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BLOG: April 2008

Drug companies, doctors vs. Congress

Are we about to see first cracks in the iron-firm grip of pharmaceutical companies on how the medicine is practiced in this country? A bill has been introduced in the U.S. Congress to require drug companies to disclose anything of value - consulting fees, gifts, travel expenses and packages, etc. - that they advance to physicians. It could also include disclosure of grants that drug companies use to influence medical colleges, educational and research institutions.

In the nutshell, it is the old quid pro quo scheme. Individuals on the receiving end need to contribute to promotion of the cause, or business, of drug companies, otherwise - they don't get the spoils. Obviously, individual doctors and institutions are targeted highly selectively. For instance, as reported in 2002, in The New England Journal of Medicine, nearly 90% of those creating practical guidelines for U.S. physicians are, in some way,

on the payroll of the pharmaceutical industry.

It is reasonable to assume that it is not much different with those deciding what kind of medical training doctors-to-be get in the college. What about society's (government) oversight? No problem there either. The business has worked it out. The government agency in question, Federal Drug Administration (FDA), is for a long time now sort of revolving door for drug industry employees, who go through their FDA "mandate" just to swing back to better positions in pharmaceutical industry.

In addition to it, the FDA - and the government itself - are very aware of its financing being very much dependant on the fees paid to it directly by pharmaceutical industry.

Is it wonder then that the face of medicine we see has "DRUGS" written all over it? Of course not. And it is not just depriving you from the alternatives to drug treatments and surgery - not seldom safer and more effective - it literally puts you at a great risk of being harmed. Yes, it is a known fact that side effects of prescription drugs

kill over 100,000 people in U.S. hospitals alone.

Good part of the problem is that the safety monitoring of drugs is compromised by the pharmaceutical industry acquiring so much of a hidden, illegitimate control over both, drug market and medical practice. They can't help but chase the profits, which often has user's safety concern belittled. Drug companies regularly get away with it, the worst scenario being agreeing to a limited compensation when they really mess up (read: cause too many deaths) and it becomes wildly known.

 They still make the money, and there is nothing in the realm of the market and its oversight to make them prioritize user safety over their profits. As a result, many get hurt.

Of course, this new legislation, even if it passes as intended, won't make this problem go away. After all, it is not about banning drug industry from making giveaways, from selectively paying hefty "consultation fees", or directing their grants or other forms of financial assistance. What the legislation would do is merely make this exposed to the public, and insomuch put constraint on how far they can go.

It may not do a lot, but would surely be better than without it. We've seen how great is the power of public awareness. Up to a few short years back, pharmaceutical industry had the power to use government's agencies to harass doctors practicing alternative cancer treatments - to the point of raids, arrests, or taking their doctor's license - even if they were having better results than conventional (drug/surgery) alternatives.

Sadly, not a few people were left to die as a direct consequence of being deprived help of such practitioners.

But this kind of terror started to generate negative publicity, and the Big Pharma had to back off. Alternative treatments were growing in importance ever since, simple because they work. Pharmaceutical industry still grossly dominates the market, but the exposure to public knowledge has set the limit to how far they - and their servant/partner, the conventional medicine - can go in suppressing the competition and taking away your right to decide about choosing your own treatment.

Similar - relatively minor - effect can be expected from the new legislature, introduced by Sen. Charles Grassley, R-Iowa and Sen. Herb Kohl, D-Wisconsin.

For improving drug safety situation, much deeper cut is necessary. On one side, it would require making FDA finances independent of the fees charged to pharmaceutical industry.

On the other, making those in the prescription drug industry that knowingly expose the users to undeclared serious health risks criminally responsible.

Granted, it is a long shot from where we stand now. But the news of the Grassley/Kohl initiative is a good thing to start the day with.