Travelers on the Path of Knowledge

Knowledge is an ocean and a few drops just aren’t enough. -Unknown

Conflict of Interest June 17, 2007

Filed under: Medicine — musaafir @ 2:56 pm

Recently I was writing a paper on drug company profiteering. While researching the topic I learned about DTC advertising (direct to consumer). The arguments against DTC made a lot of sense because when you see ads for drugs on TV, the uninformed consumer is apt to tell their doctor that they want the drug they saw in the ad, despite the side effects- which are either mumbled really quickly at the end or written in fine print. “Ask you doctor if “our drug” is right for you.”

I’m sure you’ve heard it. In most fields, the average layperson asks the one who possesses knowledge to help them make informed decisions. But here the patient urges the doctor to prescribe the drugs that are advertised on mediums they often see- not just limited to television, these ads are in magazines and journals as well.

The drug companies also are not limited to marketing directly to the consumer, they often market to doctors as well. Where do you think people get all those free sample notepads, pens, paper weights, etc. etc. In fact, some drug companies even sponsor breakfasts and seminars for certain hospitals and clinics. Here ethics get blurred because more often than not the doctors will prescribe certain drugs because of the perks associated with those companies.

Now, there is article in the NYTimes about the potential conflict of interest in the field of medicine which can lead to the detriment of patient care:

the transformation of continuing medical education into an enterprise for drug marketing. The chore of teaching doctors how to practice medicine has been handed to the pharmaceutical industry. As a result, dangerous side effects are rarely on the curriculum.

Most states require that doctors obtain a minimum number of credit hours of continuing medical education each year to maintain their medical licenses. Not so long ago, most of these courses were produced and paid for by universities and medical associations. But this has changed drastically over the past decade.

According to the most recent data available from the national organization in charge of accrediting the courses, drug-industry financing of continuing medical education has nearly quadrupled since 1998, from $302 million to $1.12 billion. Half of all continuing medical education courses in the United States are now paid for by drug companies, up from a third a decade ago. Because pharmaceutical companies now set much of the agenda for what doctors learn about drugs, crucial information about potential drug dangers is played down, to the detriment of patient care.

Drug companies should never have been allowed to become the primary educator for America’s doctors. The Accreditation Council for Continuing Medical Education, a nonprofit organization composed of the major medical associations, establishes the rules that govern continuing medical education. According to the guidelines, companies are forbidden from directly paying doctors who teach continuing medical education courses.

But the standards have a loophole that allows drug companies to circumvent the regulations. They hire for-profit “medical education communication companies” to organize the courses. These companies receive millions of dollars from drug companies to create course work and to pay doctors to deliver the content. Sometimes, they pay doctors to give lectures to other doctors. Other times, prominent doctors are paid to be listed as the authors of journal articles that are written by ghost writers, a practice that was extensively documented in court records from a lawsuit against Pfizer.

Either way, the content is rarely developed by the identified experts. Instead, it is developed by the undisclosed communication company, which is paid by the sponsoring pharmaceutical company.

Essentially, this is a new twist on that well-known instrument of corruption, money laundering. Drug companies don’t directly pay doctors to teach courses. Instead, they pay someone else to cut the checks. Similarly, the drug companies don’t explicitly tell doctors to say good things about their products. Instead, they hire a company to write good things about their products and to pay doctors to deliver the messages.

Full text.

Now you would think that those companies that have in their hands the lives of consumers would be ethical, wouldn’t you? But drug companies shrug off this responsibility because their existence is based on money and they feel that health isn’t their primary responsiblity since they are not the primary healthcare givers.. but the more involved they get in medical processes, the deeper the hole they dig for themselves..

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