Better ethics, cheaper drugs
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AS THE Commonwealth of Massachusetts and its 6 million residents struggle to pay their medical bills, they have a new tool on their side, starting today. A law cracking down on the marketing that pharmaceutical firms do with doctors goes into effect. No one expects miracles from the new rules, but they should ensure that doctors’ prescribing decisions will focus more on patient needs and less on the gifts and fancy meals many doctors have long received from drug companies.
All the favors that drug companies do for doctors raise overall health costs in two ways. First, they are a substantial part of the $57.5 billion that the industry spends annually on marketing, a cost that gets added on to each prescription a patient buys. Second, the industry’s goal in influencing doctors is often to get them to prescribe a new, higher-priced medication when a generic or cheaper name-brand competitor is just as effective. Partly as a result of high costs of drugs, one-quarter of original prescriptions for chronic conditions never get filled.
While Massachusetts, the sixth state to restrict drug-industry gifts to doctors, has the most comprehensive law, it is far from perfect. Under regulations drawn up by the state Department of Public Health, drug companies will not have to reveal the names of researchers they have paid for participating in company-sponsored clinical trials, although firms will be required to disclose payments for speeches or consulting. The only trials for which disclosure of payments to researchers will be required are for “seeding trials’’ in which the primary intent is to influence sales.
The industry opposed disclosure of researcher data on competitive grounds. But at least three large drug makers disclose such information voluntarily, and all companies must report much information on their studies to a government website, ClinicalTrials.gov.
Ideally, Congress would require disclosure of all payments, including for research, on a national basis. Lawmakers will be under increasing pressure to take such steps as they deal with reform proposals aimed at both universal coverage and lowering healthcare costs. President Obama sent a signal that prescription practices should owe more to science and less to industry marketing when he called for $1.1 billion in research on the comparative effectiveness of different medications and treatments.
This is the direction in which physicians’ decision making will have to move if healthcare is to remain affordable for individuals and the government. The Massachusetts gift-ban law, flawed as it is, should show the country that it is possible to clean up and make more transparent the links between drug companies and doctors.
