Big Pharma’s Influence

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If you want to know more about the medical profession, just ask yourself: Who sponsors doctors and the medical science? The answer is -mainly- the pharmaceutical industries. That says a lot… You really want to trust your health to Big Pharma Corporations?

Here is a general synthesis of the situation:

Battling influence of pharmaceutical industry

Linda A. Johnson
Associated Press
Sunday, September 14, 2008

Just about every segment of the medical community is piling on the pharmaceutical industry these days, accusing drugmakers of deceiving the public, manipulating doctors and putting profits before patients.

Recent articles and editorials in major medical journals blast the industry. Medical schools, teaching hospitals and physician groups are changing rules to limit the influence of pharmaceutical sales reps. And three top editors of the prestigious New England Journal of Medicine publicly sided against the drug industry in a U.S. Supreme Court case last month over whether patients harmed by government-approved medicines may still sue in state courts.

As more voices have called for change, new guidelines for how drugmakers and doctors should interact are coming from all sides, and doctors say some abuses of the past have ended. But the industries’ dealings remain fraught with potential conflict because the sectors depend on each other so much – medicine on drugmakers’ research dollars and drugmakers on the credibility researchers give them.

“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.”

In an April editorial in her journal, DeAngelis noted two studies that indicated past reports about Merck & Co.’s withdrawn pain reliever Vioxx frequently were done by ghostwriters and that reports on some Vioxx studies minimized the risk of death. Merck has denied the charges.

“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.

She said industry influence includes swaying doctors and medical students to their brands with gifts, funding research at top teaching hospitals but keeping control of the studies and results, failing to disclose study authors’ conflicts of interest, even taking over the continuing medical education system for doctors by running courses on new treatments. Critics say such courses are taught by company-paid speakers who often promote expensive new drugs over older, cheaper ones.

“We should all get together and say, ‘Enough!’ ” DeAngelis said.

Already, top journals are listing study authors’ conflicts of interest, and dozens of medical schools and medical specialty societies are barring gifts to doctors and limiting their other financial ties to industry. Some schools bar professors from being paid drug company speakers. And one expert noted drugmakers have stopped giving cash prizes to medical students for presenting favorable research on their drugs at conferences.

Still, no one is suggesting anything as drastic as cutting off industry funding for academic research on new drugs. Those billions help pay lab and other expenses at virtually all U.S. teaching hospitals, medical schools and affiliated practices, while giving the drugs’ developers the cachet of having big-name academic researchers running their studies.

The industry’s trade group, in an apparent response, in July revised its 2002 “Code on Interactions with Health Care Professionals” to ban giving out pens, mugs and other noneducational gifts, taking doctors to restaurants, and giving them tickets for shows or sports events.

“America’s pharmaceutical companies devote many years and billions of dollars to researching and developing life-saving medicines,” and help drive progress and economic growth, said Diane Bieri, general counsel for the Pharmaceutical Research and Manufacturers of America. “We will always face criticism, and at times deserve it, but our companies remain committed to listening to and learning from parties with divergent points of views.”

But pharmaceutical analyst Steve Brozak of WBB Securities said drugmakers will find ways to adapt to new rules.

“The earlier you can hook one of these doctors, the more loyal they are” to a brand, Brozak said.

Medical groups have been fighting industry influence harder since a 2006 JAMA editorial by 11 prominent doctors urged teaching hospitals to lead in cleaning up conflicts of interest between medicine and industry.

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 – but allow donations to a central supply office – and don’t let them wander their halls to speak to doctors.

“You’re not being bribed, you’re being gifted,” doctors may think, but industry freebies influence prescribing patterns, Rothman said.

Campaign to rein in drugmakers

Some other efforts to address pharmaceutical industry influence on health care – by the industry and the medical community:

— This month, Stanford University School of Medicine banned all commercial support of continuing medical education programs on specific topics, such as a drug, plus all exhibitions by commercial companies at education programs.

— The American Medical Association has urged better government oversight of drug ads aimed at consumers and blasted misrepresentation of data in and authorship of medical journal articles. In 2001, the group started a national campaign to encourage doctors and the drug and medical device-makers to stick to its ethical guidelines on gift giving.

— In 2006, the trade group Pharmaceutical Research and Manufacturers of America put out guidelines on consumer ads. Besides following FDA rules requiring accuracy, balance and evidence, the guidelines urge educating consumers along with marketing products and clearly stating major risks.

Journal of the American Medical Association editor Dr. Catherine DeAngelis led a 2004 effort in which 11 top international medical journals said they would no longer publish reports on studies not listed in a public registry. Hundreds of other journals have joined the effort, meant to stop drugmakers from burying results of studies that don’t work out.

— In 2001, the industry trade group adopted principles to govern research done on people, aimed at protecting study participants and ensuring objectivity.

The effort to counteract Big Pharma’s influence is most appreciated but the situation is rather hopeless unless it is coupled with critical thinking, responsibility, and self-education from everybody involved (patients, doctors). Never underestimating the influence of Big Pharma.

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