Contrary to a recent study from The American Journal of Medicine, a recent editorial in the Boston Globe calls for keeping doctors independent, and banning fees from drug makers to pay physicians for research and other critical work.
According to the editorial, any time a doctor “promotes drugs in exchange for pay from pharmaceutical companies, they cease to be independent evaluators of the risks posed by those drugs, and they cease to be unbiased caregivers for their patients.”
As a result of such claim (the evidence of which was not mentioned), these critics believe that “hospitals should prohibit doctors from taking part in so-called speakers bureaus, whereby companies compensate them for giving talks to colleagues about new drugs.” For this idea, the editorial goes even as far as calling for Congress to go beyond the usual disclosure requirement, and ban the practice.
For evidence of such claims, the Boston Globe simply regurgitates information already made public by Eli Lilly & Co—just in a selectively bias way. The editorial notes that since the beginning of the year, the company has paid at least 60 doctors in Massachusetts a total of more than $580,000 to give speeches about its drugs. The article fails to mention how small the individual payments are, and for what purposes physicians were paid.
The editorial claims that “company officials told the Globe that Eli Lilly provides the content that doctor’s deliver to colleagues about the medications.” What the editorial fails to mention is that the US Food and Drug Administration (FDA) mandates that companies provide the content for promotional talks, to ensure that the talks are on-label. If a company were to hire a physician to give a promotional talk and allow them to use their own slides, the company would also be held liable for anything that is on those slides, so if the slides make a claim that is off label the company would be in violation of the law.
Without citing any particular study, the Globe generally asserts that “getting money from the pharmaceutical industry can cloud doctors’ judgment when evaluating studies and side effects, as well as when they are prescribing medication.”
What should be more important for a patient: to know that a doctor has research experience and knowledge of a drug that he or she may prescribe you, or that they got paid for such research, and disclosed that payment publicly?
The editorial also claims that when doctors use “company material to promote a new drug to their colleagues, they also help broaden its use.” A specific consideration for such a claim is that overtime, doctors who use various drugs and who conduct research on them are more capable of assessing other important uses for drugs. Not only is this moral in a scientific way, it is also legal: doctors can prescribe a drug for whatever reason they deem medically necessary through their medical training and experience.
In response to such scare tactics, the Globe notes that Massachusetts General Hospital, Brigham and Women’s Hospital, and McLean Hospital – all of which also employ doctors who have received money from Eli Lilly this year – will prohibit their doctors from receiving speakers’ fees from the pharmaceutical industry starting today. As a result, the Globe unfairly calls for more hospitals to do the same.
Ironically though, the Globe itself notes that transparency “will unlikely affect how patients view their doctors.” So what effect would a ban have? What more information do patients want? Physicians are carrying out the work of medical research and clinical studies that has led to the lifesaving breakthroughs and innovations that keep Americans alive and healthy today. By asking that doctors discontinue such work because of an unfounded claim of bias is not necessary when transparency is more than enough.
If a doctor prescribes you a medicine, you have the right to know why. Patients should know whether the treatment they are recommended is more cost-effective or a physician has research, education or other experience. Knowledge of such information is solely at the discretion of the patient, and in evaluating this information, patients should be the ones making decisions and asking questions about what treatments they should receive, not editorial boards.
Contrary to the Boston Globes opinion, allowing doctors to promote drugs does not take advantage of the trust patients have in their doctors when such information is publicly available. Patients can determine themselves whether such trust has been violated. Trying to prevent such experiences from happening in the first place, will only hinder the practice of medicine and adoption of newer and better therapies.