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Pharmaceutical Industry Influences Doctors, Drug Development

Sep 15, 2008 | Parker Waichman LLP The Associated Press has pointed out that many in the medical community are accusing big pharmaceutical of deception, manipulating doctors, and focusing on profits over patients.  Much in the news has been reported to confirm this and medical schools, teaching hospitals, and physician groups are limiting pharmaceutical sales rep influence.  Also, three top editors of the prestigious New England Journal of Medicine publicly sided against industry in a U.S. Supreme Court case last month over whether patients harmed by government-approved medicines may still sue in state courts.

New guidelines for how drug makers and doctors should interact are coming from everywhere and doctors confirm some abuses are now things of the past, but there is still a good amount of conflict due to interdependency.  For instance medicine needs drug makers' research funding and drug makers need researcher credibility.  "The influence that the pharmaceutical companies—the for-profits—are having on every aspect of medicine … is so blatant now you'd have to be deaf, blind, and dumb not to see it," said Journal of the American Medical Association editor Dr. Catherine DeAngelis, a longtime industry critic.  "We have just allowed them to take over, and it's our fault, the whole medical community."

DeAngelis also recently noted two studies stating ghostwriters wrote past reports about Merck & Co.’s withdrawn pain reliever Vioxx and some reports minimized risk of death.  "Manipulation of studies and publications by the pharmaceutical and medical device industries is either increasing or there has been more exposure of these practices," she wrote.  DeAngelis added that industry influence includes influencing doctors and medical students with gifts and funding research at top teaching hospitals.  But, funding includes tight controls on studies and results, can hide study authors' conflicts of interest, and can even control doctors’ continuing medical education by running courses on new treatments. Critics say company-paid speakers who often promote expensive new drugs over older, cheaper ones teach such courses.  "We should all get together and say, ‘Enough!'” she said.

Now, some top journals list study authors' conflicts of interest and some medical schools and specialty societies ban gifts and limit financial ties to industry; some schools prohibit professors from being paid as drug company speakers and drug makers have stopped awarding cash prizes to medical students for presenting favorable research on their drugs at conferences.  Despite this, ceasing industry funding for academic research on new drugs has not been suggested as those billions of dollars help cover lab costs and other expenses at virtually all U.S. teaching hospitals, medical schools, and affiliated practices, while providing drug developers with credible academic researchers who run their studies.

Pharmaceutical analyst Steve Brozak of WBB Securities said drug makers will find ways to adapt.  "The earlier you can hook one of these doctors, the more loyal they are" to a brand, Brozak said.  David Rothman, president of the Institute on Medicine as a Profession, said about one-fourth of U.S. medical schools now have policies on industry gifts "that really pass muster."  Some bar sales reps from giving doctors drug samples, yet allow donations to a central location.  "You're not being bribed, you're being gifted," doctors may think, but industry freebies influence prescribing patterns, he warned.

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