Why Don't Drug Companies Just Pay Us to Swallow Their Drugs?

Last week in the Journal of the American Medical Association an article came out about how drug companies pay "ghost writers" to write favorable articles about their drugs and then pay doctors and researchers with established reputations in their field to be listed as the author of the paper. That made it look like a professor from a university had performed the research and written the paper, whenin fact it had been done by the drug company. In one case a basically finished paper that listed as the first author "External Author?" was later published with a doctor from an outside university listed as the first author. Merck spewed out favorable papers about Vioxx while tens of thousands of people were dropping dead from heart attacks that they could have avoided by taking a Non-steroidal anti-inflammatory drug (NSAID) which costs a tenth as much and works just as well. In a somewhat hilarious response to a question about the Assessment of Differences Between Vioxx and Naproxen to Ascertain Gastrointestinal Tolerability and Effectiveness (ADVANTAGE) study, the first author said "Merck designed the trial, paid for the trial, ran the trial . . . Merck came to me after the study was completed and said, 'We want your help to work on the paper.' The initial paper was written at Merck, and then was sent to me for editing."

So my question is, given that the drug companies are spending so much money to do questionable studies clearly aimed at promoting drug sales, paying ghost writers and doctors to promote their dubious claims, why don't they just use that money to pay the patients themselves to swallow their drugs? I mean most people don't see the bills for their drugs since the insurance companies are paying for their drugs, and nobody likes insurance companies anyway. That way if the patients dropped dead from the drug at least they wouldn't feel like they didn't get anything out of the arrangement.

Doug Bremner MD is author of Before You Take That Pill: Why the Drug Industry May be Bad for Your Health'