The Pharma Veteran points me towards this story surrounding some slightly tawdry business in creation of the Pennsylvania state formulary.  The Veteran says:

This furthers the conviction that healthcare is either tragedy or farce.  It reinforces several conclusions we’d already  developed.  First of all, it illustrates how the function of "greasing" healthcare providers has moved from office/hospital reps to higher positions within the companies.  It also shows that while the industry grapevine places one of the companies mentioned below (Pfizer) as reputedly the most aggressive transgressor, even a self-proclaimed good corporate citizen (high science Janssen, a part of Harvard-case-study-on-Tylenol-recall-J&J) swims in the same water.

The third thing this article suggests is the increasing, chain-of-influence approach that companies are adopting with respect to greasing organizational decision makers.  Many office reps perceive their companies are paying less attention to office-based practitioners and are more aggressively targeting government, MCO and PBM decision makers whose choices, the companies hope, will trickle down to the offices.  The potential for this trickle down marketing, some believe, can increase enormously when the Medicare legislation goes into effect in 2006.

The fourth lesson here appears at the bottom of the article.  A director of a mental health policy association makes the point that at least at the state level, decision makers are so dependent upon Big Pharma for vital information that there is a complete asymmetry of knowledge and power in the relationship.

My only comment here is that these numbers are so relatively small ($14,000 over a few years), and were clearly not used as straight bribes.  So shouldn’t the state find some way to pay for the educational trips and information that its officials need, without shortchanging them to the point that a few thousand from a pharma makes a difference?