Wednesday, May 02, 2007

Are The Doctors a Little Too Cozy With Drug Companies?

An article in April 26, 2007 issue of the New England Journal of Medicine (NEJM) discusses the results of a survey on physician-industry relationships. According to this survey, most physicians (94%) reported some type of relationship with the pharmaceutical industry, and most of these relationships involved receiving food in the workplace (83%) or receiving drug samples (78%). More than one third of the respondents (35%) received reimbursement for costs associated with professional meetings or continuing medical education, and more than one quarter (28%) received payments for consulting, giving lectures, or enrolling patients in trials.

The issues:
- Most doctors’ offices accept lunches from pharmaceutical companies. Here are some of the views I heard: “I am not likely to prescribe a medicine just because someone fed me lunch.” “This is a common routine for the sales people to bring ‘goodies’ to their potential clients. Anybody in a purchasing position is familiar with this practice. It happens whether you are an office manager in charge of office supplies or you are a senator in charge of national policy matters. Why should doctors’ offices then be picked out for criticism?”
- Most doctors like to accept drug samples. They see this as a help to their patients.
- The pharmaceutical companies have devised the methods to monetarily incentivize the doctors that either write their products or who can influence others to use their products. Later are the opinion leaders. They are given consultant fees and speaking fees. However, this is done by filling a niche. The physicians and health care providers need continuing medical education (CME). The pharmaceutical companies pay some doctors for doing just that. As an expected side effect, these speakers may tend to support their sponsor’s products. The companies do this in a sophisticated way by carefully choosing the speakers whose views support their cause.

Pro-Per™ points:
- I do not see any problem with accepting samples as long as they do not influence a physician into prescribing costly meds when there are cheaper alternatives available.
- Most of the doctors spend time meeting pharmaceutical reps over lunch. Their time has a higher dollar value than that of the lunch they are fed. According to a survey, the doctors think that lunch helps their office staff’s morale. But if these free lunches are likely to adversely affect the public perception, should they just say no to lunches or dinners?
- Many doctors are on pharmaceutical companies’ payroll, according to the survey. While it is easy to see conflict of interest, these physicians get paid while providing a service that is in high demand. I do not see an end to this practice till we find someone other than the pharmaceutical companies to foot the bill for these services. through action


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