Practicing good medicine

Monday, Jan. 5, 2009 | 2:05 a.m.

If you have visited a doctor’s office lately, chances are you have seen pens, coffee mugs and other trinkets that advertise a particular drug. Pharmaceutical companies spend billions of dollars annually trying to persuade physicians to prescribe their medications.

Starting on Jan. 1 the drug industry agreed to stop showering doctors with these advertising freebies under new voluntary guidelines. As reported last week by The New York Times, the new guidelines from Pharmaceutical Research and Manufacturers of America also reiterate prior ones that discouraged drug companies from sending doctors on junkets to resorts or giving them tickets to professional sporting events.

Although the new guidelines are a step in the right direction, there is reason to be believe pharmaceutical manufacturers exert considerable influence over physicians in a bid to get them to prescribe certain drugs. The nonprofit Prescription Project in Boston makes a valid point when it suggests that doctors and their patients rely more heavily on independent, evidence-based research and less on sales pitches from pharmaceutical companies in deciding which drugs to use.

As the organization’s policy director, Allan Coukell, told the Times: “We have arrived at a point in the history of medicine in America where doctors have deep, deep financial ties with the drug makers and marketers. Financial entanglements at all the levels have the potential to influence prescribing in a way that is not good.”

Despite the new guidelines, drug companies still ply doctors with free meals, often expensive ones, while delivering their sales pitches. The industry spent more than $6 billion on sales activities last year alone. And many manufacturers also pay doctors tens of thousands of dollars annually to serve as consultants.

There is nothing wrong with physicians seeking information from manufacturers to learn as much as they can about a drug. But it is unethical when doctors prescribe certain medications simply because a pharmaceutical company encouraged them to do so.