The question about doctors being too close to drug companies is recognised as a serious problem. In a Daily Telegraph article on 9th July 2006, the GMC (General Medical Council) was said to be warning doctors about taking ‘freebies’ from pharmaceutical companies, and to ‘blow the whistle’ on colleagues who were ‘taking bribes’ from drug companies. They were revising their rules to enable such doctors to be removed from the register, and ‘struck off’.
“The decision to toughen up the rules comes as evidence increases that, in return for promoting their products, some doctors are taking inappropriate gifts and hospitality from the pharmaceutical industry.
“The decision to toughen up the rules comes as evidence increases that, in return for promoting their products, some doctors are taking inappropriate gifts and hospitality from the pharmaceutical industry.
The article pointed to a report by the campaign group Consumers International that said doctors were continuing to accept kickbacks, gifts, free samples and consulting agreements in exchange for prescribing or promoting drugs. It said that such inducements accounted for a substantial part of the £33 billion spent on product promotion by the industry worldwide each year.
Despite this, concerns continue. WDDTY reported on 6th November 2007 that the drug giant Bristol-Myers Squibb (annual sales: $17.9bn) had been handed a $515m fine for mis-selling drugs, inducing doctors to prescribe drugs inappropriately, and setting fraudulent prices on some of its products. It said that the company had been caught making illegal payments to doctors as an inducement to get them to buy their drugs. Doctors had also received ‘consulting fees’ to sit on ‘advisory’ boards and programmes, some of which involved necessary trips to luxury locations. Meanwhile, the company was paying retail and wholesale pharmacies to buy its drugs. It was also encouraging doctors to prescribe its anti-psychotic drug Abilify (aripiprazole) to children when it had been licensed for use only with adults. (The source of this information was the British Medical Journal, 2007; 335: 742-3).
In another WDDTY article, “Bribery: Doctors gifted $100,000 a year to use hip replacement products”, dated 29th November 2007, Orthopedic surgeons in the US were reported to have received bribes of $100,000 and more every year to use special hip and knee replacement products on their patients. Apparently five manufacturers were fined $311m (£150m) by the US Department of Justice. The companies admitted paying 'many' orthopaedic surgeons 'consulting fees' that ranged from $10,000 to hundreds of thousands of dollars every year. Investigators discovered that the payments had been common practice between 2002 and 2006, and that as well as receiving “consulting fees”, the surgeons were also treated to lavish trips and expensive gifts. (The source of this information was the British Medical Journal, 2007; 335: 1065).
The objectives of the ‘No free meals’ group of doctors is as follows:
“We are health care providers who believe that pharmaceutical promotion should not guide clinical practice. Our mission is to encourage health care providers to practice medicine on the basis of scientific evidence rather than on the basis of pharmaceutical promotion. We discourage the acceptance of all gifts from industry by health care providers, trainees, and students. Our goal is improved patient care.
"We aim to achieve our goal by informing health care providers as well as the general public about pharmaceutical industry efforts to promote their products and influence prescribing; provide evidence that promotion does in fact influence health care provider behaviour, often in ways that run counter to good patient care; and provide products that can replace pharmaceutical company paraphernalia and spread our message.
"We believe that there is ample evidence in the literature-contrary to the beliefs of most heath care providers - that drug companies, by means of samples, gifts, and food, exert significant influence on provider behaviour.
"We aim to achieve our goal by informing health care providers as well as the general public about pharmaceutical industry efforts to promote their products and influence prescribing; provide evidence that promotion does in fact influence health care provider behaviour, often in ways that run counter to good patient care; and provide products that can replace pharmaceutical company paraphernalia and spread our message.
"We believe that there is ample evidence in the literature-contrary to the beliefs of most heath care providers - that drug companies, by means of samples, gifts, and food, exert significant influence on provider behaviour.
"There is also ample evidence in the literature that promotional materials and presentations are often biased and non-informative. We believe that health care professionals, precisely because they are professionals, should not allow themselves to be bought by the pharmaceutical industry: It is time to Just say no to drug reps and their pens, pads, calendars, coffee mugs, and of course, lunch.
These are laudable objectives. However, there appears little evidence that their motives have been generally accepted by the conventional medical establishment.
This article was first published in my e-book, "The Failure of Conventional Medicine".