Editorial: A prescription for trouble

Saturday, Oct. 7, 2006 | 7:56 a.m.

Drug companies spend nearly $20 billion a year to influence the nation's doctors to prescribe the newest and most expensive drugs. That figure was contained in a column written earlier this year for the Boston Globe by a physician who is a professor at Tufts University School of Medicine.

A lot of that money is spent on packaging free drug samples that are given to doctors, who in turn give them to patients. Obviously there is a marketing angle here. Once a patient receives a free drug sample from his doctor, he will become inclined toward that brand.

As many drugs are prescribed for long durations, inducing loyalty to a certain brand is an enormously profitable practice for the pharmaceutical industry.

The physician who wrote the Boston Globe column, Dr. Jerome Kassirer, expressed alarm at the amount of influence drug companies have gained over doctors. He wrote in his Feb. 13 column, "It's about time physicians, academic medical centers and professional medical organizations wean themselves away from the deep pockets of companies whose principal goal is not education, but marketing."

Our support of his point of view became even stronger this week after learning about a survey undertaken by the American College of Obstetricians and Gynecologists, a Washington-based professional organization. Results from 217 of the group's members are published in the current Journal of Medical Ethics.

Ninety-two percent of the respondents, all doctors, said accepting free samples from drug companies is ethical. Of those doctors, 33 percent said their decisions in prescribing drugs would probably be influenced by the samples.

The survey revealed that many doctors are not fully aware of how the drugs given to them as free samples will affect their patients, but they distribute them anyway for the sake of patient convenience or affordability.

Also revealed was that more than half the doctors surveyed felt that accepting other free gifts, meals or well-paying positions as consultants to the drug makers were actions well within ethical bounds.

The study's authors disagreed. "Guidelines need to do more to challenge this view," they wrote. In our opinion, if the medical community cannot agree on stricter guidelines and enforce them, Congress needs to hold hearings on this issue. We believe that prescription drugs can perform miracles but can also do great harm. Doctors should prescribe them based on unbiased medical information, not incentives provided by manufacturers motivated by profits.