|
|
As a profession, medicine is profoundly different. We have a covenant with society to
act in society’s best interest. Doctors go to school for years to learn their science. And
we use that science for the public’s benefit. We interpret and explain the risks and
benefits of a treatment so that a sick person can decide what course of action they wish to
take. The patient needs the doctor solidly in their corner.
In exchange for all this hard work and for acting selflessly, doctors are given lots of
privileges. Doctors are paid handsomely, they have all the rights of a profession
including deciding who gets in to the profession and who can call themselves doctors.
But once we let our own self-interest get in the way we break our covenant with society
and we invite public outrage and oversight. All these gifts, trips, tickets, and lunches
have compromised the public’s trust.
How accurate is the information provided by Pharma to doctors?
First, one has to decide what standard should be applied to promotional information. If
they are “just ads”, then perhaps they should be held to no higher standard than the
promotional material for Volvos,
Coke, or
Crest
toothpaste. If, as is maintained by Pharma, their material is “educational” then their ads need to be held to the high
standards of educational material that usually includes peer review, high factual accuracy,
and clarity.
In fact, promotional material is not meeting these standards. As Former FDA
Commissioner Kessler described, “…enormous potential exists for misleading
advertisements to reach the physician and influence prescribing decisions…misleading
advertisements can result in significant adverse consequences…needless injury or even
death may occur because physicians have been persuaded to prescribe products for uses
for which they have not been adequately tested or to substitute therapies that may be less
safe or less effective than the alternatives."
Stryer and Bero showed that much information (42%) failed to comply with one or more
FDA regulation including 35%, which lacked fair balance between risks and benefits.
My research has shown that 40% of print ads in medical journals did not present fair
balance, 58% contained images that expert reviewers felt minimized concerns about side
effects, and that 47% of the ads did not appropriately highlight risks and
contraindications in special populations such as the elderly. Few ads addressed cost.
Collectively, these research findings are typical of this body of literature.
Related articles: How
to doctors come to know about new drugs?
Interaction
of drug firms and physicians
Merck
and Pfizer fought marketing battles
Impact
of drug promotions on doctors' prescription decisions
Ethics
of marketing new drugs to doctors Relationship
of pharmaceutical companies and doctors
Impact
on prescription behavior due to marketing by pharma
companies
Overall
impact of drug promotion and advertising on pharma
industry |
