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Doctors–Drug Companies Relations: Inappropriate?

By Moni Constantinescu
March 21, 2007;  Playfuls.com

Doctors may be biased when they recommend certain drugs, which could be detrimental to their patients.

How does this come about? Well, drug companies give money and gifts to doctors in what sometimes seems to be an excessive fashion. Doctors in turn could recommend drugs to their patients because of industry influence, instead of having their patients’ best interests in view.

At least that’s what Dr. Joseph Ross, a researcher at Mount Sinai School of Medicine in New York says, lead author of a new study of disclosure laws in two pioneering states.

Minnesota and Vermont were the first two states to enact laws designed to shed light on the practice, but getting key information required a lawsuit in Vermont and photocopying individual disclosure forms in Minnesota, the researchers said.

According to the report drug companies are able to hide millions of dollars in payments and make it difficult to know who’s receiving them. The researchers said many doctors accepted amounts exceeding recommended limits, but that it was hard to sort out which payments were inappropriate.

“The hoops that we had to jump through just to get the data in each state is enough to show these laws really aren’t working,” Ross said.

Most of the payments studied were related to education, research, meals and personal visits with doctors to promote new drugs, the researchers said. However, reasons for many payments were not specified, sometimes because companies declared them trade secrets.

The point of disclosure laws is to monitor whether money and gifts influence physicians' decisions when prescribing medication. Minnesota’s law dates to 1993; Vermont’s was enacted in 2001. Defenders say it’s not surprising to find imperfections in these early efforts and that improvements in both states’ laws are under way.

California, the District of Columbia, Maine and West Virginia also have disclosure laws and similar legislation was proposed last year in 11 other states, the researchers said. Ross said it’s unclear whether similar problems would be found elsewhere.

American Medical Association guidelines recommend that gifts to doctors should not exceed $100 and should benefit patients. Other medical groups and the Pharmaceutical Research and Manufacturers of America, or PhRMA, an industry trade group, have similar recommendations.

The study appears in today’s Journal of the American Medical Association.