>>Pharma and MD's, however, are joined at the hip here in the US. I've rarely been to see an MD without at least one pharma rep coming by to visit.
>>Why do they do that if there is no ROI and why do the MD's spend time with them if there is no ROI?

Asking leading questions is not a proof. ;-) There are lots of reasons why medical suppliers send reps to see practitioners- yes it's usually in the interest of sales, but what's wrong with that as long as MDs are smart enough to make decisions based on merit?

Even if they are not, what is to stop a nation setting up something like Pharmac: http://en.wikipedia.org/wiki/Pharmaceutical_Management_Agency ... read the section under "Performance and Political Status" and note who is opposed to an organized reduction of pharmaceutical budget to benefit the people. Hint - it's not the MDs, or the MB,ChBs as it would be in NZ.