Tuesday, August 28, 2007

Conflicts of Interest May Affect Your Health

The FDA reauthorization bill that recently came to a vote in Congress, allows continuation of conflicts of interest between FDA advisors and the drug industry.

Under this bill the FDA can continue to allow advisors with financial interests in pharmaceutical companies to serve on FDA advisory committees. The bill also continues to let the FDA receive over 50% of its budget from fees paid to it by the pharmaceutical companies it regulates. This has resulted in the FDA becoming beholden to pharmaceutical companies.

Rep. Peter DeFazio of Oregon, pointed out that when it came time to renegotiate PDUFA, the FDA met with pharmaceutical companies 112 times to negotiate agency standards the FDA must achieve in order to receive these fees, while consumer advocates and doctors groups only got to meet with them five times.

The problems with unsafe drugs being recalled after harming and killing some patients and various food products being recalled after sickening and killing consumers has highlighted the problems at the FDA.

With respect to drug company oversight, one way to lessen the grip pharmaceutical companies have is to inform consumers when their health care provider may have a conflict of interest due to gifts or income from a drug company. That's why DeFazio reintroduced the Drug Company Gift Disclosure Act, which will require prescription drug manufacturers, packers, and distributors to report annually to the Commissioner of Food and Drugs any gifts with a value of $50 dollars or more provided to doctors and other health care providers in connection with their marketing activities.

It’s time the public knew the truth. Safety and efficacy should be the priority, not drug or food industry profits. Think it’s time for you to get involved?

Let your Representative in Congress know how you feel.


Constance said...

So true……

I have numerous friends who are pharmaceutical sales reps and they have actually found their job to be harder since they are not able to lavish the staff “legitimately” with gifts as they did previously. And it’s scary that some doctors only offer certain prescriptions based on what they where given by a pharmaceutical rep, not based on what is best for the patient either medically or financially.

Sue said...

I have to agree. Its scary to think that we put our lives in our doctor's hands and they are being bought by pharmaceutical companies. It makes me scared to take any prescription drugs.

Silent Sales Rep said...

I've been quiet about this too long. The doctors in my territory who say they don't want gifts are not at all reluctant to ask (read that demand) lots of samples to pass out to patients; not charging for the samples, but charging for an "office visit" that involves nothing but pushing what the pharmaceutical company is promoting.

Ellen Troyer, MT MA said...

I don't think any of us have to be nearly as scared of prescription drugs, or over-the-counter patent medicines, if we better educate ourselves about what we agree to take, or what we allow our families to take-today's internet makes that task fairly easy.

I have also known doctors, and I'm sure Spencer Thornton has known many, who have always made it a practice to never accepts gifts from pharmaceutical reps-and that included all those expensive free lunches for the office staff.

I reported on a program called Best Buy Drugs (a new Consumers Report Division) in the February 7th 2007 Friday Pearl.

You might want to revisit that information. I was delighted to find that two drugs my Mother takes could be replaced with a generic version for less than half of what we had been paying for a supposedly better version that was introduced after the patent had expired on the original drug. According to Consumers Report-the drug efficacy was the same.

If we all work at staying healthy and sharing disease prevention information, we have the power to collectively lower the cost of health care.

Spencer Thornton, M.D. said...

Many doctors depend on company reps to inform them of both the benefits and risks of the drugs they are selling. Unfortunately they are clearly biased -their job is to sell their company's product.

The bottom line is that most reps do an excellent job. It is up to the physician to keep up by independent study - not always easy with a busy work load.

A Fed Up Ophthalmic Office Nurse said...

Every successful person has a heavy work load in today's world, so please understand that you, Dr. Thornton, offend a lot of us by saying doctors are too busy to keep up with the science and medicine required to practice good and safe medicine.

This seems a good place to remind you that it's uninformed doctors who are prescribing the drugs linked to over 100,000, mostly unnecessary, drug reaction deaths a year.

The drug information doctors receive is from sales reps hired for the length of their legs and the size of their breasts or pecks, not the size of their brains.

And Constance, if you have pharmaceutical rep friends, you must know that they rarely work more than three or four hours a day, and most of that time is delivering donuts and sandwiches to doctors offices for staff who way to often aren't even required to listen to the reps in-service discussion before they pick up the free food in the lunch room.

For the most part, pharmaceutical sales it's a dead end job that best fits party people types who collect their 60 K and company car benefits and hang out at some metaphoric beach, or at home, more than most of us want to admit, since the cost of all this folly is passed right on to the patients.

Ellen Troyer, MT MA said...

Hey Fed Up Office Nurse,

I'll bet that early morning rant felt good!

My take on medical sales reps is that most are just as you suggested, but some of them are absolute gems.

The gems devote a lot of time to actually understanding the science behind the products they represent and docs are smart enough to know that so the gems get more than 2 minutes of the doctors time because they have earned the doctors respect by being good educators.

Unfortunately, these gems are rare and hard to find.

Spencer Thornton, M.D. said...

Dear Fed Up Ophthalmic Office Nurse:
I do understand your work load. My nurse would agree with you on that. And you certainly make some good points - particularly abut the uninformed doctors who prescribe drugs linked to over 100,000 drug deaths a year. But I'm sorry you are so down on drug reps.

Maybe I was lucky. Almost all of the reps i saw regularly in my 35 years in my ophthalmology office were hard working, concerned and knowledgeable.

I cannot remember a single one who brought donuts or free lunch for my staff, but I can remember several who were invited to join us for lunch which I provided.

silent sales rep said...

To Fed Up Office Nurse

Who licked the red off your candy?

And why insult us? I work long hours, and I don't have big breasts (don't I wish).

Thank you Dr. Thornton for speaking up for us who represent drug companies You are right. Most doctors, or their staff, do not accept gifts or make demands, and we don't appreciate the few who do.

3 Amused RNs said...


We don't know about the fed up ophthalmic nurse, but the red is still in our slow gin.

Stoping thinking you can speak out of both sides of your mouth without anyone on this blog noticing.

In your first post you said, "I've been quiet about this too long. The doctors in my territory who say they don't want gifts are not at all reluctant to ask (read that demand) lots of samples to pass out to patients; not charging for the samples, but charging for an "office visit" that involves nothing but pushing what the pharmaceutical company is promoting."

We suggest you pick a position and stick with it - or go away because you sound like a idiot, or the biggest suck-up in the world, or both.

Anonymous said...

3 Amused RNs
The slow gin may be your problem. You are drinking too much and not thinking.

SSR conditioned her reference to the ones "who say they don't want gifts". That doesn't mean everyone. It's probably just a few. But I get her point, and appreciate it.

Spencer Thornton, M.D. said...

Consumer Reports has weighed in on the issue of drug samples.

CR says (page 10 in the October 2007 issue), "Free samples are not free. they are part of the drug company's advertising budget and contribute to the high cost of drugs.
The free sample is a tool to tune the patient in to brand-name recognition, so that when it runs out they will stick with the same brand, despite the expense.
There might be less-expensive drugs that are just as effective."