E-DRUG: Drug firms accused over doctor 'perks'
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[Copied as fair use]
By Annabel Stafford and Melissa Fyfe
May 2, 2006
DRUG companies are facing more scrutiny of their relations with doctors,
after accusations that they are offering improper inducements and using
doctors to promote expensive, but unproven cancer treatments.
Australia's competition regulator Graeme Samuel has proposed tougher
regulations to clamp down on drug companies offering perks and gifts to
doctors as an inducement to prescribe their medicines.
But in a damning finding, Mr Samuel said he was virtually powerless to
change a system that was failing to stop pharmaceutical giants improp-
erly promoting their products.
See: http://www.accc.gov.au/content/index.phtml/itemId/716327
At the same time, a group of Melbourne cancer specialists has spoken out
against doctors who they claim may have undeclared connections with drug
companies and are misleading the public about the new generation of
costly anti-cancer drugs.
The specialists say new treatments including the breast cancer drug
Herceptin have been over-promoted, and it is crucial for doctors
speaking to the media to disclose their connections with drug companies.
One of the specialists, Ian Haines, said the connections included
payments to attend conferences, international first-class travel and
"consulting" or "advising" fees.
Dr Haines said that doctors used to discuss research over sticky buns
and tea. Now there was a "gravy train" that included "lavish" dinners
provided by drug companies. "No one wants to be left on the platform
when the gravy train goes through," he said. "We all want our seat."
The Australian Competition and Consumer Commission, in its attempt to
curb such practices, has proposed that drug companies be subject to spot
checks to pick up the perks and gifts they offer to doctors.
In a draft determination, the watchdog said regulations meant to stop
drug companies from currying favour with doctors or advertising
medicines to consumers were all but failing.
Despite this, the ACCC recommended that the current system continue'
with the new spot checks' because it did not have the authority to
design a better system and the existing one was better than nothing.
The findings have sparked calls for tougher regulation from consumer
advocates who say aggressive marketing by drug companies has led to
consumers being prescribed inappropriate medicines and paying too much.
The pharmaceutical industry regulates itself through a code of conduct,
with fines of up to $200,000 for code breaches.
But the ACCC found fines were rarely imposed and when they were, most
were at the lower end of the scale. The fact that several companies
repeatedly breached the code indicated the sanctions were not working.
Alleged and past breaches by drug companies included:
# Providing benefits to doctors to encourage them to prescribe their
medicines.
# Circumventing bans on advertising to consumers by promoting "disease
states" such as impotence or running "educational campaigns".
# Making the names of generic medicines illegible in software used by
GPs, resulting in expensive medicines being used.
"The sanctions are ineffective," Australian Consumers' Association
health policy officer Viola Korczak said. "There were 51 complaints last
year. But none of the sanctions were over $150,000 and the majority were
around $25,000. That is not going to stop repeat breaches."
Ken Harvey, a senior research fellow in the La Trobe University School
of Public Health said: "The ACCC is quite clearly saying that the code
is not working well, but that they really think it's the Government's
responsibility, not their's (to fix it)."
Dr Harvey and Ms Korczak said the Government or the Therapeutic Goods
Administration should be regulating the industry.
Cancer Council Victoria director David Hill welcomed the three doctors'
comments about their colleagues and drug companies. Oncologists had to
be vigilant about the influence of drug companies, he said, and more
transparent in public debate.
"There's a big responsibility on clinicians to examine themselves and
make sure when they are asked to make a public comment that they really
do face up to any potential conflict of interest or bias that may be
creeping in," Professor Hill said.
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Ken Harvey
k.harvey@medreach.com.au