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Healthy Skepticism Library item: 13871

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

Are Perks Compromising MD Ethics?
CBS News 2008 Jun 26
http://www.cbsnews.com/stories/2008/06/26/eveningnews/main4213269.shtml


Abstract:

Conflict Of Interest Issues Raised By Drug Company Freebies Given To Doctors


Full text:

For five years, Mathy Downing has struggled for an explanation.

Why would her daughter Candace – a happy 12-year-old – hang herself from the bedpost, leaving no notes and no clue?

“We had no warning,” Downing said. “Absolutely no warning.”

The Downings blame Candace’s suicide on the antidepressant drug Zoloft.

They wondered why the doctor gave such a powerful drug when Candace’s only complaint was anxiety in school. Then recently, in their lawsuit against the doctor, they think they found an answer, CBS News correspondent Wyatt Andrews reports.

“I said, ‘wait a second … what?’” said Candace’s father, Andy Downing.

Wait a second, because Candace’s doctor, Matheme Selassie, had been paid around $12,000 making speeches touting Zoloft, with some of the payments coming from Pfizer, the drug’s manufacturer.

The Downings believe the money influenced the prescription.

“Did the doctor tell you he was taking Pfizer money?” Andrews asked Mathy Downing.

“Absolutely not,” she said. “How dare he! How dare he take money for a medication that killed our daughter.”

Today the chances are good your doctor accepts benefits from drug companies – and not just the free samples and the pens you see in most doctors’ offices.

Estimates say drug-company payments to doctors go as high as $57 billion a year, according to a University of Quebec study, covering consulting fees, speaking fees on drugs, and medical seminars on the benefits of drugs.

That means the industry spends far more money marketing to doctors than it spends on advertising.

“If they are being paid, it ought to be reported,” said Sen. Charles Grassley, R-Iowa.

Grassley is also looking at the money drug companies pay doctors for academic research. He is investigating some 20 top medical schools – including Harvard, Stanford and the University of Cincinnati, for under-reporting the income top researchers are getting from the drug industry.

Grassley wants to learn if the money is influencing research.

At Harvard, for example, Dr. Joseph Biederman, whose research has led to huge increases in bipolar diagnoses in children – and the prescriptions to treat those children – is being asked why he allegedly failed to report $1.6 million in fees from drug companies.

What kind of flag does that raise for Grassley?

“Well, it raises a flag to me that they might have something to hide,” he said. “It raises a flag that the university doesn’t care.”

Biederman tells CBS News some of that industry money was “not personal income,” and that his life’s work is devoted solely “to rigorous and objective study.”

Fixing this problem is complicated because some relationships between doctors and drug companies are legitimate, and necessary to achieve breakthrough therapies. Sen. Grassley says the answer is more public information.

Grassley and other senators have proposed a law requiring drug companies to report any payments to doctors of more than $500. That reporting will be available publically on a government Web site.

“There has to be full transparency,” Mathy Downing said. “Parents, families have the right to all the information.”

As for the suicide of Candace Downing, Selassie says in a deposition he was paid to speak about adult use of Zoloft. He declined further comment.

Pfizer, in a statement says its paid consulting work with doctors helps the company learn “how to reduce adverse reactions … and improve effectiveness.”

But the big question for the Downings is still about the money.

How much of the industry’s money is buying legitimate consultations, and how much of it could be buying the wrong prescription?

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909