Yesterday, I wrote about Dr. Carlat’s confession of being a shill for Wyeth (see “Dr. Carlat’s True Confession: 199,999 More to Go“). As a follow-up, I decided to see what Carlat is saying on his blog and what drugs reps are saying on Cafe Pharma.

Carlat recounted some feedback under his post “Return the 30K, You Cheap Thief“, which was inspired by a comment made to the WSJ Health Blog. In my critique, I never suggested that Carlat give back the money. He did, after all, take time off to do lunch-and-learns. Many reps in the Wyeth Company board over at Cafe Pharma, however, suggest that these gigs usually involve little or no work at all and may even be counterproductive (see below).

Regarding giving the money back, this is Carlat’s retort:

“I’d be curious to hear opinions about: A. Whether I should return the dirty money; and B. Where it should go if I can bear to part with it?”

Here’s my opinion: If you decide to write a book and get an advance on royalties, I’d say you should donate $30,000 to an appropriate charity or patient support group — one that does NOT usually get money from the pharmaceutical industry. You can make pretty good promotional hay out of it and easily recoup the $30,000 from additional sales of the book! Maybe I can be your agent…give me a call.

Here are some comments from the “field hands” (aka, Cafe Pharma posters):

“Many hookers and paid escorts have written their memoirs in the past. It will continue. It allows them to ‘purge their conscience’ and sell themselves in a different area.”

Nice to see my ho analogy also used by sales reps. I wonder if there is a little black book out there that names the “johns”? Who are the “johns” anyway? The doctors that were served the lunch and swallowed the pitch, I’d say.

Surprisingly, many reps — perhaps NOT all of them Wyeth reps — were happy Carlat wrote his confession:

“I am glad this doctor wrote this article. I, for one, hate hate hate doing speaker programs, especially with the crappy and antiquated slide decks we have. They are a waste of time, resources, money, and since I don’t have many access issues, and these slide decks have nothing new in them, what is the freaking point????????”

Clearly, this rep needs to be fired! There’s likely to be a great ROI on these lunch-and-learns, as I pointed out in my post yesterday. But it’s nice to know this rep hasn’t got access issues. Does he/she close deals and get more scripts written?

“I’m glad the good Dr. wrote the story, and hope it causes much more damage to Wyeth’s reputation, if that’s even possible. Does not matter how many people do it…bribery and fraud is just that, bribery and fraud. I’ve witnessed it myself, reps knowingly doing speaker programs to line their Dr.’s pockets with cash for a quid pro quo. There is very little educating going on at these programs most don’t even adhere to the guidelines Wyeth claims to strictly enforce. Sorry, it’s black/white the way I see it and what I see is crime.”

Dr. Norm Sussman is Outed!
As for other physicians confessing their sins, here’s what Carlat claims:

“Many physicians wrote their own mini-confessionals about giving drug talks. One doctor, also a reformed Effexor speaker, described a teleconference in which Norm Sussman minimized withdrawal problems with Effexor. In response, the doctor had an “ethical lapse” and couldn’t help mentioning to the audience that Lexapro might be an easier drug for primary care doctors to prescribe, much to Sussman’s annoyance. The writer eventually quit speaking for Wyeth.”

A rep on the CafePharma Wyeth discussion board also outed Sussman:

“As I see it, any practicing physician who does what I do could be viewed as a whore (therefore, making you his pimp!!!). He is being asked to deliver canned information but is sternly discouraged from interpreting this information.

“If anyone should be outed here, it is DR SUSSMAN, KING OF THE WHORES!!! In the world of psychiatry, Dr Sussman is more than willing to wine and dine your most (self) important Drs in his luxurious offices overlooking 5th Ave (unless you work for Eli Lilly!!!) for a substantial. He will pretty much tout your drug (except Prozac and Zyprexa) to just about anybody at anytime (not quite anywhere though, the NYC business is plenty fine for him, although, FL and CA aren’t off limits). A few years back he did a program for me (I do not and never have worked for Wyeth). After scheduling the program, he called me back shortly before the program to say that he needed to do a teleconference for Glaxo right after my program and asked if the restaurant had a space for him to do it. Considering his “reputation”, how could I say no. Doubledipping. We paid at lest $2k plus a limo out to LI. I soon found out thought that for every Dr who was thrilled to hear Dr Sussman speak, there was a Dr commenting that he was “shilling” for us too and that he was going to tell everyone why “our” drug was so much better than all of the other a-ds. Estimates are that he makes over $500K doing this. That is f**king obscene.”

Sorry for editing the language — as I and Confarta sales rep Charles Charles have noted many times, Cafe Pharma denizens are apt to spew potty words at the drop of a dime: