Dean Baker takes issue with a Washington Post story link here
on doctors shilling for drugs and drug companies paying them big money to push greater use of their drug including for uses prohibited by FDA link here
The Post article is a routine description ("fair and balanced" as the big papers like to claim) leading to the fact that the doctors are well-paid for what amounts to treating patients while never seeing them. In some cases they push uses that are criminal, as when they recommend or prescribe a drug for unapproved use.
Baker's problem with the Post piece is its failure to recognize the central role of drug patents in this business. Without the patent, the drugcos couldn't charge the prices that make the big marketing payoffs and their huge profits possible.
Baker fails to note that this might just have something to do with the high cost of health care in the US (highest in the world) or the funding to pay campaign funds to crucial legislators to leave the system unfixed.
I believe it is criminal to prescribe drugs for a patient that has not been seen. There are a lot of "barriers" to entry in being a doctor. For example, malpractice insurance costs are extremely high, so high that dozens of obstetricians have left practice in the United States because they could no longer afford the malpractice insurance. Maybe that's part of the reason doctors in the U.S. are so expensive to see.
True, no patents, no payoffs. It is also likely that there would not have been many or even most of the drugs for which payoffs were garnered. Sounds like a win-win to me. No patents, no drugs, no need for payoffs. What more could anyone want?