Monday, Feb 19, 2018
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Breaking the drug connection

A BILL before Congress that would inform medical patients about potential financial conflicts involving physicians and pharmaceutical companies is well-intentioned but it's more a Band-Aid than cure for a complicated malady.

The measure, known as the Physician Payments Sunshine Act of 2007, would require public disclosure of the name and address of physicians who get more than $25 a year in travel, entertainment, and other compensation from drug makers.

The intent is to warn patients of physicians who might over-prescribe a certain company's medication or medical devices in exchange for financial inducements. But it wouldn't actually change what many critics believe has developed into an unhealthy relationship between doctors and Big Pharma.

A better way of keeping conflict of interest out of the examining room would be to bar physicians from taking any compensation from drug companies - gifts, meals, trips, consulting jobs - that might influence their practice of medicine. Federal law already prohibits direct payment for prescribing drugs or medical devices, but gifts and consulting arrangements are essentially unregulated.

Such legislation might end handouts of drug samples by pharmaceutical representatives, a freebie many patients enjoy, but it would represent a more effective cut in a long-standing pattern of influence.

The drug industry wouldn't spend billions of dollars a year courting physicians - more, reportedly, than it spends on research or advertising - if it didn't get a good return on its investment. There is plenty of evidence that drug marketing to doctors has paid off handsomely.

To their credit, some physicians already have divorced themselves and their practices from the relatively small gifts traditionally provided by "drug reps," including pens, mugs, scratch pads, and food.

Turning away free drug samples is a tougher choice because physicians give them to lower-income patients and those without insurance. The other side of the charitable coin is that patients may end up taking more expensive medication without the alternative of a less costly drug that might be just as effective. Also, drugs brand new to the market may carry a higher risk than others that have been around longer to gauge potential side effects.

The bottom line: sick people shouldn't be required to expend energy tracking down complicated and potentially unclear information on payments their physician might be getting from drug companies.

A broad ban on such compensation would be a better tool to ensure that the independent judgment of health-care providers is not based on anything other than a patient's best interest.

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