Health News Review

GlaxoSmithKline announced this week that it would begin the “process to end direct payments to healthcare professionals for speaking engagements or attendance at medical conferences by start of 2016″ and that it would stop paying drug reps based on the number of prescriptions that doctors write.

The announcement got a lot of news coverage.

Disappointing was the PBS NewsHour “debate” between Drs. Jerry Avorn and Thomas Stossel, both on Harvard’s faculty.   Key questions about GSK’s announcement and the reasoning and timing for it were skirted. That may have been due, in large part, to the decision to pair Avorn with Stossel.  PBS should have given more background about Stossel.  He is perhaps the leading academic defender of drug companies in the U.S.  The Harvard Crimson called him “The Pro-Industry Professor.”

Stossel stammered through most of his on-air answers and said some things that render his airtime a jumble of confusion, such as:

  • Connecting docs being paid by drug companies with “improved longevity and life quality.”  Huh? For the payment-receiving doctors, perhaps.
  • “I hope (Glaxo) made that decision because they feel they have alternate ways of getting information about their products to doctors.”  Whoa.  What alternate ways did he mean?  Host Judy Woodruff didn’t follow up on that.
  • Stossel went on to say “If they don’t, the shareholders ought to be very concerned and patients ought to be concerned.” (An online commenter wrote: “I don’t think it was an accident that he put ‘shareholders’ before ‘patients’. Shows who he is concerned about!”)
  • Comparing drug company payments to docs with Harvard paying its faculty. The specific excerpt:  “Now, as far as being paid, well, I think that the institution that Dr. Avorn and I work at pays us, and we and our colleagues go out and encourage patients to come to our institution, but at the same time, we think we give outstanding, objective care. Now, being paid is an important part of our economy, and the onus shouldn’t be on who pays whom, but on, what is the quality of the service?” High school debate teams might call that a non sequitur.

You can read the transcript.

 

So much more could/should have been done with that much air time.

Other, more inquisitive news coverage was provided by:

“First, the new rules won’t change much of anything in the large U.S. market: Under its deal with the Justice Department, GSK has already adopted the proposed global sales rules in the States, and a provision of ObamaCare mandates that pharmaceutical firms publicly disclose how much they pay doctors, with the amounts available in a searchable government database starting next fall. That has led the entire industry to ease up on the doctor junkets and speaking fees already.

Second, industry shifts make the education part of the sales mission less important: Well-informed specialists are prescribing more and more medications, replacing prescriptions from generalists and primary care physicians. Drugmakers have already laid off tens of thousands of sales reps since 2006, when the sector peaked at 105,000 sales jobs.

And third, it’s not clear GSK’s changes are as far-ranging as they sound. The company maintains that it still needs to educate doctors about its products, and says it will still “support fair, balanced, and objective medical education for health care professionals” through “unsolicited, independent educational grant routes.” These grants have often been given out through for-profit companies that rely on drug company largess, says Harvard Medical School’s Dr. Jerry Avorn, a critic of Big Pharma’s marketing practices.”

“Why is Glaxo making these changes now? Well, the company has been rocked by allegations of ethical missteps and worse. Why is Glaxo making these changes now? Well, the company has been rocked by allegations of ethical missteps and worse. There’s been a bribery investigation in China . And last year, a settlement of alleged health care fraud involving the marketing of some drugs in the U.S. The settlement included a restrictive corporate integrity agreementwith the federal government.

There are some other reasons it might be more palatable for Glaxo, and perhaps other companies, to dial back marketing now. There are fewer new drugs being launched for mass markets — think cholesterol-fighters, antidepressants and blood pressure pills. And more doctors’ offices and hospitals have restricted interactions between physicians and the drug industry.

Also, public scrutiny of these relationships has been increasing year by year. In 2014, a plank of the Affordable Care Act will bring even more sunshine to bear. Makers of drugs and devices doctors.”

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