Should pharma give cash to doctors?
It seems you can put a price on health. Lu Rahman looks at the way drug company payments bring a whole new meaning to the term doctor’s note …
We live in product-conscious times. But how often do we ask our doctors for a specific drug or medicine? Unless you spend your spare time researching drug formulation on the internet, probably never. It’s your doctor that prescribes a particular product. End of.
According to analysis from ProPublica’s Charles Ornstein and Ryann Grochowski Jones, in the last five months of 2013 pharma companies spent almost $20 million convincing healthcare professionals to prescribe their newly-patented drugs. What is interesting is that many of them are almost identical to existing drugs that treat the same conditions such as diabetes, schizophrenia, obstructive pulmonary disease and multiples sclerosis.
And when doctors opt to prescribe these new drugs, they already exist in cheaper more effective versions, says ProPublica who produced a list of the top 20 drugs that companies are paying the most to promote. Out of those, nine had a competitor also ranked in the top 20.
So how do drug companies persuade doctors to prescribe new over old? For a start, they have to, which probably makes them pretty persistent. Huge investment - time and money - goes into producing a drug so it’s all about payback. According to Ornstein and Jones, doctors in the US often accept considerable sums of money for speaking and consulting engagements. As an example Novo Nordisk splashed out $816,000 in consulting fees in the last five months of 2013.
And what is consulting? Basically it’s advice on a medical product or treatment. While the payment is not directly related to the drug a pharma company is trying to promote, there has been the suggestion that the fact money changes hands between big business and the doctor affects the way in which he or she views that firm’s medication.
Earlier this year in an article in the Independent, the British Medical Journal called for the financial interests of doctors to be made public. This followed an investigation which uncovered that private healthcare companies had offered incentives – sometimes worth tens of thousand of pounds – to doctors to refer patients to their hospital.
We all like to think that when we take a trip to the doctor, they’re thinking about our health, not their bank balances but it seems this isn’t always so. Of course it could be argued that healthcare is business which needs to show a profit. And if a doctor is paid a consulting fee from a pharma, does that really mean he or she will automatically favour that company’s products over another? It’s a question that can’t really be answered but one that we all probably know the answer to…
