Regulation of pharmaceutical companies promoting their drugs to doctors

[TrueLight]

hey everyone

does anyone think that the influence of pharmaceutical companies on doctors is too much? ...how they send drugs reps to promote their drugs to them? do you think the pharmaceutical companies are to blame, and as such should be regulated by the government? or do you think that the pharmaceutical companies should regulate themselves on how they see fit? or do you think its not the fault of the pharmaceutical companies but the government's fault and the TGA? and thus regulations on pharmaceutical comapnies should be abolished because they have to spend millions of dollars to bring a drug to the market because of TGA regultion and so to recoup loss they have reps to try sway doctors influence of what drugs they write to patients. Does anyone think that the pharmacetuical industry should be self regulated but get the government out of the way of tax payer funded monopoly rights in the form of patents, or that the government should stop paying pharmacetuical companies because of the PBS system?
ANYWAY MY POINT IS, i want to get a wide variety of opinions on if people think the self regulation of the pharmaceutical industry's promoting to doctors in Australia is appropriate? or do people think that more stricter regulations will fix the problem of this (or it might not be a problem to some people)

relating to this> http://www.news.com.au/story/0,,24249924-1702,00.html

ALL opinions are welcome!!! and hopefully this will help me form mine!

thanks

[Fyrefly]

The doctors at my clinic do not seem to mind... the reps always bring lunch or afternoon tea with them.

[TrueLight]

lol yeah there was this doco on sbs insight about this and a few doctors didnt a few did... so you think the system now is appropriate?






PS. Theres 32 views of this but 1 reply... it would be awesome if more people could reply on here

[Fyrefly]

lol yeah there was this doco on sbs insight about this and a few doctors didnt a few did... so you think the system now is appropriate?

I dunno... I don't really have an opinion.
Doctors are smart people... I don't think they're easily pulled in by flashy reps or advertising... I trust them to make careful decisions in what they prescribe.

[TrueLight]

ha thats what i hope... but i think the evidence (somewhere lol i was reading ok!) says that they do influence the prescribing habits of doctors.... thats why the pharmaceutical companies pay thousands or millions of dollars on advertising and reps!

[d0minicz]

if they are being hassled/bombarded unwillingly then that's just a bit too far ...

[Glockmeister]

lol yeah there was this doco on sbs insight about this and a few doctors didnt a few did... so you think the system now is appropriate?

I dunno... I don't really have an opinion.
Doctors are smart people... I don't think they're easily pulled in by flashy reps or advertising... I trust them to make careful decisions in what they prescribe.

I think that's a problem with doctors in general. The idea that since they are 'smart' (whatever that means) therefore they are invulnerable to general psychological forces that can influence the decision. To me, that's a load of crap.

A bit tangential, but I remember seeing a TED lecture online (at Ted.com) from Dan Ariely, a behavioural economist who was talking about a study conducted with doctors. The experimenter gave them a case study of a patient with a bad hip (it was in pain). The pain had not subsided and thus the patient was referred to hip replacement surgery. The day of the surgery, it turned out that there was medication s that hadn't been tried. For half the doctors, they were told that they has missed one medication, ibuprofen. The other half was told they missed two medications, ibuprofen and prioxicam. It turned out that doctor were more likely to send patient to hip replacement if they were told they missed two medications compared to when told they missed one medication.

[TrueLight]

ha see they do get influenced, even if its very subtly...... now the problem i have now is is it the self-regulation of pharmaceutical companies fault or is it the fault that there isnt enough regulation?.......... thats the thing thats confusing me............

[Glockmeister]

ha see they do get influenced, even if its very subtly...... now the problem i have now is is it the self-regulation of pharmaceutical companies fault or is it the fault that there isnt enough regulation?.......... thats the thing thats confusing me............

Well my personal opinion below:

Well, there are 2 factors in this issue, one of which you have eluded to. Yes, I do personally think there's a problem of how pharmaceutical companies are regulated (that said, we do better than the US, where drugs are marketed direct to the public. That's illegal in Australia). We need a way of acknowledging the fact whilst pharmaceutical companies can be a important source of information, they can often be a biased source of information. In terms of regulation, some of the regulation I can think of includes

-  Regulating the content of information that pharmaceutical companies give out to doctor by forcing drug representatives to submit their advertisement to some sort of independent authority (say the TGA).
- Preventing direct-to-public drug advertisement (already happens here, needs to happen in the states)
- Some sort of acknowledgement that pharmaceutical-type companies, whist that they do need to make a profit, that they need to regard themselves as accountable to the wider community, not just their shareholders. People before profit, so to speak.

A lot of this goes into the broader sphere of what sort of ethical responsibility do pharmaceutical companies have to the wider community.

The other major factor is the doctors themselves. There's a lack of acknowledgement from doctors in regards their vulnerability to this sort of thing. This needs to be stopped. After all, if there is no demand, there won't be a supply either. For example there shouldn't be any advertisement in medical journals from pharmaceutical companies. Another example is prevent the 'ghost writing' of journal articles. That is, senior scientists and doctor putting their names onto article that are practically written by pharmaceutical companies.

[TrueLight]

ha TGA isnt really independent... its part of the government... it would be better if there was a body that was independent of government or pharmaceutical companies... so it truely isnt biased
yep agree on the balance issue between profits and ethics
yeah thats a good last point.
i reckon doctors needs to be educated in getting independent info and to prevent mis-information or finding out that it is biased...doctors should probably also alert an independent body of any breaches of unethical promoting.

[Glockmeister]

ha TGA isnt really independent... its part of the government... it would be better if there was a body that was independent of government or pharmaceutical companies... so it truely isnt biased
yep agree on the balance issue between profits and ethics
yeah thats a good last point.
i reckon doctors needs to be educated in getting independent info and to prevent mis-information or finding out that it is biased...doctors should probably also alert an independent body of any breaches of unethical promoting.

Well... the information is there, though the MIMS,The Cochrane Libraries and the various databases you'd use in university. The problem is that there's so many hours in a day that doctors have to read these things, so having information delivered to (from the pharmaceutical companies) them makes life easier for them. Unfortunately, that makes an obligation in the mind of the doctor that they must reciprocate the goodwill of the drug reps by prescribing their drugs (there is empirical evidence to support this idea)

[TrueLight]

yep i agree except it would be fine... just as long as there is no unethical practice going on or any inducements (which you have said there is and i agree) or any offers to send doctors overseas!... so yeah more unbiased info! except when you have pharm reps, its not really independent since their whole job revolves around 'selling' that drug to the doctor, and giving free samples too!

[Glockmeister]

yep i agree except it would be fine... just as long as there is no unethical practice going on or any inducements (which you have said there is and i agree) or any offers to send doctors overseas!... so yeah more unbiased info! except when you have pharm reps, its not really independent since their whole job revolves around 'selling' that drug to the doctor, and giving free samples too!

Exactly! And Doctors, for some reason, seem to think they are impenetrable to those forces.

[TrueLight]

ha no way. thats why they spend so much mola millions on promotion, if it didnt work they wouldnt waste the money!



ps.
oh i was looking through things... and well.. have you ever heard of ig farben? quite interesting...basically petro-chemical phamaceutical company with lots of power and money funded by american interests (rockefeller i think?) and they produced bombs, gas for nazi concentrations camps to kill jews and making lots of profits... then found guilty of war crimes, they got measly sentences and got split up into companies that still exist today... really incredulous...check it out really amazing... ig farben trial

[shinny]

Exactly! And Doctors, for some reason, seem to think they are impenetrable to those forces.

It's not just us; everyone thinks they're impenetrable to advertising. Doing otherwise feels like an admittance of a weak will of sorts, perhaps of which doctors are particularly prone to though since I guess we're in a higher position of power than most, and also because of expectations such as;

Doctors are smart people... I don't think they're easily pulled in by flashy reps or advertising...