Thursday, September 4, 2008

Drug Wars (legal ones)

There has been a debate going on in the country for the last couple of decades about the relationship between doctors and the pharmaceutic industry.

My problem isnt that pharm companies "exert to much control" over my prescribing habits (by the way I am a psychiatrist.) It's that the common thought is I dont know how to handle commercials.

The argument has been made that drug reps should be limited in their exposure to doctors because of the amount of influence they exert over the prescribing habits of doctors. This has been supported by many studies in the medical literature for a couple of decades. And while statistically this is true I have yet to be impressed by any debate as to why this is a problem.

It is true that drug companies expend a large amount of money in marketing drugs, and they would not be doing this if this didnt work--a given. But this is a capitalistic society so how else are drugs to be brought to market?

Let me simplify. Now lets suppose Toyota came out with a new car next year, and lets supposed it had a new feature that allowed it to miraculously sense when drivers were sleep at the wheel and automatically pull over. Now this sounds like something that could potentially save lives and property. Now lets say that Toyota never made a commercial for this car. Further more lets say the makers of this new feature couldn't even tell other car makers they had invented this life saving feature. Could you picture this spectacular new car with this wonderful new feature sitting on a lot with no one aware of its existence. Would sound kinda silly wouldn't it? How would we tell people about this amazing discovery? Oh yeah commercials.

The medicine industry is an industry, and just like every other industry in a capitalistic society the bottom line is profit driven. And while I am no big fan of pure capitalism managed health and pharmaceutics operate more on these principles without much regulation. While I do believe there should be some governmental regulation of these two jauggernaut industries, I dont believe we will see that change anytime soon given the sheer amount of money they can throw around Washington

As a blog I read from The Last Psychiatrist explains. The pharmecuetics industry and the field of medicine are inextricably linked. Aside from giving out pens and note pads, drug companies sponsor education conferences for doctors, buy text books for residents, and give lectures on new drugs. If they go who is going to fill the void? Academia?They get most of their funding from the government. Is the government going to pick up the tab? Expecting the government to do the research, and teach the doctors about the drugs is a big leap of faith. Our government wont even spend money to educate the masses in the public educational system do you really think they are going to spend money to educate the so-called educated?

If we are going to talk ideals, let's assume the government was willing to impose regulations on these companies. With all the money it would take to lobby politicians do you really want to waste your fifteen minutes with a senator griping about a $0.25 ink pen or $15 lunch a doctor got to hear a talk about something that could potentially save your life? Or we should lobby decreasing restrictions on patent laws to get cheaper drugs to market quicker and increasing stringency on generics to make sure they are up to par with trade brands. If you could only hold patents but so long and generics were better this whole debate would be moot. If all medicines cost the same and worked just as well then it would decrease the motivation to create new ones that did the samething as the old ones.

Now we are in this debate in the first place because in the past there were serious abuses of this relationship between pharm and physicians. Paying docs to enroll patients in studies, kick backs for prescribing etc. But now we have over corrected the problem by saying NO commercials. Seriously a pen is not a roundtrip ticket to Hawaii. A dinner talk on HOW THE DRUG WORKS is not a payment for prescribing it. We need to focus on the real problems between the pharmecuetics industry in the practice of medicine. We should focus less on "Did my doctor give me this medicine because he got a ink pen" and more on "Why doesnt my medicine cost the same as this pen"

Makes common sense to me

I have to give a shout out to The Last Psychiatrist. check it out, i put some of this post all throughout that blog.(in my comments, I'm no thief)

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