Drug companies maintain large sales forces that call on doctors and hospitals to promote the companies' pharmaceutical products. The New England Journal of Medicine published a survey recently measuring the extent of the physicians complicity. Of the physicians surveyed, 80% accept free drug samples or free food from their drug reps. Nearly 30% accept payments for services like promotional speeches and consulting.

One of the more remarkable activities of the pharmaceutical sales representatives is the promotion of "off label" uses of a drug. That is, influencing doctors to prescribe a drug for uses that do not have FDA approval. Take for example, Gabapentin - a drug manufactured by Parke-Davis and approved only for treatment of a specific type of epilepsy, Parke-Davis reps promoted Gabapentin for the "off label" treatment of migraine and certain psychiatric conditions (a broader market and larger sales potential than the FDA approved use). After the visits, almost half of the doctors told researchers* that they intended to prescribe Gabapentin more widely or recommend it to colleagues.

* Published in PLoS Medicine, Lisa Bero, PhD, University of California, San Francisco, the researchers said,