The relationship between doctors and drug companies are controversial and researchers, ethicists, professional bodies, and patients have long been concerned that this relationship may be the basis of doctors prescribing drugs not because they are the optimal drug for a particular condition, but because the drug has been successfully promoted by a drug company.
There have been several investigations into the issue. A report by journalist Ray Moynihan way back in 2003 states: “Twisted together like the snake and the staff, doctors and drug companies have become entangled in a web of interactions as controversial as they are ubiquitous.”
The summary points were:
- Entanglement between doctors and drug companies is widespread, and evidence shows that interactions with industry influence doctors’ behavior
- Evidence is strong that sponsored research tends to produce favorable results
- Leading academic institutions are currently debating the rules governing relations between researchers and sponsors
- Pharmaceutical expenditures are rising rapidly, and entanglement may undermine rational prescribing strategies
- Critics argue that a culture of industry gift giving creates entitlements and obligations for doctors that conflict with their primary obligation to patients
Seven years later an article by University of Toronto’s David Henry appeared in PLOS entitled: Doctors and Drug Companies: Still Cozy after All These Years.
Henry found that although drug companies had curtailed industry-sponsored activities, lavish gifts and entertainment, and generous travel support in response to the Code of Practice of the Pharmaceutical Research and Manufacturers of America, open-ended activities such as “unrestricted” research grants, “educational” grants, membership in speakers’ bureaus and advisory panels, consultancies, and stock-holding continues and causes “an insidious blurring of professional boundaries and obligations”.
Why is this a problem?
The close ties between companies and doctors, explains Henry, may lead to inappropriate prescribing that can harm patients, create divided loyalties for doctors between the health system, their patients, and manufacturing companies, and may lead to use of unnecessary and expensive medications with consequent costs falling on health care systems and patients.
The point for the consumer is that we don’t always know if our doctors are prescribing the best possible medicine for us; and what’s more, chances are that the doctor you consult hasn’t been told about all the drugs available, or doesn’t have the time to go into the pros and cons of each new drug on the market.
Harvard professor reveals what’s wrong with big pharma
The relationship between the medical profession and the pharmaceutical industry was also deplored by Harvard Professor of Medicine and Former Editor-in-Chief of the New England Medical Journal, Arnold Seymour Relman (1923-2014), who said:
“The medical profession is being bought by the pharmaceutical industry, not only in terms of the practice of medicine, but also in terms of teaching and research. The academic institutions of this country are allowing themselves to be the paid agents of the pharmaceutical industry. I think it’s disgraceful.”
Another outspoken voice warning of the dangers associated with some pharmaceutical grade drugs is Peter C Gøtzsche. Gøtzsche is a Danish physician, medical researcher, and leader of the Nordic Cochrane Centre at Rigshospitalet in Copenhagen, Denmark. He co-founded, and has written numerous reviews within the Cochrane Collaboration. He is the author of a number of books on evidence-based medicine, including Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare.
Gøtzsche says that prescription drugs are the third leading cause of death after heart disease and cancer.
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And he has the figures:
Through his research Gøtzsche has found that 200,000 people in America are killed by drugs every year. And half of these people die while they do what their doctors told them, says Gøtzsche .
Gøtzsche is particularly concerned about Non-steroidal, anti-inflammatory drugs (NSAIDs) which he says carry a huge death toll, primarily by causing bleeding stomach ulcers and myocardial infarction. According to him, most of those who die could have done well without drugs or by taking paracetamol.
Gøtzsche says antidepressant drugs are another major killer that people could do well without, stating that their effect on depression is questionable.
According to Dr. Gotzsche the main reason we take so many drugs is that drug companies don’t sell drugs, they sell lies about drugs. This is what makes drugs so different from anything else in life — virtually everything we know about drugs is what the companies have chosen to tell us and our doctors.
And this is the sad point: the reason we as patients trust their medicine is that we extrapolate the trust we have in our doctors into the medicines they prescribe.
If you want to find out more, you watch Dr. Gøtzsche below.