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Healthy Skepticism Library item: 998

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

Bush Administration's Proposed Physician Gift Guidelines Criticized by Pharmaceutical Industry
California Healthline 2003 Jan 3


Full text:

The New York Times on Dec. 26 examined opposition to guidelines proposed by the Bush administration to restrict gifts that pharmaceutical companies offer to physicians and health insurers to encourage them to prescribe or recommend certain treatments. The proposed guidelines, issued by HHS in September, state that gifts such as trips, entertainment and expensive meals “looked like illegal kickbacks” that violate federal fraud and abuse laws (Pear, New York Times, 12/26/02). The guidelines also say that “switching arrangements,” in which physicians receive gifts to shift patients from one treatment to a different medication, are “suspect under the anti-kickback statute.” In addition, the guidelines state that payments to physicians who serve as “consultants, advisers and researchers” for pharmaceutical companies could “pose a substantial risk of fraud and abuse” in cases where the amount paid exceeds “fair market value for services rendered” (California Healthline, 10/01/02). HHS plans to issue final guidelines in the next few months.

Reaction

According to a coalition of 19 pharmaceutical companies, the proposed guidelines are “not grounded in an understanding of industry practices,” which include payments to health insurers to increase the use of certain treatments and to have medications added to prescription drug formularies, as well as gifts to physicians who switch patients to certain treatments. Dr. Michael Maves, executive vice president of the American Medical Association, said that the practices help fund professional education programs for physicians. He added, “Without the financial support from industry, medical societies would most likely be forced to curtail or stop offering these important educational programs.” The guidelines could lead to increased prescription drug prices because pharmaceutical companies “may be less willing to offer large discounts if those discounts cannot be tied to movements in the market share,” Alissa Fox, policy director for the BlueCross BlueShield Association, said (New York Times, 12/26/02).

 

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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