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Wednesday, March 28, 2007

How much do drugs companies influence your doctor's treatment decisions?

"Approximately US$19 billion is spent annually by drug companies for marketing to doctors. Tens of thousands of sales representatives descend on doctors' offices every day. Patients in doctors' waiting rooms are often outnumbered by drug reps (typically young, female, attractive).

Drug companies write the package inserts of all drugs, carefully including the information they choose and omitting information they want to avoid.

Drug companies underwrite a large percentage of continuing education courses for doctors. In doing so, they make sure that the speakers represent the company view.

Drug companies design studies that are meant to produce favorable results and then publish the studies in medical journals. Studies with unfavorable results are not published.

Drug reps typically bring stacks of studies, all favorable, which impress doctors, who no longer have the time or motivation to search the medical literature themselves.

Drug reps do not include independent studies with less favorable conclusions. Many doctors never see these."
Gary Moller comments:
What this article did not mention is the fact that drugs companies also invest millions in successfully influencing politicians and bureaucrats. For shocking evidence of the extent of this political lobbying in the USA, go here.

Back in the days when I hired physical education graduates straight from university to work in our rehabilitation programmes it was common for the attractive ones to be recruited within a year or so by our opposition: the drugs companies. Their new job over on the Dark Side was to promote drugs to doctors like blood pressure and cholesterol lowering pills. What is described that happens in the USA happens in NZ. Sadly, NZ allows the advertising of pharmaceutical drugs direct to the consumer using media like television.

Side effects of drugs medication is always underplayed, as is the reporting of any ill effects which consequently distorts official statistics to give the impression of a drug appearing to be much safer than it really is.

If a doctor is even aware of effective alternative treatments for conditions like weak bones, arthritis and high blood pressure these usually receive very low priority treatment that is little more than lip service, or else completely dismissed as a waste of a patient's time and money. I am still astonished at how often a doctor dismisses out of hand a therapy like glucosamine for arthritis despite the wealth of research evidence in its favour.

When a drug is prescribed for a condition like blood pressure this may be done on the basis of a handful of potentially flawed tests of blood pressure done in the artificial envirnoment of a medical clinic. The drug is then dished out with advice along the lines of; "Try this and we will see how it goes". Unless the medication is being closely monitored through the person's day, such as with a blood pressure machine, then the prescribing of this potentially harmful medication sure is a hazardous hit and miss exercise! Would you run a business without having accurate measures of key performance indicators? Of course not and why should your health be any different when ingesting potentially hazardous drugs?

Maybe it is not in the interests of the prescriber or the manufacturer to monitor these drugs properly because it might be discovered more often than not that they are not very good at doing what they are supposed to do and may even be doing more harm than good!