Friday, January 27, 2012

EDITORIAL Of doctors and drug makers -

Did your doctor prescribe that expensive drug solely because you need it, or in part because she has friendly feelings toward the pharmaceutical company that makes it, which treated her to a Hawaiian vacation-cum-"medical conference"? Patients may get some insight into such questions thanks to a lesser-known but important provision of the 2010 healthcare reform law that requires the makers of drugs and medical devices to disclose most payments and gifts to physicians.

The proposed regulations, which are going through a period of public comment, are appropriately strict in ways that would both protect patients and reduce medical costs. The payments and gifts would be available on a searchable public website. Free samples of drugs would be exempt from reporting, but otherwise, anything worth more than $10 total for the year would have to be disclosed.

Of course, many doctors are motivated only by the well-being of their patients, and there are times when drug company payments are appropriate and beneficial to medical research. But pharmaceutical companies are known for underwriting luxurious medical meetings for doctors that are more about play than work, and for paying physicians hefty sums to pitch their drugs to colleagues, often at lunches also paid for by the companies. Doctors with the best intentions can be influenced, consciously or not, by relentless marketing, especially when it's done by their peers.

Physicians who received research funding and other payments from pharmaceutical companies have sat on advisory boards for the U.S. Food and Drug Administrationand have recommended drugs made by those companies. A survey published in the Annals of Internal Medicine in 2010 found that 71% of doctors had accepted food from drug companies, and that doctors who took payments were more likely to prescribe those companies' expensive brand-name medications rather than cheaper generics. Fourteen percent of doctors had been paid to serve on advisory boards and enroll patients in clinical trials — and that number was half what it had been in 2004, before the practice came under greater scrutiny. Some drug companies recently began voluntarily reporting payments and gifts to doctors.

In other words, the website will be a force for good even if few patients examine it. Watchdog organizations and news reporters will use it. For many doctors and pharmaceutical companies, the knowledge that their actions will be held up to public light is enough to curb the potentially troubling behavior.

Posted via email from Jack's posterous

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