Thinking through pharma bans

In theory, no thoughtful person would object to the idea of keeping physician decision-making independent, particularly where costly drugs are concerned. No one, including the doctors themselves, benefits if physicians are making decisions that drive up the cost of care unnecessarily.

That being said, many doctors have written to us here at FierceHealthcare to say that they don't support pharmaceutical industry gift or sample bans. Are they just naïve as to how such gifts affect their judgment? Not necessarily. I'd argue that their position deserves more of a hearing. As some readers may notice, I haven't been gentle to the pharmas in this newsletter, but at this point, I'd argue it's time to take a deep breath.

From my editor's chair, I learn a lot about the ongoing efforts to push drugmaker influence out of the care process. My sense is that some are carefully targeted and others are more a matter of bowing to popular opinion. I'm not visiting all of these campuses, so I couldn't go as far as to say gift, sample and drug rep restrictions weren't thought through, but my instinct is that there are a lot of politics involved.

At minimum, it seems to me that we in the industry ought to take care to look at the varied relationships pharmaceutical companies have with doctors on a case-by-case basis. Continuing Medical Education grants deserve a different level of scrutiny than vendor clocks and Kleenex dispensers, and free samples can't be lumped in with prescriber data-driven marketing efforts. Of course, practices and facilities should consider all of these channels, but it's important to distinguish between them. And my gut feeling is that disreputable pharma practices are being lumped in with lesser issues.

I'll readily admit that I'm probably missing some of the nuances here. I'm not suggesting that, say, Henry Ford Health System went to the trouble of banning unscheduled rep visits and pharma perks completely--even setting up a system to monitor them--without having in-depth discussions on the subject. But I am suggesting that the industry, as a whole, may be on the wrong side of one of those pendulum swings where the real facts regarding pharma influence (some of which are appalling) may be obscured by rhetoric.

By all means, let's be zealous in helping doctors avoid undue outside influences. But let's also treat them like adults. - Anne

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