PharmaAltruism

Pharmaceutical companies and their salesmen know all the successful tricks of the trade. Bombard physicians with free samples of their products, load them down with all manner of self-serving pamphlets extolling the virtues of their drugs, promising to fix whatever ails patients, and the doctors never need think about alternatives; just so quick and easy to resort to whatever is at hand - courtesy of the pharmaceutical giants.

"Free" lunches with sales representatives, free tickets to pricey entertainment, free trips for the family, all there for the grasping. From time to time ethical considerations tickle the consciences of one or another of those tasked with physician oversight, and gentle admonishing of excesses may be circulated through the medium of medical association ethics boards, but in this fast-paced and high-energy world, that's life.

Now, an editorial in the most recent edition of the Canadian Medical Association Journal points out - inconveniently for those heedlessly partaking of these conventional offerings - that lectures, seminars and other ongoing "educational activities" that doctors are obliged to take are largely paid for - gasp! - by those very same drug companies with an obvious vested interest in their product promotion.

Who might ever have imagined that busy family practitioners could be so readily enticed to surrender their professional morals to the enticements of pharmaceuticals holding out those comfortable grab-bags? This isn't overt corruption, this is the status quo, nice little entitlements as a gesture of good will from the manufacturers to the prescriptors.

"This is big business. Of the $2.6 billion spent in the United States on accredited continuing medical education activities in 2006, $2.45-billion (60%) came from pharmaceutical and medical device manufacturers", wrote editor-in-chief Dr. Paul Hebert. "Some would argue that physicians are getting a good deal on their continuing professional education, so what is the problem?"

Problem is, on the evidence, self-interested subsidization of medical education stresses and embellishes the positive side of the equation, while handily overlooking any possible negatives involved, such as product side effects, decidedly adverse in nature. "It is time to stop the "free lunch" approach and place our continuing medical education system firmly in the hands of unbiased and qualified people, not corporations whose main concern is the bottom line" thunders Dr. Hebert.

Hear, hear. Just as pharmaceutical companies sponsor university research in various aspects of health care and disease management, favouring skewed outcomes that shine a broad light of approval on their products, as opposed to research discoveries that smudge the potential of future sales, in the process utterly discrediting universities, research faculty and the neutral process of investigation for the public good.

The stress of the pharmaceuticals in persuading prescribing physicians to lean heavily in favour of drugs, rather than giving full and holistic treatment procedures a trifle more depth of consideration, impacts deleteriously on the patient, and ultimately, on the professional efficacy of the prescribing doctor. Effectively eroding the relationship of trust between patient and doctor.

While fattening the bottom line for the product producer. What's in it for a pharmaceutical company to invest a certain percentage of profit in ongoing research to result in really beneficial drugs, after all? When they can simply rest on their laurels, producing the same drugs with slight variations which are purported to alleviate symptoms, but which in fact emulate the placebo effect?

The tried-and-true money-making products just skirting the edge of usefulness, producing side-effects, both manageable and serious, will continue in production. There's gold in that practise. Unlike investment in the production of truly useful medications which might hold the potential of "cure" - for to produce those drugs would be tantamount to cutting off a plentiful source of reliable income.

Dr. Hebert is concerned for his profession, for the population treated by his professional peers. It is the protection of both that concerns him; on the one hand the mandate and purpose of the profession, on the other the ongoing health management of patients. The focus on drug management over other workable therapies is the problem.

The paid-for access to doctors' prescription pads is the crux of the problem. Case in point: Canada's largest public drug manufacturer, Biovail, offering doctors $1000 for writing 15 prescriptions for Cardizen LA, a new drug treatment, and then completing a report on each patient for use in a study of the drug's effectiveness.

Little wonder this unprincipled corporation is facing U.S. and Ontario regulatory civil charges, facing up to millions of dollars in fines and settlement costs.