Today’s New York Times features an editorial that proposes a seemingly common-sense solution to reduce the influence of the pharmaceutical peddlers:
A potentially useful antidote to drug company influence over the prescribing practices of doctors is under consideration in Congress. The idea is to have government-funded health professionals visit doctors to give unbiased guidance on the safety and effectiveness of drugs to counter the one-sided sales pitches they get from pharmaceutical company representatives. The end result should be better care, quite often at lower cost.
Objective advice on drugs has already been shown to affect prescribing practices in various locations in this country and abroad, according to testimony before the Senate Special Committee on Aging last week. In a Pennsylvania project, for example, experts from Harvard Medical School prepared educational materials and trained pharmacists and nurses to deliver it, enhancing medical care and saving more than $500,000 a year on gastrointestinal drugs alone in a pharmacy assistance program for low-income senior citizens. Total savings to public and private health insurance programs were surely much higher.
Similar physician-education programs are being established in several other states and have been set up in Australia, England, the Netherlands and several Canadian provinces. The Kaiser Permanente medical system has educated its own doctors on drug issues for years.
Now Senators Herb Kohl, Democrat of Wisconsin, and Richard Durbin, Democrat of Illinois, are planning to introduce legislation that would authorize federal grants to prepare educational materials and train health professionals to conduct visits to prescribing physicians. Their hope is that the program would pay for itself by lowering drug costs to federal programs.
With comprehensive, unbiased information, doctors should be more likely to prescribe the best drug for a patient, not necessarily the newest, high-priced drug that is being pushed by a drug company sales representative. [link]
This proposal sounds good on the surface but, in and of itself, is inadequate. “Unbiased information” is less readily available than it used to be, in large part due to the shift away from public funding of medical reasearch and toward private funding. Many studies and drug trials are now financed largely by the pharmaceutical industry, which stands to benefit if there is a favorable outcome to the research. History has already taught us that such a conflict of interest fails to serve the public good and can be downright dangerous. It is not enough for neutral third parties to disseminate “objective advice on drugs.” Congress should also take action to ensure that the advice being dispensed is truly objective, preferably by reversing the trends in funding and allocating more public monies for medical research. Additionally, there needs to be greater transparency in where the research money comes from. For example, if a study is funded by the [fictitious] Pediatric Bipolar Institute, it might be helpful to know that this institute was founded and is supported by Eli Lilly or other pharmaceutical companies. Physicians and other medical professionals, who often are so stretched for time (thank you, managed care) that they lack sufficient time to keep up with or closely examine the latest research findings, deserve a system that makes the research more accessible and more transparent. And the public deserves a health care system that puts their needs and well-being ahead of the profits of the pharmaceutical industry. In short, while the band-aid suggested in the Times editorial is nice, it is not enough to stanch the bleeding. Congress should know that and act accordingly.