As a retired nurse, I can tell you big pharma pursues doctors, and pharmaceutical reps have the funds to garner the support of doctors to order certain drugs. ER doctors were particularly attractive to the reps. They would woo the staff also with providing lunch, and giveaways like pens, gift cards, and other assorted "freebies." I often wondered why some doctors would write prescriptions for medications that may not be needed, like pain meds for injuries that were not severe and could be taken care of with OTC meds. Perhaps kickbacks have been around for a long time. 😙