Both state legislatures and Congress are getting riled up about the excesses of the pharamceutical gravy train for physicians, and the company's ability to manipulate physicians to do their bidding through clever marketing. Today's New York Times editorial addresses interest in the U.S. Senate on creating a mandatory registry of all payments from pharmaceutical companies to physicians. (Several states, notably VT and MN, already have laws to require such reporting, and the Times has been having a field day mining those reports in recent weeks.) Several state legislatures are considering outlawing the selling of physicians' prescribing data. (The NH law to ban such sales has been challenged in court.)
What I find interesting about this is that it is flushing the industry out into the open with regard to some of its key rationalizations. The defense of the drug rep arriving at the physician's office with a complete listing of all prescriptions the doc has written for the company's drug and for its competitor drugs? It allows the company to fine-tune its educational message to the physician, addressing the physician's particular needs for drug information. The defense of payments to physicians generally? It is all about education, and physicians are independent scientists who make up their own minds and who cannot be swayed by few free coffee mugs or sandwiches.
To which the New York Times responds, addressing a mandatory payment registry: "If there is nothing wrong with such payments, neither the doctors nor the industry should object to public disclosure." On the matter of the sales of data to drug companies, it is well known that the reps are instructed by the companies to go to considerable lengths to hide the fact that they have these data from the physicians. So the same argument applies there as well--if this is all about education, and the more effective targeting of drug information, why go to such lengths to conceal from physicians the fact that your detail rep has these data?
Is your doctor tied to drug makers? [editorial] New York Times, July 2, 2007, p. A18.
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In this post that refers to what is being stated in the media, only two mild issues are being addressed, comparatively speaking. There are other corrections of greater importance that need to be eliminated from the pharma industry, such as clinical trials created by this industry that are more marketing and commercial instruments than science. Perhaps of greater importance is the need to sever the pathologically intimate relationship this industry has with elements of our government for the sole purpose to protect thier interests instead of the public.
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