Healthy Skepticism Library item: 13353
Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.
Publication type: news
Lassman S.
Does a drug firm's free lunch influence doctors?
The Boston Globe 2007 May 18
http://www.boston.com/news/globe/editorial_opinion/oped/articles/2007/05/18/does_a_drug_firms_free_lunch_influence_doctors/
Full text:
JUST WHAT is the best and most appropriate way for a company that researches and manufactures a prescription medicine to educate physicians about the products it develops? It’s a question that is increasingly being discussed in academic and political circles, yet too often those leading the discussions know little about the pharmaceutical industry’s commitment to patient education.
Take, for instance, a study published in the New England Journal of Medicine broadly titled, “A National Survey of Physician-Industry Relationships.” The authors surveyed 3,167 physicians across six specialties to quantify what type of interactions or relationships exist among medical device manufacturers, pharmaceutical companies, and other “medically related”
companies. Ironically and rarely noted in the subsequent media coverage, the authors sent each physician a check for $20 for their participation.
The authors found that 94 percent of physicians reported “some type of relationship with the pharmaceutical industry.” That makes sense. Physicians treat patients with pharmaceuticals and receive the latest, best information on the medicines they prescribe from the companies that make them.
Eighty-three percent of doctors report receiving food from the pharmaceutical companies in the workplace. Pharmaceutical representatives commonly find that busy doctors would rather meet over a modest lunch in a workplace setting — probably equal in value to the $20 check made out to the doctor by the study’s authors — rather than block out time better spent meeting with patients.
Every day, patients depend on the knowledge, expertise, and independent clinical judgment of doctors to help make increasingly complex decisions about their personal health. These professionals are duty-bound to provide patients with the latest, most accurate information regarding complex healthcare choices. I’m not a doctor, but it seems to me to be insulting, as many critics do, that a meeting, a pizza, or a pen would inappropriately influence a physician’s prescribing decisions.
Who better to know about the scientific complexities of prescription medicines than the companies that create them? Pharmaceutical experts are a key source of information for healthcare providers on side effects and new studies regarding medicines they may prescribe. Clearly, patients benefit from these exchanges. Picture the opposite. What would a patient’s reaction be if a doctor shrugged his or her shoulders in confusion when asked about a drug that may be life changing?
The authors of the New England Journal of Medicine survey say it themselves:
“Finally, this study did not assess the risks, benefits, or overall appropriateness of various types of physician-industry relationships. Such judgments are the logical next step in discussions regarding physician-industry relationships, but they cannot be made solely on the basis of the data from this study, although they have been described extensively elsewhere.”
Patients are the clear winners when doctors and pharmaceutical experts communicate. Any effort to quell discussion or limit the sharing of research and information is not in patients’ best interests.
The information exchange also goes both ways. Doctors learn firsthand the trends in medicine safety before anyone else in the medical community. It’s the kind of experiential knowledge that can’t be taught in the university or even learned in a lab, and they share their experiences with a given medicine with these representatives.
This debate is really about trust. The industry values the relationship its representatives have built with the nation’s healthcare professionals, and it is critical to the mission of helping patients that these interactions be maintained at the highest ethical standards. Just as patients trust their physician, it is equally important that physicians trust their pharmaceutical representatives.
More than four years ago, the Pharmaceutical Research and Manufacturers of America set strict voluntary guidelines to provide guidance on interactions with physicians. For example, the code spells out that discussions between physicians and sales representatives must benefit patients and advance health education, and that expensive meals and lavish gifts for a physician’s personal use are never appropriate.
PhRMA’s Code on Interactions with Healthcare Professionals is also in step with the ethical guidelines of the American Medical Association — the nation’s largest physician group founded nearly 160 years ago. Both PhRMA and AMA are explicit about guiding marketing activities so healthcare providers’ independent judgment is preserved, while still helping physicians and nurses understand the evolving and growing body of scientific research for each medicine.
America’s pharmaceutical research companies and healthcare providers have a shared goal: to improve the lives and health of patients. The debate on physician education and pharmaceutical representatives is an important one.
PhRMA and its member companies remain dedicated to improving their work with physicians so that they — and their patients — have the latest and best information about important and often life-saving treatment options.
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Scott Lassman is the senior assistant general counsel for the Pharmaceutical Research and Manufacturers of America.
