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Dollars, doctors

Published March 15, 2013 1:01 am

Ties to drug companies unsettling
This is an archived article that was published on sltrib.com in 2013, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

It's unsettling to learn that companies that produce the drugs and devices doctors can choose to prescribe have paid Utah physicians $25.8 million since 2009. Although the companies say much of the money is for research to determine the efficacy of their products and consulting to make those products better, the amounts changing hands make the common practice questionable.

Some physicians are receiving money for things that have nothing to do with research — trips and entertainment, for example. In the same way that big contributions to politicians can cast a shadow over policy decisions, large sums of money going into doctors' pockets may call into question some medical decisions, especially when it comes to expensive drugs, devices and treatments being peddled by Big Pharma.

According to the latest update on ProPublica's "Docs for Dollars" database, which keeps track of such payments, the sums going to Utah doctors have increased six times in four years. And the database only looks at 15 manufacturers that account for 47 percent of the U.S. drug market.

Recent lawsuit settlements have forced drug makers to disclose the formerly secret financial ties they have to doctors. Fortunately, responding to concerns of the Obama administration, Congress will require manufacturers to report payments to doctors starting this year.

While the ProPublica report doesn't point to malpractice or the prescribing of unnecessary treatments, research — and common sense — indicate such payments, given under any guise, can influence doctors' choices of costly brand-name therapies and contribute to higher medical costs.

The American Medical Association has published ethical guidelines for gifts from industry which include the tenet that physicians should not accept gifts if they are given in relation to the physician's prescribing practices.

Drug-company sales representatives use marketing ploys, including providing free samples and wining and dining doctors, to get their products into the hands of patients. It's logical that the more expensive the drug or treatment, the more money the pharmaceutical company is willing to invest to promote it.

And physicians are human. When a doctor accepts a favor, whether a pen, a lucrative research contract or all-expense-paid trip to a convention, that doctor may be influenced to prescribe the company's product.

In politics, such quid pro quo dealings are unsavory; in medicine they are intolerable.




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