Under the care of pharma-nurses

Administering an injection

KAI RYSSDAL: British drugmaker GlaxoSmithKline said today it's agreed to pay $70 million dollars to settle a price-fixing lawsuit. Add that to the $150 million Glaxo paid out last year for overcharging Medicaid and Mediacare and the company's out almost a quarter of a billion dollars. Sales of course are how drug companies make money. All the other companies, too. But pharmaceutical makers have gotten some special scrutiny for marketing drugs directly to patients. You've seen the television and magazine ads, but did you know the industry also pays nurses to help administer some of those drugs? And make house calls. Cathy Duchamp checked it out.


CATHY DUCHAMP: Cori Wisniewski doesn't look like a nurse. She wears blazers and stylish sunglasses. Drives a Mercedes. You might take her for a pharmaceutical sales rep. But she's not. She's a pharma-nurse.
CORI WISNIEWSKI: Well, first of all I am functioning under my own registered nurse license. And I have never been told not to talk intelligently about all the therapies. I've never been told that. Just to do the best job you can.

Pharmaceutical company Berlex pays Wisnieski and 79 other registered nurses to help people with multiple sclerosis take a drug called Betaseron. Other MS drug makers as well as companies that make diabetes medications do the same. The goal: to teach patients how to give themselves shots and manage the side effects.

WISNIEWSKI: And so for the first couple times, here's what it would sound like. [POP!]

This day Wisniewski's shows patient Gina Aplet how to use a new injector. Pharmaceutical companies call pharma-nurses a win-win. The companies make more money when patients stay on medications. Patients keep their disease in check.

But there are skeptics. MS patient Gina Aplet was one. Aplet had already tried two MS drugs by the time she met nurse Wisniewski. One made her feel like she had the flu for an entire year. The other left pockmarks in her legs and arms.

GINA APLET: It looks like someone took a 9-iron to a 3-par you know.

She says her doctor didn't know what was going on. The person who did was the pharma-nurse.

APLET: With Cori it's different. With Cori its just more one-one-one, dealing with one particular thing. She provides me information, I mean, a lot of support when I have questions.

But some people are raising red flags. One is pharma industry watchdog, Marcia Angell.

MARCIA ANGELL: Essentially it's allowing doctors to outsource the medical treatment of their patients

Now at Harvard Medical School, Angel wrote a book called the Truth About Drug Companies.

ANGELL: These nurses who work for the drug companies, indirectly if not directly, have a lot of face-time with patients. They can convince the patient that this drug is really important, when maybe it's not.

But physicians who oversee patients don't necessarily have a vested interest in a particular drug. Sylvia Lucas, a neurologist at the Western Multiple Sclerosis Center in Seattle, says pharma nurses are a Godsend:

SYLVIA LUCAS: The bottom line is that if this drug is not working, we know that. If there's progression of disease, we're gonna change the drug.

Lucas says lack of funding for staff nurses and for more doctors drives the need for pharma-nurses. Lucas herself sees about 500 MS patients a year, but has just one staff nurse to help.

LUCAS: I would love it to have two hours to spend with each patient, saying this is where you inject, these are the side effects you should expect. This isn't a cure, but it really is supposed to prevent picking up disease down the line. You know, it's almost like insurance.

For MS patient Gina Aplet, her pharma-nurse is her insurance agent. Aplet's staying on her medication and doing well.

APLET: It's not that I feel any better but I know that psychologically I'm doing better because I know that I'm not just sitting idly by waiting for the next strong episode to hit. I'm doing what it takes to make sure that when there is a cure I'm the number one candidate.

I'm Cathy Duchamp for Marketplace.

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