Big pharma’s enticements

The great majority of doctors prioritize their patients’ needs above everything else, or so we’d like to think.

Doctors are the foundation of any healthcare system across the world. They spend years studying, specializing and undergoing rigorous training before using their skills to diagnose ailments, administer treatments, and lead patients through healing.

There’s no debating the commitment of most doctors, a number of whom have taken time out to write think pieces for DAILY TRIBUNE as columnist; their commitment and medical expertise very apparent.

However, a recently exposed case in the Philippines involving a small group of doctors allegedly participating in a pharmaceutical multi-level marketing scheme highlights a serious concern. We are referring here to the well-proven ability of big Pharma to co-opt medical personnel, allowing them to put profit ahead of patient well-being.

Dr. Minerva Calimag, president of the Philippine Medical Association (PMA), has emphasized the need to reiterate the ethics of the medical profession and the openness required in the dealings of physicians with the pharmaceutical business.

“The trust that our patients place in us is the cornerstone of the physician-patient relationship. To preserve this trust, it is crucial that we maintain an unwavering commitment to moral conduct, particularly when dealing with the pharmaceutical industry,” a national daily quoted Calimag as saying.

“Advocate for practices and policies that prioritize patient welfare and the integrity of the medical profession over the interests of any third party, including the pharmaceutical industry,” she told her fellow doctors.

As Congress (here we go again) expresses its intent to investigate the matter, it is critical to recognize that, while some physicians may have been influenced by unethical activities, the great majority prioritize their patients’ needs above everything else. Or so we’d like to think.

Big Pharma’s influence on doctors can lead to unethical practices as seen by the many scandals that have made the news worldwide. The methods employed by drug makers to co-opt medical practitioners are staggering not only in scope but in callousness.

It could be through the handing out of gifts and samples, funding of educational programs, the provision of consultancy fees and kickbacks from prescribed medications, ghostwritten research, and the hosting of medical organizations’ “seminars” and junkets.

They may seem innocuous, but the stream of complimentary medication samples, pencils, notepads, or even extravagant meals may instill doctors’ sense of responsibility and affinity for big pharma. This can unintentionally lead doctors to prescribe a company’s products, regardless of whether they are the most effective or cost-efficient alternative for the patients under their care.

As continuing medical education is a must to keep knowledge current, many healthcare professionals have found themselves serving as “scholars” of pharmaceutical corporations, with the net effect of their being receptive to product push by their benefactors.

Drug companies have invariably been accused of funding and rewriting research studies that praise their products to high heavens while downplaying any adverse effects or inflating their effectiveness. These falsified research eventually make their way into medical publications, further influencing prescribing patterns.

But probably the most troubling means by which pharmaceuticals practice control over medical professionals is the age-old dangling of the carrot — financial incentives such as large consultancy fees or rewards for pushing medications to colleagues, in actions that constitute a clear conflict of interest.

Allowing drug companies to co-opt or make mindless zombies out of some doctors can have catastrophic effects, as patients may be administered inappropriate drugs that could have serious, if not fatal, consequences.

Likewise, the emphasis on pricey brand name pharmaceuticals can drive up healthcare expenditures, frequently with no added therapeutic value as compared to cheaper generic equivalents.

The medical profession has a clear ethical imperative to prioritize patient well-being. To do this, a multifaceted strategy is required through stricter regulations, transparency and open communication, independent education, and patient empowerment,

Regulatory organizations, like the Department of Health and the doctors’ own groups, must establish stronger restrictions regarding contact between doctors and pharmaceutical corporations. This might include restrictions on donations, financial disclosure requirements, and heightened monitoring of industry-sponsored research.

Doctors must disclose any financial links to pharmaceutical corporations to their patients. This transparency builds confidence and empowers patients to make educated decisions regarding their treatment.

To keep up to speed on the newest advances, physicians should rely on independent medical education providers. This lowers pharmaceutical firms’ influence over their learning.

Patients also play an important role. They should feel empowered to challenge the prescriptions recommended to them and discuss other possibilities with their doctors.

From where we sit, the latest medical scandal in the Philippines serves as a wake-up call on the need to cut the umbilical cord shared by some doctors with questionable practices with their big pharma benefactors.

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