The Sunshine Act Will Publicize Big Pharma’s Undue Influence on Doctors / Newsweek May 22, 2014

Some doctors can’t hide their glee. “Conflicts of interest and financial relationships between drug companies are ubiquitous in almost every single aspect of medical practice and medical research and medical education in the U.S.,” Eric Campbell of Massachusetts General Hospital tells Newsweek. 

Campbell has been on the trail of potentially unethical behavior for some years. In 2004, he and his colleagues surveyed 140 institutions—125 medical schools and the 15 largest independent teaching hospitals in the U.S.—and discovered that 60 percent of department chairs had some form of personal relationship with the pharmaceutical industry. This included serving in a variety of positions: consultant, member of a scientific advisory board, paid speaker, officer or a member of the board of directors. At the institutional level, two-thirds of the departmental units were firmly obligated to the industry by way of research equipment, unrestricted funds, residency or fellowship training support, continuing medical education support and funding from intellectual property licensing 

“It’s actually hard to find areas where people don’t have a frequent and often very lucrative financial relationship,” Campbell says. 

How lucrative? One study, published in March 2014 in The Journal of American Medical Association, found that nearly 40 percent of the 50 largest pharmaceutical companies had academic medical center leaders sitting on their boards. The annual compensation for these directors is over a quarter of a million dollars, on average. “These individuals have a fiduciary responsibility to the shareholders as members of the board, and that’s a very different relationship to a pharmaceutical company than just consulting,” says Walid F. Gellad, an assistant professor at University of Pittsburgh’s School of Medicine and author of the study. 

Holding a leadership position at an academic medical center brings considerable influence over research, clinical and educational missions. And when one of these medical center leaders is also charged with providing stewardship for a profit-making business, it represents a substantial conflict of interest.(...) 

Pharmaceutical companies have made handing out many small gifts an intrinsic part of their business. In 2012, the industry spent more than $27 billion on the promotion of its products. To market drugs, companies use a variety of methods, including what they call “detailing”—face-to-face promotional activities directed toward physicians as well as pharmacy directors. This may include taking doctors out for meals and giving them gifts in the form of medical textbooks. 

Providing free samples to physicians is another part of routine company marketing costs. Doctors prefer to believe they are helping their poorer patients when they accept and pass along these free samples. Besides the obvious conflict of interest there, their patients ultimately end up paying higher overall prescription costs because doctors often feel compelled to prescribe the sampled drug rather than a less-expensive generic alternative. Pharmaceutical companies also host meetings and pay physicians substantial speaker fees to discuss the use of particular drugs. 

“[There has been a] completely institutionalized form of payola—an underground economy in medicine—for years,” Campbell says. “Doctors and institutions have benefited from many of these relationships for a long time…. They see absolutely nothing is wrong with them. Many of them see it as their right.”(Más)