The story takes the reader along the road the doctors at the clinic traveled to end the drug rep visits at the beginning of 2006. It wasn’t easy and often there were conflicts. They worried that the samples the salesmen and women left would dry up, and they wouldn’t have any free medicines to give patients who couldn’t afford to buy them. As it turned out, giving them free samples was not the best idea. Once patients got used to a free-sample medication and then had to buy it on their own, price became a barrier. Hawryluk checked the literature and quoted one study from the University of Chicago that found patients who received samples paid between $212 and $244 a month on average for medicines compared with $168 for those who did not receive samples. Why? Docs usually prescribed the expensive brand drugs pushed by the drug reps and once patients became accustomed to a drug, they were reluctant to switch them to cheaper generics. Judy Carroll, a nurse at the Madras clinic, told the paper, “Truthfully, the pharmacy reps don’t leave anything that’s useful to our patients. It’s the expensive stuff that no one in this area can afford.”

Finally, the doctors tired of asking the drug reps whether their drug was covered by Oregon’s Medicaid program. “We got tired of hearing people say, ‘No, but it’s covered by Blue Cross.’” In 2004, the withdrawal from the market of Vioxx, a popular anti-inflammatory drug heavily promoted by the industry with help from the press, pushed the clinic to its final decision. The drug, as CJR wrote in 2005, caused 61,000 fatal heart attacks and thousands of non-fatal heart attacks before it was withdrawn. We concluded the Vioxx saga was not the media’s finest hour.

The Bulletin’s story shows how the press can redeem itself. It can and should reveal the dark side of the drug industry.

Follow @USProjectCJR for more posts from this author and the rest of the United States Project team.

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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.