Pharmaceutical companies can pay doctors to enroll patients in drug studies and collect data, a practice that has become increasingly common in recent years as public funding declines.
But Dr. Greg Rosenthal, a Toledo retinal surgeon, said patients should be told their doctors are getting cash, stock options, or other benefits for enrolling them in those studies.
They may get thousands of dollars for each patient using the drug being studied - and other viable alternatives may not be considered because of it, Dr. Rosenthal said.
"It's not just your doctor telling you what's best for you," said Dr. Rosenthal, retinal director at Vision Associates. "It's your doctor probably telling you what's best for him or her."
Dr. Rosenthal is one of the founders of Physicians for Clinical Responsibility, a worldwide group of primarily retinal doctors who oppose entering into financial arrangements that may conflict with patient care.
He was among those who testified last year before the U.S. Senate's Special Committee on Aging, chaired by Sen. Herb Kohl (D., Wis.).
Resulting legislation introduced by Senator Kohl and Sen. Chuck Grassley (R., Iowa) would require both drug companies and medical device makers with at least $100 million in annual revenues to report all gifts to doctors.
Penalties for not reporting would range from $10,000 to $100,000 per violation, and a government Web site would be created to post payment information.
Dr. Rosenthal said the legislation, the Physician Payments Sunshine Act, would help clear up the relationship between doctors and companies if it is passed.
Yet that relationship, a pharmaceutical trade group said, should not be chilled by improving transparency, a laudable but complex goal.
Drug research companies provide doctors with information about a range of topics about prescriptions, to which they need reliable and timely access, according to a statement last week from the Pharmaceutical Research and Manufacturers of America.
Doctors often provide useful feedback on medications, the statement said.
Last week, the special committee on aging heard testimony concerning medical devices, and at least one more hearing for the legislation will be held in the next few weeks, a committee staff member said.
The legislation's language is being worked on, and there seems to be a lot of support among senators, he added.
Physicians for Clinical Responsibility has other issues with drug trials, including the use of placebos in tests when an ailment's history is known and patients will be harmed by no treatment, said another founder, Dr. Leon Bynoe, of Retina Associates of Coral Springs in Florida.
"To me, it seems almost unethical to do that," he said.
Plus, some doctors overlook good alternatives to the subject of drug company studies, Dr. Bynoe said.
Dr. Rosenthal said patients also should be aware that doctors are paid by drug companies to give lectures on identified material as part of their marketing message.
Patients have the right to know all the data on treatments, both risks and benefits, he said. "Disclosure is everything," Dr. Rosenthal said. "Patients need to know what is going on with their health care, and they need to know where their doctors stand."
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