Doctors and Drug Companies: Conflict of Interest?
Monday, March 12, 2007
By: Jack Williams
It's a relation****p that's drawing more and more scrutiny these days,
the frequent interplay between big drug companies and doctors who
prescribe their drugs. As Houston Public Radio's Jack Williams
re****ts, students at the University of Texas Medical School at Houston
are getting a firsthand look at the pros and cons of what some see as
a major conflict of interest.
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If you wait around long enough at nearly any doctor's office or
hospital, there's a good chance you'll see a pharmaceutical rep
hauling in a case of drug samples along with a couple of pizzas for
lunch. It's a fact of life for both doctors and drug reps, an
understanding that freebies sometimes equal a few minutes of face time
with doctors. It's an uneasy relation****p that critics say is ripe for
conflict of interest, where doctors prescribe drugs from companies
they have relation****ps with. At a recent debate at UT Houston, Dr.
Paul Anthony, chief medical officer for Pharmaceutical Researchers and
Manufacturers of America, argued that conflict of interest is a fact
of life, but has to be managed.
"I don't think it's possible through any set of codes or any kind of
policy to eliminate conflict of interest. What we all need to do as
physicians is learn to manage conflict of interest, because it's
always going to be there and we should make sure that we're aware of
what those potential conflicts are when we make a prescribing
decision."
Several schools, including Stanford and the University of
Pennsylvania, have banned all freebies from drug company reps at their
medical schools. Dr. Howard Brody of the University of Texas Medical
Branch in Galveston says some doctors are blinded by what he calls
"self-deceit," believing they're not influenced by drug company gifts.
He says one solution to the conflict of interest problem would be to
funnel research money through a neutral agency instead of having it
come directly from the drug company to research physicians.
"You could still have new research. You could still have new drugs.
The companies could still make a very nice profit but we wouldn't have
this problem that we of the control of the information flow being so
vested in the hands of the industry."
Drug companies say they would use other ways to market their products
if those tactics worked, but have yet to find ways that work better
than what they're doing right now. Dr. Eugene Boisaubin is a professor
of medicine at UT Houston and says there has to be a balance.
"I guess in the best of all worlds we always will have pharmaceutical
companies, we need them for good products, but we'll teach physicians
to be more aware of what the influences might be and how to look at a
more balanced view and what other sources are they can use besides the
pharmaceutical industry to get information that is a little more
science-based and not just promotional."
Both sides agree that the bottom line should be patient care,
regardless of where the medications are coming from. The
pharmaceutical industry has recently instituted what it calls "pharma
codes" that loosely regulate freebies given to doctors.
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I was recently visiting a local podiatrist when a pharmacy rep showed
up with several boxex of pizzas and to my surprise and the doctor's
credit,, he told the pimp to "Get the hell out of here." And said to
me, "I don't need that crap."
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