At last we're joining the global move to clean up corrupt ties between doctors and drug companies, says Ray Moynihan in The Australian.
THE tough new code forcing drug companies to come clean about freebies for doctors is a welcome sign of a healthier medical system. For far too long some of the most profitable companies have wined and dined your local general practitioner without your knowledge.
The drug industry and the medical profession call it education. Those who are not on the gravy train call it what it is: bribery.
As any Australian knows, food, flattery and friendship is the best way to build relationships, and the sophisticated marketing folk inside Big Pharma are masters at building lifelong relationships. It starts with sponsorship of medical students' parties, moves on to so-called sponsored education of GPs and ends with senior specialists living lives lubricated with company largesse, jetting between company-sponsored conferences in the world's best locations.
Many leading doctors in the US earn more than $100,000 a year from their promotional work for drug companies, on top of their hospital salaries.
If the Australian Competition and Consumer Commission's tough approach to disclosure works, we may get to learn what the senior specialists in Australia are earning from their drug company junkets.
There are legitimate reasons for doctors and drug companies to get together, particularly for important research studies. During such interaction, someone occasionally may need a feed. But, as a government adviser told me recently, Roche's $200- a-head nosh-up at the Sydney Opera House can never be justified.
Increasingly, ethical doctors who work with industry on clinical trials are politely declining the offers of five-star accommodation, caviar and $80-a-bottle pinot noir.
Attempting to defend the indefensible, Australian Medical Association president Mukesh Haikerwal lamely told me there was evidence that the free meals had no effect on doctors' prescribing habits. As the senior representative of the medical profession, he is ill-informed. The weight of the evidence suggests drug promotion works and it is one of the reasons for the unnecessary prescribing of costly and even harmful new drugs. It hurts patients and the public purse. The website www.healthyskepticism.org has a wealth of scientific studies there for anyone to see.
The normally media-savvy AMA made a big blunder this week, proclaiming that $200-a-head meals were acceptable, then criticising the ACCC's new approach as potentially harmful to education. The argument is that doctors won't go to company-sponsored education if the food isn't good enough. But why on earth would a doctor want to attend company-sponsored education in the first place? Would you want your GP to learn about a Pfizer drug from a Pfizer-sponsored educational event?
The fresh wind of reason is finally blowing through the corridors of the medical establishment as more and more thoughtful doctors become concerned about their entanglement with the drug industry. Medical journals, doctors' organisations and university departments everywhere are starting to question their closeness with industry and in some cases wind it back. The 50,000-member American Medical Students Association boasts a "pharma-free" policy: none of its members accepts any gifts, trips, meals or consultancies from drug companies.
The ACCC has concerns about whether the tough plan will be enforced. It will require drug companies to disclose many details about the freebies they provide to doctors, including trips, hotels, food and wine. Given the industry's track record, it is possible the spin doctors are working on ways to circumvent the new rules. It will be incumbent on the ACCC and the wider community to make sure the industry follows through.
But the industry is not the real problem here: company shareholders demand their executives maximise sales and profits. The real culprits are the doctors. It goes without saying that most are decent, hardworking professionals. The problem is the culture of entitlement: somehow a doctor's status means they are above the standard rules about bribes and inducements.
This week's ACCC reform is aimed at changing that culture and ending the crass bribes. In the meantime, why not ask your doctor whether they've had any lately?
Ray Moynihan's book Ten Questions You Must Ask Your Doctor (Allen & Unwin) is expected next year.
UPDATE
Mike at Pharma Watch has a (v funny) take on this.
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