Thursday, October 01, 2009

Mixed Medicine

The Boston Globe has done a very good job in following PHARMA's tentacles into the medical community in Massachusetts. Articles on the rather dubious "marketing" techniques of large pharmaceutical companies have appeared regularly, the latest of which appeared on Tuesday.

That article detailed the practice by which the drug companies got doctors to shill the newest pill to their colleagues by paying them handsome "speaking fees."

At least 60 Massachusetts doctors collectively have earned more than a half-million dollars this year as speakers paid by pharmaceutical giant Eli Lilly & Co. ...

The use of physicians in speakers programs or “bureaus’’ like Lilly’s, in which doctors generally use company-prepared materials to explain a drug’s uses and dosing to their colleagues, is widespread in the drug industry. But the practice is under growing scrutiny and some academic medical centers are barring their doctors from participating, believing that physicians essentially become hired advertising guns, with weakened credibility.
[Emphasis added]

It's a sweet deal for the drug-makers. They prepare slides and written materials, hand them to the doctors who then cheerfully read from the script. There doesn't appear to be any restrictions on the information provided, so it is possible that what is being read out by the doctors as far as dosage and usage is different than what was provided to the FDA for approval. Doctors interviewed by the Globe claim that they review the materials carefully and use their own judgment when it comes to the speech, but that doesn't change their status as shill.

Massachusetts will require disclosure of such arrangements between doctors and drug makers next year, but in an editorial in today's edition, the Globe believes it necessary to go even further:

The state, which as of next summer will require drug companies to disclose their speakers and the amounts they are paid, should not stop with transparency. Neither should Congress when it considers a Senate bill that would require such disclosure nationwide. While transparency is a good first step that exposes doctors’ financial relationships to the broader medical community, it is unlikely to affect how patients view their doctors. More important, it will not address the subtle ways the payments influence and interfere with patient care.

Exactly so. Few patients, when handed a prescription for a very necessary medication, are going to challenge their own health giver by asking for his relationship to the maker of the medication. Even fewer will do the research necessary to find out if their doctor is on the payroll of the drug maker. The practice is a horrid conflict of interest, and the doctors should know better. Apparently the pay has blinded some of them to that fact. At this point, an outright ban against using doctors in this fashion is the only safe answer.

The Boston Globe has done its job admirably on the issue. I just wish more newspapers and news outlets would do likewise.

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