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December 26, 2002

Pharma Bribes & Corruption of Medicine

In October, Bush's Health and Human Services department actually proposed cracking down on bribes regularly offered by pharaceutical companies to steer customers to their products. And the medical industry is up in arms to reverse this small stab at ending this modern corruption of medicine.

Few consumers realize how pervasive the practice is of doctors having much of their ongoing professional education underwritten by pharma companies or how HMOs are paid off to shift customers to particular name brand drugs.

In a recent Nation special report, I noted that even the major medical journals were corrupted by the fact that it was nearly impossible to find an independent medical expert to review medical studies. Scarily, "independence" in the medical profession means a doctor has received less than $10,000 per year in payoffs from a particular pharma company. No, seriously.

"Scientific studies" published in such journals are usually backed by the companies whose products are being discussed - not surprisingly, 98% of such research supports the effectiveness of the drugs discussed. Even on official Food and Drug Administration panels setting medical guidelines, over half the panelists typically have financial interests in the drugs being reviewed. And pharma companies are increasingly funding and controlling research at academic university labs as well.

The statements by those protesting the new guidelines are actually scarier than anything critics might say:

"Without financial support from industry, medical societies would most likely be forced to curtail or stop offering these important educational activities," said Dr. Michael D. Maves, executive vice president of the American Medical Association.

Merck & Company said it routinely gave discounts and payments to health plans to reward "shifts in market share" favoring its products. Merck complained that the administration proposal would "criminalize a wide range of commercial conduct" that the industry regards as normal and entirely proper.

"Pharmaceutical companies may be less willing to offer large discounts if those discounts cannot be tied to movements in market share," said Alissa Fox, policy director for the association, whose members insure more than 84 million people.

What kind of medical system are we running where all of ongoing medical education will grind to a halt without industry bribery? What kind of "market" do we have where bribery decides which products get prescribed by health plans?

Let's give the Bush administration points for even making a proposal in this area. But it will be interesting to see whether they cave from pressure from their pharma allies.

That the Inspector General for Health and Human Services, Janet Rehnquist (yes, the daughter of that Rehnquist), is under investigation for undermining existing rules meant to prevent medical bribery doesn't give you much hope.

Posted by Nathan at December 26, 2002 02:07 AM

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