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The NPR article pontis out that the reason that they pay most of the doctors is not to get them to spread the word, but to get thenm to prescribe even more of the product. the deliberately pick those physicians who are at the top in prescribing their product. Big Pharma has found out that by letting these physicians become thought leaders (even if they never had an original thought they are flattered by that moniker) that those doctors boosted their sales by six figures in a month by prescribing even more of the medication. Any physician that the thought leader talked to ( the money was usually for a dinner talk at Applebee’s) who also increased prescribing was a bonus. An investment of $1500 pays off by several orders of magnitude.The really big bucks go to the true thought leaders, the academics. One friend of mine (who is critical of the whole idea of paying doctors, by the way) got over $50,000 from one company. Most physicians who take the money don’t realize they are being played.

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