Are Docs Getting Too Cozy With Drug Companies?

Sometimes, it’s the subtle comment that gives you pause. Shortly after giving a lecture at a recent conference, a DPM found out that a particular company had sponsored the series of lectures he had participated in and he expressed regret. “If I had known (the company) was sponsoring the lecture, I would have mentioned their product.”
Then there are the more outrageous examples of drug company influence, like the one captured in an éxpose on ABC’s Primetime earlier this year. On the program, a doctor revealed that he had received approximately $10,000 worth of freebies from various pharmaceutical companies over a four-month period. The freebies included a trip to a Florida resort, a family ski trip, hockey tickets and computer equipment.
In between these incidents, you find statistics that should raise more than a few eyebrows. A recent survey by the Kaiser Family Foundation, a non-profit organization, found that 61 percent of doctors received meals or gifts from pharmaceutical companies in 2000. According to a Reuters article, that same study found that 84 percent of the $15.7 billion ($13.2 billion) spent on promoting drugs in 2000 was spent on physician-targeted promotions.
Do these enticements alter physician prescribing patterns? Yes, they do, according to the findings of a study, published in a 2000 issue of the Journal of the American Medical Association. The study found that doctors who had relationships with drug companies tended to prescribe newer, more expensive drugs even when they didn’t provide any clear therapeutic advantages over cheaper medications.
Are there any solutions to this serious ethical dilemma? Recently, the Pharmaceutical Research and Manufacturers of America (PhRMA) announced the creation of “a new marketing code” that will attempt to address any ambiguity in the interactions between pharamceutical companies and healthcare professionals. This code will reportedly take effect on July 1.
The code is well-intentioned as it seeks to reinforce that these interactions be focused on “ … providing scientific and educational information and supporting medical research and education.” The guidelines also seek to eliminate gifts of a recreational or entertainment nature and rein in extravagance, limiting gifts given to docs as “items primarily for the benefit of patients … if they are not of substantial value ($100 or less).”
However, keep in mind that this code from PhRMA is a “voluntary” one. In other words, it’s self-regulation that will be difficult to enforce. As this issue went to press, the American Medical Association was reportedly looking to update their ethics rules as well.
Speaking strictly from a layman’s prespective, I think this issue will be around for quite a while because there is a need for doctors to work hand-in-hand with pharmaceutical companies.
After all, doctors who act as advisors or consultants to these companies can help them identify untapped areas for drug development or suggest studies for exploring new indications for existing medications. Of course, pharmaceutical companies have the deep pockets to support new studies or clinical trials that can help bring new medications to the patients who need them.
That said, staying on the right ethical path is ultimately up to the doctors. In short, those who participate in investigatory trials or other studies must be unswervingly true to following the study protocol. Proper patient selection is a must. While some docs may yield to the desire (and influence of the drug company) to add a borderline patient to their study, erring on the side of caution is likely the best course of action in the face of ethical temptation.