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    Thursday, December 26, 2002

    Bedfellows: The feds have plans to breakup the cozy relationship between pharmaceutical companies and physicians, a move which is being resisted by both parties:

    In contending that the proposed federal code of conduct would require radical changes, those opposing the change discuss their tactics with unusual candor and describe marketing practices that have long been shrouded in secrecy.

    Drug makers acknowledged, for example, that they routinely made payments to insurance plans to increase the use of their products, to expand their market share, to be added to lists of recommended drugs or to reward doctors and pharmacists for switching patients from one brand of drug to another.

    Insurers, doctors and drug makers said such payments were so embedded in the structure of the health care industry that the Bush administration plan would be profoundly disruptive.

    Moreover, doctors said that drug companies were a major source of money for their professional education programs, and that the administration proposal could drastically reduce such subsidies.

    "Without financial support from industry, medical societies would most likely be forced to curtail or stop offering these important educational activities," said Dr. Michael D. Maves, executive vice president of the American Medical Association.

    Doctors of all types echoed that concern.


    For "doctors of all types" read: "medical societies of all types." Much to the shame of the profession, our professional societies have become financially dependent on drug companies. They all rely on donations from pharmaceutical companies, not only to finance their educational programs, but to finance their day to day operations. Which makes me wonder what they do with all that money they charge for membership dues, which are usually several hundred dollars a year or more. (In the case of the AMA it 's around $2,000 which is one of many reasons I'm not a member.)

    This is a practice that should give us all pause. The medical societies and associations are known for putting forth guidelines that set the standard of care. Last year, the American Heart Association disgraced itself by recommending the use of a drug of dubious merit for strokes when it was discovered that the drug maker gave hefty amounts of money to both the organization and to members of the guideline panel. More recently, the outgoing president of the AHA was reprimanded by the FDA for shoddy research practices involving drug trials. Then there's the American Pain Society which takes money from drug companies to finance the writing of "pain treatment guidelines" which - surprise! - are weighted heavily to the use of drugs for the treatment of chronic benign pain.

    And I haven't even touched on the practice by "pharmaceutical benefits managers" of sending doctors faxes repeatedly to get them to switch drugs to their parent companies drugs, but the Times article covers it. The drug company and HMO dodge that it's just "common marketing practice" is ridiculous. It may be common practice but it's in no one's best interest - except the pharmaceutical companies and the HMO's. We have to recognize that drugs aren't like other consumer products. They have side effects, they have interactions, and they work differently in different people. Drug therapy has to be individualized. The decision of what drug works best in which situation has to be the decision of the patient and the doctor. It can't be driven by the same marketing techniques that are used for cars and widgets.
     

    posted by Sydney on 12/26/2002 08:07:00 AM 0 comments

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