How drug companies influence their most valuable patients

As a boy, Philip Kucab, MD, felt special when his pharmacy rep — who sold him his hemophilia medicine — joined the family for dinner or sent a gift basket during the holidays. Now, Dr. Kucab, a resident at Detroit Medical Center, looks back on the relationship with a more cynical view, according to The Washington Post.

In a new study published in PLOS Medicine, Dr. Kucab and his colleagues detail direct-to-consumer marketing techniques, detailing the great lengths drug companies go through to connect with hemophilia patients — gifts, assistance in paying for drugs, internships, college scholarships, coloring books, grants for summer camps and apps where they can track their drug infusions.

While the connection between patients and companies may seem mutually beneficial on the surface, these complex relationships may disguise an effort to secure customer loyalty or sell more expensive drugs for a rare disease where each customer — who requires a lifespan of treatment — can prove extremely valuable.

There are many options for hemophilia treatments on the market, but little comparative data exists on the methods. Physicians are concerned that these relationships may persuade patients to try a treatment that's more expensive but not proven to be more effective than cheaper alternatives.

"They definitely get in the way of the doctor-patient relationship, because there's sort of a buddy relationship that develops," said Ellis Neufeld, MD, PhD, medical director of the Boston Hemophilia Center. "We had one 9-year-old explain to us that he and his mom had gotten a pitch in their home from a sales rep that one drug was better than the other. That's way past the bounds of any propriety. It's very, very pernicious — so if you take a drug that on the average costs $200,000 per patient per year ... [it] is well worth it to a manufacturer."

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