scrive su Forbes del 1 luglio 2015 John LaMattina
“Doctors Got $6.5 Billion from Drug, Device Makers in U.S.,” screams a recent headline from Bloomberg. This story is derived from data that reporters were able to access thanks to a provision in the Affordable Care Act (“Obamacare”) which mandates that all payments made by companies to doctors be made public. The data show that about 607,000 doctors and 1,121 teaching hospitals received these payments in 2014, and many find this alarming. The issue is, of course, that these payments constitute a conflict of interest (COI) in that doctors are receiving payments from the very companies making the products that they will be prescribing. Professor Jason Dana of the Yale School of Management expressed serious concerns.
“If we have a financial incentive to believe something or conclude something, we kind of trick ourselves into thinking it’s true. And we are not always aware that we are doing it…….No pharma companies spend this kind of money in a disinterested way.”
Dana is not alone in his views. Long time pharmaceutical industry critic Dr. Marcia Angell has implied that drug companies pay off medical experts to use their influence to change national health guidelines to favor the use of expensive drugs. Even John Oliver jumped on the issue of pharma payments to physicianson his satirical show Last Week Tonight. The public, already concerned with drug pricing, can easily come to the conclusion that the $6.5 billion given to doctors by drug and device companies is being used to influence prescribing practices
However, digging into the data, a different picture forms. In 2014, Pfizer PFE +0.00% paid physicians about $287 million, but $234 million (over 80%) went to pay for research. Similarly, 78% of Merck ’s $125.2 million in physician payments were also for research. The notion that doctors do research will likely come as a surprise to most. But the fact of the matter is that clinical trials for new drugs are run not by the sponsoring manufacturers, but by doctors at the leading teaching hospitals in the country and under the aegis of independent review boards. Much of the $6.5 billion being paid by companies to physicians is being used to pay doctors for their work in conducting clinical trials to find new drugs to treat Alzheimer’s disease, breast cancer, diabetes, rare diseases, etc. This work is very complex and time consuming. Surely, one cannot expect that people would do this work for free.
Skeptics like Dana will argue that physicians will “trick” themselves into believing that a drug they study has value. But, when conducting these studies, physicians are seeking whether a drug is safe and effective for their patients. They really have no financial incentive. The test data that they generate will determine the drug’s fate. If the drug in some way falls short, doctors will abandon it and, like any scientist, will move on to work with another promising drug. If the drugs works, they will have been part of the team to help bring a new treatment to many in need.
The transparency provision of the Affordable Care Act is serving a great purpose. It is bringing clarity to the previously murky world of company payments to doctors. It can also be a tool to teach people how physicians and companies interact to create new medical breakthroughs. It is unfortunate that journalists seek to sensationalize the numbers to foster distrust not just in pharmaceutical companies but the medical community as well.