I always have been suspicious about the influence drug companies exert on doctors. We know of perks for the already over-privileged medico class, from paid-for conference attendances to get-away holidays and personal gimmicky gifts (see image above). Now Choice published an article detailing what is happening behind the scenes in you GP practice.
Pharmaceuticals are big business. Drug companies in Australia had a turnover of $18 billion in 2006-07. Developing new drugs and conducting the various clinical trials required before they can be brought to market is expensive, so there’s clear incentive for drug companies to market their drugs aggressively.
A company holds a patent over a medicine for up to 25 years before generic versions of the same drug can be manufactured by other producers and offered to consumers at a lower price. So it’s in the company’s interest to generate the highest possible return from their product before the patent expires.
Little information is publicly available on the actual amount drug companies spend on marketing drugs, but some estimates suggest it’s more than they spend on research and development.
Pharmaceutical marketing, like all marketing, is used to stimulate demand and increase the bottom line, so if it didn’t work, they wouldn’t do it. Because the information provided isn’t independent it can lead to inappropriate prescribing practices, which expose consumers to unnecessary risk. It can also increase the cost of the Pharmaceutical Benefits Scheme (PBS), which is funded by taxpayers.
But despite strong evidence that pharmaceutical promotion isn’t in the best interest of consumers, the Choice survey of 180 practicing GPs shows that drug companies have a major influence on GPs prescribing drugs, with almost two-thirds of them meeting pharmaceutical representatives an average of seven times a month.
And even though only 24 per cent of doctors trusted the information as much as an independent source, most (81 per cent) would rather receive it because they believe it was often the only way to get timely information on new drugs.
The survey of 180 doctors found that 73 per cent referred to pharmaceutical companies or their representatives for drug information. This made the companies the second-most important source for doctors after clinical evidence.
Drug companies are the main source of information for 16 per cent of doctors when deciding whether to prescribe a new drug, the survey said.
More than half of doctors said there were not enough independent sources of information on new drugs. Only half of the doctors were aware of the independent drugs adviser, the National Prescribing Service. But a spokesman for the service said it had “significant penetration” (which is weasel-speak for saying they don’t do enough).
Choice found that 65 per cent of doctors saw at least seven pharmaceutical representatives on average each month, and a handful said they saw 20 or more in one month. Doctors received an average of 10 promotional mailings a week from drug companies. Forty per cent of doctors were also sponsored by a drug company to attend a conference, seminar or training in Australia – and 3 per cent overseas – in the past 12 months.
Choice said the results showed there was a need for independent monitoring of pharmaceutical promotion beyond the industry-administered code of conduct, which it described as “ineffective”. One in eight GPs were unaware of Medicines Australia code, which did not set specific limits on drug company visits and mailouts, as in the British code, which prohibits a representative from visiting a doctor more than three times a year, it said.
And not surprising, a spokesman for the federal Health Minister, Nicola Roxon, said there were no plans to increase funding to the National Prescribing Service.
By the way: drug companies not only manipulate prescriptions in Australia. Choice provides supporting evidence from a couple of European countries.
- A UK survey of 1097 practitioners found that GPs who report weekly contact with drug reps are more likely than those who have less frequent contact to prescribe drugs without first checking for published clinical evidence of effectiveness.
- Another study of 1019 GPs from the Netherlands found that more frequent visits from drug reps were associated with a lower quality of prescribing.
When correctly prescribed, medicines can provide benefits. But used incorrectly or inappropriately, they have the potential to cause significant harm – but that’s not something drug companies are concerned about (as long as regulators and courts cause them grieve).
Source: Sydney Morning Herald