Pharmaceutical Sponsored Talks Facilitates Two Way Communication on Therapies
Over the past several years, and even more recently, academic medical centers have begun to “tighten restrictions on doctors speaking on behalf of drugmakers.” These policies are founded on the belief that staff and faculty who engage with industry creates a potential for bias, which can further create a potential conflict of interest. Despite their claims, no evidence has been shown that such bias or conflicts have ever harmed any patients or the clinical care these staff and faculty provide to patients.
Supporters of the relationships between academia and industry assert that such partnerships are essential to advance science and innovation in medicine. Those that see the value in the collaboration between industry and academia recognize that working together, these two groups can further patient care and discover new ways to treat patients and improve public health.
One such supporter, Joseph Hammang, Pfizer Inc.’s senior director of science policy, pointed out to the Pittsburgh Business Times that paying doctors to speak to their peers about diseases and company products was a way to create a “two-way street between the end user and factory door.” In other words, allowing doctors to speak about products brings the data, experience and information gained by working closely with industry to doctors who have not shared such exposure. And this kind of information is not something a doctor would be able to just read about in a journal or supplement because it’s a hands-on, interactive experience that allows doctors to engage with their colleagues and truly learn from one another.
To some, “There’s this idea that doctors have time to read what they need to know about medicine in medical journals.” But as Hammang pointed out, “for a doctor who sees 40 patients a day that is unlikely to happen.” As a result, the best source to get information from then is from “the people who have developed the product.”
Consequently, when these relationships between academia and industry do exist, both entities equally agree of the importance and responsibility to disclose physician-industry ties to patients. Accordingly, a large number of companies have already begun disclosing such payments voluntarily, and in advance on the Sunshine Payment Act legislation passed in March of this year. While some would point to the total number of payments doctors in Pennsylvania received from these companies, the average breaks down to a little more than $7,500 per doctor.
While these numbers are pretty low, academic medical centers are creating policies, such as those at the University of Pittsburgh Medical Center, which prohibits employees from speaking on behalf on drug companies when they don’t have complete control of the session’s content. This kind of policy shows that relationships with industry can still be properly maintained and encouraged, and Dr. Barbara Barnes, vice president for sponsored programs, research support and continuing medical education at UPMC, said the system’s conflict of interest policy has worked well.
Other academic medical centers, such as Harvard Medical School, and the University of Michigan Medical School are taking more strict approaches, almost completely banning such relationships. A number of other academic medical centers such as the Cleveland Clinic and the University of Pennsylvania Health System already disclose physician-industry ties on the Web. Posting such payments “improve doctor-patient relations with increased transparency,” and demonstrate to the public not only is there nothing to hide, but that many doctors participate in such relations for the benefit of their patients.
As more academic medical centers begin to disclose, companies like Pfizer point out that the burden of transparency and disclosure now falls on the institutions. Those academic medical centers that improve doctor-patient relations with increased transparency are models for other institutions to follow, while centers that restrict payments and industry involvement should be discouraged because of the stifling effect they will have on innovation, research and education.
In the end, the goal of public health and medicine for all Americans is to be healthier and live longer. To accomplish this end, we need doctors in academia to keep working with industry because the tradeoff of information and experience they share, combined with the new transparency and disclosure requirements will ensure this goal is met while maintaining a high level of patient trust.