easy to imagine a stereotypical "When my patients find their pancreas swimming around in their fish tank, I recommend ACME Pancrease De-marination forceps". But the more important bit is the massive grey area. Let's say your kid plays with Bob's kid on their little league team, you've added each other on Facebook, you put out a post asking if anyone has any advice about your fish tank dwelling pancreas and bob chimes in because he's a doctor. Do you assume Bob is being paid then?
- refurb 2y agoI assume 100% of people on social media are doing for other than altruistic reasons. 100%
- killerdhmo 2y agoAnyone have the actual paper? Does it list who (eg Huberman) is receiving the payola?
- anigbrowl 2y agoResearchGate makes it easy to email and ask for a copy, though you can usually find the corresponding author listed in the journal entry. https://www.researchgate.net/publication/381007622_Industry_Payments_to_Physicians_Endorsing_Drugs_and_Devices_on_a_Social_Media_Platform https://www.researchgate.net/publication/381007622_Industry_...
- deleted 2y ago[deleted]
- beala 2y agoYou can search the database they used: https://openpaymentsdata.cms.gov/ 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 displayed on Open Payments (1144596339) to his CA license number (A96452) which he displays on his about page [4]. So it does look like this is the Peter Attia of podcast fame. [1] https://openpaymentsdata.cms.gov/physician/908146 https://openpaymentsdata.cms.gov/physician/908146 [2] https://peterattiamd.com/kevinsayer/ https://peterattiamd.com/kevinsayer/ [3] https://opennpi.com/provider/1144596339 https://opennpi.com/provider/1144596339 [4] https://peterattiamd.com/about/ https://peterattiamd.com/about/
- spondylosaurus 2y agoOpenPayments is a super cool tool. It's worth noting that some small payments can amount to things like "the drug rep came by to leave some pamphlets for the waiting room and donuts for the staff", which is how you'll occasionally find a doctor who accepted a grand total of $50 in payouts. For the $100k+ payouts, though... hell, even the $10k+ payouts.... EDIT: Just looked up one of my doctors and it says he accepted a whole $70 last year, entirely in food and beverage lol. I hope he enjoyed the cookies or whatever it was :P
- thenerdhead 2y agoShow me the incentive and I'll show you the outcome - Munger
- consumer451 2y agoFrom related stories on TFA page: > Doctors received approximately $12.1 billion from drug and device makers between 2013–2022, study reveals https://medicalxpress.com/news/2024-03-doctors-approximately-billion-drug-device.html https://medicalxpress.com/news/2024-03-doctors-approximately...
- davidgay 2y agoThis 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 of physicians received at least one payment, and roughly 94% of payments were associated with one or more marketed medical products. A small percentage of physicians received the largest amounts, often exceeding $1 million". So: nice but small for most doctors, rather (too?) large for a small percentage.
- Jensson 2y ago> $12k/doctor/year on average That is a ton of money, imagine how much you would do if you get an extra months of salary to do it? And they get that level of an offer every year... A month of salary is a very large bribe for anyone.
- jws 2y agoDoes 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.
- refurb 2y agoFree 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.
- mistrial9 2y ago[flagged]
- WarOnPrivacy 2y agoNot for a very long time. The current prescription opioid crisis is for the millions of patients in pain unable to get any pain meds (ex: ibupofen following surgery).
- whimsicalism 2y agolots of people i see posting about the difficulty of availability stuff seem to be drug seeking for chronic reasons
- vsuperpower2020 2y agoIt depends on the doctor. Seeing as some doctors give them too freely and others would rather let patients suffer, I propose we just save time and use a roulette table. It's transparent, easy, and you know exactly why you're been awarded or deprived of pain medication.
- mistrial9 2y agono the sad facts are that modern non-opioid pain treatment is very often more effective than opioids .. I believe there are research studies easily found that show that.
- spondylosaurus 2y agoEven people who get their hands on opioids (to use or abuse) frequently do because they're an order of magnitude cheaper than therapeutic drugs. Biologics to treat inflammatory arthritis can run thousands of dollars a month without insurance. Generic tramadol to mask the pain of inflammatory arthritis is less than fifty bucks a month with GoodRx.
- serf 2y ago>The current prescription opioid crisis is for the millions of patients in pain unable to get any pain med as a person with a dear family member who is addicted to opiates and watches their compulsive behavior of going from new doctor to new doctor for prescriptions and samples I suggest there is more than one 'opioid crisis' unfolding.
- arp242 2y ago> The research team points out that while some may see the practice of being paid to endorse drugs as unethical, it is not illegal and does not affect licensing. Does the US have no transparency laws for this? As in: "if you promote a product, then you must disclose if you're paid for it"? Even for things like "sponsored posts" on Instagram this is required; e.g. from the FTC: "Do you work with brands to recommend or endorse products? If so, you need to comply with the law when making these recommendations. One key is to make a good disclosure of your relationship to the brand." https://www.ftc.gov/business-guidance/resources/disclosures-101-social-media-influencers https://www.ftc.gov/business-guidance/resources/disclosures-... That must also apply to drugs? Some Open Payments website seems incredibly untransparent, and wouldn't comply with the social media transparency requirements as I read that FTC page. Surely the rules for Instagram tat can't be more strict than drugs?
- Jensson 2y agoImagine if doctors had to say if the drug company paid him to prescribe the drug when he prescribes a drug for you?
- deleted 2y ago[deleted]
- MrJohz 2y agoThat seems like it would make sense though, wouldn't it? To it's important information that you, the patient, need to understand before you can make an informed decision about whether or not the medicine being given to you is the best option for you. Otherwise you can't know if a recommendation from your doctor means they've genuinely considered all the options and chosen the best one, or just that one company paid them the most money.
- s1artibartfast 2y agoThat is already illegal.
- trimethylpurine 2y agoI think you're right. Same as everywhere else, legality and enforcement are at odds. US isn't special in that regard.
- newsclues 2y agoWhat about tv and YouTube?
- bastard_op 2y agoWhen has doctors endorsing any drugs, on x or real life, ever been anything more than paid advertisement?
- skhunted 2y agoThe system is great at extracting wealth, manipulating people and manufacturing demand. It’s hard to find advice that is genuine and believable. Lots of genuine people are having their messages diluted by misinformation and misdirection. Nothing can be trusted.
- destitude 2y ago"The research team points out that while some may see the practice of being paid to endorse drugs as unethical, it is not illegal and does not affect licensing." - are there countries where this is illegal and/or never get paid for drug endorsements?
- SilverBirch 2y agoIn the UK you can't advertise anything that needs a prescription from a doctor.
- DoreenMichele 2y agoThere 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.
- deleted 2y ago[deleted]
- spondylosaurus 2y ago...are drugs and surgeries not healthcare?
- DoreenMichele 2y agoEating 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.
- nitwit005 2y agoWe've tried and failed to get people to "eat right" and exercise for the last century or so. We've put a stunning amount of effort into that option, and failed.
- DoreenMichele 2y agoMy dream career was urban planning. We used to design walkable cities and now we design a world that is car centric. Designing exercise into our daily lives used to be part of the urban planning profession. Paris was redone to put a stop to health issues in overcrowded slums. Nutritional value of produce has gone down for decades while we strip mine our soils and try to make up for it with chemical fertilizers. I don't think the obesity epidemic is going to be solved with lecturing people like they aren't trying hard enough to starve themselves while we build "fuck you, pedestrian" environments all over the country.
- moose44 2y agoWhat about in real life?
- to11mtm 2y agoGood, I'm on my public account. Happy to say this publicly at this point: After the first time (over 12 years ago, now) I was misdiagnosed (and thus mismedicated) and dealing with a toxic work environment, I wound up in a spot where I 'had' to take a specific medication and do a follow up in a month. The medication made me nearly useless at work, I had to have my music at ear damaging volume to not fall asleep driving. At my first follow-up, I stated my concerns, and the doctor basically told me 'deal with it' when I asked for alternatives and whether this was the right thing given the circumstances. I was so taken aback, it was only then I looked around the room. The Notepads. The Pens. The Calendars on the wall. All of it, it wasn't just the company it was that medication, that might work good for some people but FFS not anyone that just has untreated severe ADD/ADHD and childhood bullshit. It didn't just 'not help', it also really turned me off from getting good help for a bit, which had a lot of consequences I'll live with the rest of my life one way or another. I think at one point there -were- a couple settlement things related to the whole debacle. 1. So I was forced to see this doctor even though she was out of network and an in network doctor was likely available. For like a thousand dollars of related 'visits' my settlement would have been a hundred bucks. 2. IIRC, the medication was at least one of which, where, another nice benefit I couldn't see in the patient room were some cruises/vacations neatly wrapped as some form of 'knowledge sharing'. RE Point 2, everyone in IT wonders why we use dumb technology BigCos/Influencers push? Here's why lol
- takinola 2y agoWhile 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.
- lantry 2y agoYes, physician behavior is influenced by pharmaceutical sales/marketing. https://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2013/11/11/persuading-the-prescribers-pharmaceutical-industry-marketing-and-its-influence-on-physicians-and-patients https://www.pewtrusts.org/en/research-and-analysis/fact-shee...
- refurb 2y agoConsidering "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.
- SoftTalker 2y agoSo 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.
- recursive 2y agoI don't think those things are really different. Consider, for the sake of argument, that the doctors are endorsing drugs from the goodness of their hearts for the betterment of humanity. What incentive do the pharmas have to pay them? They're not known for altruism. If the payment had no impact whatsoever, they'd save their money. If docs know they might get paid, that's really not ethically different from having a payment agreement in advance.
- ClassyJacket 2y agoWhy in the absolute hell is it not illegal?
- kumarm 2y agoToday in an AI related post on X, I got an ad for Nityananda (A known fugitive from India who claims his own country now) teaching about AI. The guy probably didn't graduate high school. I hope X will add some quality control to ads they are showing. Ad that came up: https://i.imgur.com/dSkqV6I.png https://i.imgur.com/dSkqV6I.png
- epgui 2y ago[flagged]
- deleted 2y ago[deleted]
- tonymet 2y agoI'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.
- vedtopkar 2y agoI think it's the difference between suspicion of the pharmaceutical vs the pharmaceutical company. You can criticize the company without criticizing the treatment.
- tonymet 2y agocan you explain that reasoning more? that makes no sense
- xboxnolifes 2y agoIn this case of doctors being paid to endorse drugs, the problem is that there is payment being exchanged at all. The issue persists whether or not the drug is effective.
- tonymet 2y agosure but if we all agree that corruption is widespread , how can we discern what is effective? We're making our assignments based on corrupt testimony -- that of the corrupt vendors & doctors. How much we trust the drugs rests entirely on how much we trust the industry
- Slava_Propanei 2y ago[dead]
- Slava_Propanei 2y ago[dead]
- poikroequ 2y agoIn other news, the sky is blue.
- not_the_fda 2y agoDoctors endorsing anything are being paid. Doesn't matter if its on X or not. The whole system is corrupt. Every large pharmaceutical and medical device manufacturer has been busted for kickbacks and have mandatory internal training as part of the punishment to prevent it, yet it still happens. If you try to bring a product to market and are looking for feedback and an endorsement, doctors will openly hint of receiving compensation for the endorsement.
- zrn900 2y agoThe article assumes this happens only on X. That's the American medical system. And not only endorsing - doctors are 'incentivized' to prescribe their drugs by pharma companies without any need to 'endorse' them too.