More on Doctors & Payola

Another interesting article in the Times discusses shining the light on pharmaceutical industry gifts to doctors. What’s interesting about it is that shows another example of how industry self-regulatory principles often have holes (here, a lack of “detail”) that leave the problem to be addressed unaddressed.

In the privacy field, the most notable example of this was the IRSG Principles, which allowed databrokers to sell personal information to anyone they deemed “qualified,” and surprise, surprise, even criminals were “qualified” to buy Social Security Numbers. But back to doctors:

In the midst of a Senate hearing about the money and gifts that drug makers routinely provide to doctors, Senator Claire McCaskill mentioned that she had a brother who runs a restaurant.

“And he said that the most lucrative part of his business was the private room that is used mostly by drug companies” to entertain doctors, said Ms. McCaskill, Democrat of Missouri. “He said that you wouldn’t believe how much expensive wine these guys buy.” The tab often totals thousands of dollars, she said later.

Marjorie Powell, senior assistant general counsel for the Pharmaceutical Research and Manufacturers of America, assured Ms. McCaskill that major drug makers no longer offer doctors expensive dinners. The industry’s code of ethics mandates that free meals be modest — pizza, for instance, Ms. Powell said.

“I would, with all due respect, suggest that there has been a change in your brother’s restaurant in recent years,” she said.

Ms. McCaskill pressed, “Are they allowed to buy alcohol?”

Ms. Powell responded, “Our code does not go into that level of detail.”

The senator said, “So they can.”


After the hearing, Ms. Powell’s trade association released a statement criticizing the state registries, saying they “disarm doctors by inhibiting access to critical scientific information about the benefits and risks of treatment options that help patients win their battle against disease.”

The laws have led to some embarrassing disclosures: that some doctors earn hundreds of thousands of dollars from drug makers, that doctors who are paid by drug makers tend to prescribe more of their drugs, and that some doctors who have been hired to perform clinical trials have serious medical disciplinary records.


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