Pharmacies process cards such as a "One Month Free Trial Voucher" povided by Boniva (GlaxoSmithKlline)

or

VIAGRA

or

any of several ADHD drugs (control, addictive, for "hyperactive" (read...perhaps super-intelligent kids)

The drug rep hands a bunch of these cards to the doctor

These cards all have numbers IN SERIES

These numbers in the bunch are recorded by the Drug Rep

eg:  1000 to 1020

All these cards have a no copay which is provided by a third party insurance outfit which reimburses the Pharmacy. 

The patient's name is not on the card, however, the Pharmacy must use the current patient info

plus

the ID number on the card

the Bin number on the card to direct the computers

the other numbers relevant to processing the prescription given with the card

NOW:

the Pharmacy computer sends this info to the "coupon" processor company, such as McKesson or EDS or whatever.

THEN:

The Pharmacy gets immediate (within a few seconds) approval and hands the patient the prescription.

THEN:

The "coupon" processing company alerts the Drug manufacturer which then alerts the Drug Rep that number so and so   from example above   number 1005 from Dr. Such in perhaps Wing Ding, Minnesota has prescribed a 1 month supply of Boniva, retail at perhaps $100.00  Dr. Such either earns points or something or...Gets his office lunch served daily by a variety of Drug Reps.

I have a personal friend who has a catering business in Charlotte, NC who actually has several Physicians offices DAILY to cater lunch from him.  I do not have the nerve to ask who they are.  That is his business.

I know for a fact that ... I can give you the name of the practice personally if you ask me...in Newport, TN that gets lunch DAILY.

The website:

www.nofreelunch.org

This was started by an MD who felt that doctors were unduly influenced by the Drug Reps to prescribe drugs that possibly were not appropriate.

I am a member of that outfit.

We take no gifts from Drug Reps.

When I worked for Walgreens in Sevierville, TN, back in 2002, we had a memo (edict) that told us pharmacists we were not allowed to talk to any drug rep.  Walgreens considered this bribery. There's a story to that, too.