Do Drug Companies Influence Doctors?

A Physician's Perspective and Past Experience

Apr 2, 2009 Stephen Allen Christensen

Although many physician's groups have attempted to distance themselves from the drug industry, the ties between doctors and Big Pharma remain strong...for now.

Citing inappropriate influence on public health issues by the pharmaceutical industry, a group of prominent doctors is calling for a change in the relationship between drug makers and physicians.

A proposal authored by the editor-in-chief of the Journal of the American Medical Association, the CEO of the American Psychiatric Association, the former presidents of the American College of Physicians and the American College of Cardiology, and seven other experts urges medical associations to reject nearly all funding from pharmaceutical companies.

In outlining the reasons for the proposal, Dr. Steven Nissen, one of its co-authors, remarked, "It has not always been flattering to see how physicians’ relationships to industry appear to have colored their judgment in matters of public health.” (Tanner L. Plan seeks to slash industry influence on doctors. AP Medical, April 1, 2009)

Dr. Nissen may have been alluding to cases where doctors who were financially tied to drug companies were also instrumental in devising treatment guidelines that recommended medications manufactured by those same firms.

Premarin: Low-Profit Treatment for Menopause, or an Anti-Aging Miracle?

  • The drug Premarin was first approved by the FDA in 1942 for treating the symptoms of menopause (hot flashes, vaginal dryness, night sweats, etc.). Since only a minority of women have menopausal symptoms that are severe enough to require medical therapy, projected sales of the medication were not particularly impressive.
  • When gynecologist Robert Wilson (at the behest of the drug’s manufacturer) published several hyperbolic journal articles and his best-selling book, Feminine Forever, Premarin’s place as an anti-aging agent for women was secured. Dr. Wilson’s foundation received a total of $1.3 million from various drug companies, including Wyeth, the maker of Premarin. (Overdosed America. John Abramson, MD. Harper Collins, 2004:58-62)

The Marketing of Statins for Cholesterol

  • With the nation’s collective attention focused on lowering LDL cholesterol levels to prevent cardiovascular disease, statin drugs have been pushed to the fore as the holy grail of laundered lipid panels.
  • In truth, regular physical activity is far more effective at reducing mortality from heart attacks and strokes than is a lower LDL cholesterol level—but lifestyle changes cannot be marketed for profit.
  • Five of the 14 experts who formulated cholesterol guidelines in 2001 disclosed financial ties to companies that manufacture statins, and four of the five (including the panel’s chair) had relationships with all three makers of the best-selling drugs.
  • The panel’s recommendations—which included the widespread use of statins—were published in the May 16, 2001, issue of JAMA and quickly became protocol for virtually all physicians who treat patients…a population that now includes children.

COX-2's for Arthritis: A Case of Misrepresentation

  • At the end of 2001, 57% of all money spent on arthritis drugs in the US was being spent on Celebrex and Vioxx, both of which were among the top 10 selling drugs.
  • Earlier that same year, Pharmacia Corporation was required to notify physicians that the company’s marketing of Celebrex had been “false or misleading and therefore in violation of the Federal Food, Drug, and Cosmetic Act.” (Personal files)
  • Unfortunately, the effectiveness and safety of both medications had already been extolled in highly-esteemed medical journals read by all physicians.
  • Evidence uncovered in the interim suggests that both Vioxx and Celebrex were marketed as safer alternatives to older anti-inflammatory drugs when manufacturers were aware that they actually weren’t—and possibly manipulated data to protect the medications’ status in the marketplace.

Multiple other instances of “Big Pharma’s” misbehavior have been brought to light. Now, with direct-to-consumer advertising, drug companies exhort patients to demand the newest medications hitting the market. So even if physicians can partially loosen the grasp of the pharmaceutical industry, they’ll still have to contend with misinformed patients.

The copyright of the article Do Drug Companies Influence Doctors? in American Affairs is owned by Stephen Allen Christensen. Permission to republish Do Drug Companies Influence Doctors? in print or online must be granted by the author in writing.
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