It is almost impossible to watch any television programming without seeing a commercial showcasing an individual suffering from depression, sexual dysfunction, and migraines that has been cured by the great and wondrous brand magenta pill and, of course, walks on the beach (Note: this is not an advertisement for the great and wondrous magenta pill). Even TiVo’s diabolical plan to ruin the effectiveness of commercials has been foiled due to the pharmaceutical brands increasing presence in program plots. A Newsweek editorial notes the “sneaky phenomenon” of product placement in movies, such as “Harold & Kumar Go to White Castle,” and television shows, such as “Grey’s Anatomy” and “Scrubs.” According to IMS Health, a pharmaceutical information and consulting firm, pharmaceutical companies directed $4 billion dollars to direct-to-consumer advertising in 2004. Although there is a call for regulation surrounding this specific type of advertising, consumers are generally expected to be capable of assessing the validity of advertising and realizing its merit. However, what if the patient’s main salesman was their trusted physician?
Pharmaceutical Research and Manufacturers of America (PhRMA) stated that in 2004, pharmaceutical companies spent $37 billion dollars on research and development. Conversely, an average of over $20 billion is spent yearly on marketing activities directed at physicians. In 2004, IMS Health accounted for “$27.7 billion on promotion, including $15.9 billion on free drug samples, $7.3 billion on sales rep contract (i.e. free lunches and pens)…and $500,000 on journal advertising.” Many individuals value our physicians as the equivalent to Malcom Gladwell’s Mavens and Salespersons; they are our medical gurus. We expected them to be well read on medical innovations and have a general interest our health and, with the finical stress related to today’s healthcare, our financial stability. However, because physicians can potentially gain from relationships within the pharmacy industry, it is impossible not to question the need for the monthly $108.03 that the doctor may prescribe.
A growing number of medical institutions and physician offices prohibit or implement restrictions on gifts (ranging from free drug samples and lunch to pen’s displaying company names) from pharmaceutical companies. Massachusetts, Minnesota, and Vermont all have bills addressing this issue in diverse manners. Massachusetts calls for a complete ban on gifts, while Vermont and Minnesota have placed monetary limits on gifts. Additionally, two pharmaceutical companies, Eli Lilly & Company and Merck & Company, have agreed to disclose all payments to doctors for speaking and consulting services via an online database in 2009. This development comes a year before the expected passing of the Physician Payment Sunshine Act, which will require similar pharmaceutical transparency.
Although some believe that the relationship between physicals and drug companies should almost completely be severed, this actually may lead to further problems. Many of the practices, such as providing free samples and supporting research can be detrimental, but with regulation and transparency can also be beneficial. Research shows that free drug samples are more likely to reach the hands of the rich versus the poor, because they are insured and see doctors. Furthermore, these drugs are more expensive, because the patient continues to pay for drug refills instead of utilizing the equally efficacious generic equivalent. Conversely, for necessary drugs that do not have a generic counterpart the free samples at least provide some financial break.
Another possible consequence would be the decrease in research. Research suggests a correlation between pharmaceutical funding and “pro-industry research results”. However, without the corporate funding and with no financial federal support, many important studies would not be possible.
Consumers generally view the pharmacy industry as a somewhat unscrupulous industry. However, transparency and tightened regulation is needed, not complete disregard. With openness, instruction, and an increased interest on patient s, this industry may begin to be redeemed. If passed, The Physician Payment Sunshine Act may be the first of many national regulations to address one of many issues plaguing this industry.
