Healthy Skepticism Library item: 17369
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: Broadcast
Sedgman J
GPs seek right to give drug info to pharmaceutical firms
PM : ABC Radio National 2004 Nov 17
http://www.abc.net.au/pm/content/2004/s1245798.htm
Full text:
MARK COLVIN: To a proposal that has the medical community divided.
Some doctors are investigating ways of supplementing their income by selling information to pharmaceutical companies about the drugs they prescribe. They argue that market research companies already collect such data for the drug companies so why not cut out the middle men.
One of the proponents of the scheme, Sydney doctor Jodhi Menon, says patients’ personal details would not be revealed, only the medicines they were prescribed. He says patients could also choose not to take part in any such arrangement.
But the Australian Health Ethics Committee says that’s not the only issue at stake here, as Jayne-Maree Sedgman reports.
JAYNE-MAREE SEDGMAN: Every day our buying habits are monitored by an increasingly sophisticated market research industry, but how would you feel if your local GP told the pharmaceutical giants which medications you were taking?
It’s a plan proposed by a number of doctors, including Sydney GP Jodhi Menon, who says arrangements between doctors and the drug companies already exist that pose far greater ethical dilemmas than this new plan.
JODHI MENON: Pharmaceutical companies, from time to time, carry out so-called trials, where they get GPs to enlist their patients, to enrol them in the trial, and in return what they will supply is a few handouts, some presents for your patients, maybe you will get a gift at the end of the trial and so on. Now, that sort of thing is being done right now, and I think that is more open to abuse than this sort of thing.
JAYNE-MAREE SEDGMAN: Dr Menon argues the average GP needs such payments to supplement their income, and says he believes patients would rather see their doctors rewarded than some market research company.
JODHI MENON: If the doctor is going to make money, firstly it’s transparent. He will say so in a big poster in his room to say that this is what he’s doing. And secondly, I think you’ll find most patients would prefer any income of that sort to go to their doctor, rather than to some nameless big company with whom they can’t be absolutely certain that their secrets are safe.
JAYNE-MAREE SEDGMAN: Proponents of the scheme say patients could choose not to participate. But the Chairman of the Australian Health Ethics Committee, Dr Kerry Breen, says there are other issues at stake.
KERRY BREEN: This is an issue that goes to the very heart of medical ethics and the status the community grants to doctors as professionals. This raises issue of the confidentiality of any information the doctors possess about patients, and no such information can be released without a patient’s permission.
I note that the proposal talks about de-identification of the patients’ prescription information, but once you get into that level you’re really talking about market research, and that raises issues surrounding privacy, and also independent ethical reviews.
So, whichever way you look at this proposal, it’s got problems.
JAYNE-MAREE SEDGMAN: Dr Breen says drug companies will always find ways to glean information about prescribing habits, but doctors don’t have to hand it to them on a platter.
KERRY BREEN: The industry gets its information from various sources, and I presume they get it from their own sales in certain areas, and they get some idea as to what doctors are doing, but I think there are two problems here. One is the doctor’s getting money directly for patient data, which I don’t think they’re entitled to, and secondly, as I’ve said already, it’s basically saying that we really do want you to know what we’re doing. We really want you to be able to influence our prescribing. And I don’t think that’s the sort of the trust that the community want to have in their doctors.
JAYNE-MAREE SEDGMAN: And it seems those concerns are shared by the Royal Australian College of GPs. Associate Professor Jane Gunn represents the College’s National Standing Committee for Research. She says there’s no escaping the ethical dilemmas such a scheme would create.
JANE GUNN: We would want to ensure that such a scheme was subject to review by properly constituted ethics committee, that ethical guidelines were adhered to, and it’s likely that a scheme such as this would struggle in that ethical review, however I don’t know the full details of what they’re proposing.
We wouldn’t dismiss it totally out of hand, but it does raise issues about patient privacy and whether or not the data was going to be used for the best interests of patients and the general practice community.
MARK COLVIN: Jane Gunn of the Royal Australian College of GPs, ending that report by Jayne-Maree Sedgman.
