Take a look at this article that expands our discussion from last week into territory beyond samples.
Where should healthcare providers draw the line? Is it where we recognize that there may be a conflict of interest? Or is it where our patients perceive that we may have a conflict?
What
do you think of the article's stance? Should all gifts, no matter how
small, be denied to providers? Should this be an individual decision,
or should it be an organizational or institutional policy?
In what situations should we be required to declare a potential conflict of interest, and to whom should we declare them?
45 comments:
First, I feel like there has to be a distinction made between regular pharmacists and other healthcare providers, especially those who are in prescribing roles, as I consider the possibility of being swayed by a drug rep a much more real concern for those persons who are actually doing the prescribing, whereas, in the case of the typical pharmacist, they will not have a direct say on what medication the patient will be getting. I think that conflicts of interests that develop with a doctor are the primary responsibility of that doctor; they need to be ethically sound and competent enough to realize when they are being taken advantage of and when they are falling behind in regards to keeping patient health and safety at the forefront of their concerns. That being said, the information that drug reps are purchasing to perpetuate their preying tendencies is likely available for almost any major group to obtain, whether that be for a fee or not; thus, I feel it is also the responsibility of the agency that presides over doctors to monitor these behaviors, in a similar way as drug reps do, and prematurely crack down on any suspicious behavior that they encounter. As was the case in last week's discussion, I do not believe that all gifts should be discontinued because of their potential to effect doctor's prescribing patterns - the drug information, samples, and even pens and the like are valuable assets to the doctors practice. Even in the case of a delivered or promotional meal, it shoud be up to the discretion of the doctor at first and then governed by an authoritative body. In the case of pharmacy, I again do not consider the influence of drug reps to be worth consideration because there is not any scenario I can imagine where it would be advantageous for a drug rep to try and get over on a pharmacists to cause them to promote certain medications. They should be entitled to even more than doctors because they generally do not have the direct prescribing ability, and because they are the one's more likely to use the information to personally discuss with patient rather than to treat their case. Also, I just really want my pens and snacks back.
- Jesse R Alvarado
In my opinion, healthcare providers should keep conflicts on interest at the forefront of their concerns because these conflicts could potentially result in jail time of serious trouble. Conflicts of interest can occur both when we recognize one, and when a patient perceives one, though the former should be addressed first so the latter does not even have to occur. I don’t think that gifts should be denied all together, because in a perfect word, prescribers should all know what the drug reps are trying to do and know better than to be swayed. However, this is not the word we live in but gifts are gifts and this is just the word we live in. It is hard to decide if it should be an individual’s decision as to if practitioners receive gifts, or if it should be an organization. On one hand, if it was an individual’s decision, the individual could either be a person who is easily convinced or a person who knows what drug companies are doing and just getting a free meal. On the other hand, in regards to doctors who are easily swayed, maybe an organization controlling gifts could be a good thing. Every situation should be looked into before declaring a conflict of interest, unless it is a complete obvious situation. I can only think of declaring a conflict of interest, in this case, by physicians because of the relationship between physicians and drug reps.
I don't think we need to add more rules for the pharmaceutical companies. Their goals are simple. They want to make profit and will use all the marketing strategy possible. Instead, the regulation needs to be focussed on the physicians' end. They are the ones who promised to follow an ethical code of conduct. By law they are required to provide the best treatment for patients without compromise. I don't know if there is a punishment for conflict of interest, but if not, there needs to be one.
I don't think that more restrictions will help with a conflict of interest. The drug companies developing these drugs are making a contribution to patient health. Admittedly, they make tons of money pushing drugs on physicians, but we can't forget how most of the drugs that save patient lives have begun. Most have started with costly research and drug reps pushing to make a profit in return. Physicians have the sole responsibility of choosing the best medication for the well-being of the patient, and samples definitely can help patients, when used appropriately. The gift giving system may be abused by physicians and reps, just like most businesses are, but when used appropriately, I do feel there is a benefit.
I personally do not think that there should be more restrictions but on pharmaceutical companies. They are like any other business that wants to get their name out there. I do not think there is anything wrong with giving gifts as long as these gifts are within reason. Drugs that have saved patients’ lives have come from these pharmaceutical companies. It is in the physician’s hands as to how much he does or does not prescribe of the medication. When it comes down to it, it is not the pharmaceutical companies who are prescribing a medication it is the physician and a physician should be able to distinguish the difference in being given a gift verses being taken advantage of. I would hope that a physician would not prescribe a drug just because they feel pressured by a pharmaceutical company but rather prescribe what they truly think is better for the patient. I am not sure if there is any way to really judge or regulate this process. Also I think that being able to give out samples of medication can really benefit patients. If it is a medication that a patient cannot afford and they only have to take it for a short time, samples could be their answer to health.
Amanda Elliott
I feel that physicians should still be able to get samples and other "perks" so to speak from drug representatives, but with increased restrictions. There needs to be a line drawn between free samples and having a physician "endorsed" by a drug company. Medicine should not be an marketing endorsed business. Ultimately, the practice of medicine should be about the the needs of the patients. It should not be about getting funding from drug companies to promote their products.
-Matt Ferro
I feel that pharmaceutical representatives are doing their job of promoting their company. However, I do not think that the AMA should sell information about the Doctor to the representatives. That is taking advantage and abusing their promoting system. I feel that they should have to get the know the Doctor's on a personal level and build that relationship that way instead of trying to impress and be 'fake' friends. I do not agree that all gifts should be discontinued. I thought the pens and dinners are a nice touch, but I do there there needs to be a limit. I would hope that there are doctor's out there smart enough to make the best decision for their patient and not based on a friendship. I do think that pharmaceutical reps should be regulated in how they promote, just because it can get out of hand, and then people are promoting for their job over promoting for patients. I do think promoting has to be done because a new medication can help cure people of lots of illnesses. I also think if the patient has noticed a conflict of interest then that should denote a problem with the system, but I don't think patients really notice because they usually already have a drug in mind that they want. And I, agree with Jesse, I miss my numerous pens and post-it notes.
-lora steffner
I think that the drug reps should rely more on the facts about their drug rather than "befriending" the prescribers in order to do their job. Taking advantage of personal relationships is just wrong, so i do not think that prescriber information should be sold or even compiled by the drug rep. The health of the public is on the line, so the drug reps should be more concerned about how their work is going to help the general public then how they can use personal prescriber information to sway prescribers. Staying with this line of thinking, "gifts" should also not have an effect( or even be allowed) if they are extreme. A pen, i feel is not going to sway a prescriber, or make them feel indebted to the drug company. A 500 dollar silk tie however (which by the way has nothing to do with the drug) will more than likely make the prescriber feel indebted to the drug company or rep, causing them to make a decision based on emotion rather than fact.
~Heather Taylor
I think that the drug reps should rely more on the facts about their drug rather than "befriending" the prescribers in order to do their job. Taking advantage of personal relationships is just wrong, so i do not think that prescriber information should be sold or even compiled by the drug rep. The health of the public is on the line, so the drug reps should be more concerned about how their work is going to help the general public then how they can use personal prescriber information to sway prescribers. Staying with this line of thinking, "gifts" should also not have an effect( or even be allowed) if they are extreme. A pen, i feel is not going to sway a prescriber, or make them feel indebted to the drug company. A 500 dollar silk tie however (which by the way has nothing to do with the drug) will more than likely make the prescriber feel indebted to the drug company or rep, causing them to make a decision based on emotion rather than fact.
~Heather Taylor
I think that the drug reps should rely more on the facts about their drug rather than "befriending" the prescribers in order to do their job. Taking advantage of personal relationships is just wrong, so i do not think that prescriber information should be sold or even compiled by the drug rep. The health of the public is on the line, so the drug reps should be more concerned about how their work is going to help the general public then how they can use personal prescriber information to sway prescribers. Staying with this line of thinking, "gifts" should also not have an effect( or even be allowed) if they are extreme. A pen, i feel is not going to sway a prescriber, or make them feel indebted to the drug company. A 500 dollar silk tie however (which by the way has nothing to do with the drug) will more than likely make the prescriber feel indebted to the drug company or rep, causing them to make a decision based on emotion rather than fact.
~Heather Taylor
I think that the drug reps should rely more on the facts about their drug rather than "befriending" the prescribers in order to do their job. Taking advantage of personal relationships is just wrong, so i do not think that prescriber information should be sold or even compiled by the drug rep. The health of the public is on the line, so the drug reps should be more concerned about how their work is going to help the general public then how they can use personal prescriber information to sway prescribers. Staying with this line of thinking, "gifts" should also not have an effect( or even be allowed) if they are extreme. A pen, i feel is not going to sway a prescriber, or make them feel indebted to the drug company. A 500 dollar silk tie however (which by the way has nothing to do with the drug) will more than likely make the prescriber feel indebted to the drug company or rep, causing them to make a decision based on emotion rather than fact.
~Heather Taylor
Healthcare providers need to understand that they are in the business to help people—not exploit them. To address this pressing issue of conflict of interest, the federal government need to take a concrete stance by drawing the line where reasonable observers recognize that there may be such a conflict. Setting up such regulations to monitor those conflicts of interest will only serve to reduce the risk of such conflicts affecting the outcome of patients’ health. Furthermore, drawing the line even before the patient perceive there may be any conflict of interest will protect the integrity of the health professional and the health profession in general.
As ideal as it may be, denying providers the receipt of gifts from pharmaceutical companies is probably the best way to ensure a level playing field for all health professionals. The patients’ interests should remain top priority, and if this is the only way to ensure that, then the federal government should lead the way towards implementing strict regulations to address those problems. Regulations should start at the top—that is working from the highest branch of government, to the academic medical centers, and further radiating outwards to smaller community practices. The State Board of Pharmacy should be in charge of sending secret inspectors to check on the quality of patient care.
I do not feel that more restrictions placed on pharmaceutical industries will make much of a difference. Although according to the article, "social science research demonstrates that the impulse to reciprocate for even small gifts is a powerful influence on peoples behavior" preventing a doctor to remain objective; pharmaceutical industries are out to make money, and if they are prohibited from giving gifts, they will find some other way to convince the doctors to prescribe their product in order to make money. That being said, I think it is the prescribing physician's responsibility to remain objective despite the "bribing" of pharmaceutical companies and fulfill their oath of doing what is best for their patients, despite personal gain or interest. More regulations won't solve the problem. The pharmaceutical industry is a business and they will find a way of making money despite stricter regulations
I think they should definitely implement tighter restrictions if the occurrence of this problem continues to increase. It’s sad to say but I feel this is what it is coming down to. We should be able to depend on physicians to make decisions strictly based on the best interest of their patients. Unfortunately, this is not always the case. I put a large amount of the weight on the physician’s shoulders because the drug reps, specifically, have one job and one job only and that is to try and sell their product. It should be up to the physician to maintain their integrity and uphold the importance of their patients.
-David Williams
As with last week’s article, this article only reinforces my belief that the pharmaceutical companies and their marketing tactics are corrupt and ill intentioned. I was shocked at how many people from last week believed that doctors should accept gift and there should be no limitations to how drug reps do their job and sell their products. What is the benefit that patients receive from doctors receiving bribes in the form of gifts, feigned friendships, dinners, etc.? Health care services are first and foremost dedicated to the well being of the patients. This system does not seem to contribute to this overarching goal in any way. Of course, prescribers need to be made aware of new medications, informed of the latest innovations; however, this can all be done without the addition of bribes. There is most definitely a conflict of interest. It’d be nice to believe that prescribers would not allow themselves to fall for their tricks or compromise their morals and ethics; but it is ignorant and self-righteous to believe that anyone of us is able to fully escape any subconscious bias that their tactics may cause. “Psychologists, sociologists, and economics have explore human behavior in conflicted situation … Their research has established that behavior is not entirely rational, individuals are not always conscious of their motives, and many popular beliefs about how individuals act in light of specific information are simply wrong.”
After reading the article, I do not think that there should be further regulations with conflict of interests. I think that having such restrictions will not matter. The drug companies will find some way to sell their product, and if offering a gift is not allowed, they will have to come up with another way to sell their products. They have to make their money and that’s what they are out there to do. In some cases, I think there is a benefit to patients when their physician works "closely" with a pharmaceutical rep. Sample medications can be used to help patients find the ultimate drug to help their problem. With sample meds, patients can try a medication and if it doesn’t work for them, they can easily try something else and not have to put much money into it. However, with conflict of interests, I believe it is ultimately up to the physician on deciding what to do. It is their responsibility, their obligation, to better the patients they see. It should be the first thing they think about when writing a prescription for the patient AND when they become "friends" with drug reps. It is up to them to do what is right and forget to think about any personal gain when befriending with pharmaceutical drug companies.
I think that biases can definitely occur when "bribes" are used such as free lunches, samples, or free outings and trips. However, I think that physicians and other healthcare professionals are responsible for differentiating between objective information and persuasive tactics. I don't think that pharmacists are as big of a target as prescribing physicians, but with pharmacists stepping into a more clinical role, it is definitely something that we need to be aware of. In my opinion, I don't think that there need to be additional measures put in place to limit spending by pharmaceutical companies. This is a founding principle of our society and drives economic growth, and it's up to the "consumer," which in this case may be the patient or the healthcare provider, to determine which product they want to use. I also think that while pharmaceutical representatives may not always have the best interest of the patient in mind, if they can't use the business aspect to sell their drugs, the companies will not have an incentive to continue developing new therapies. The United States is one of the leaders in developing new medications and testing, and this is in large part due to the research of pharmaceutical companies. While I'm sure conflicts of interest exist and that practitioners do not always use an objective approach when treating patients, I believe that a large majority of these providers hold themselves to the highest standards and will not let conflicts of interest get in the way.
I think that increasing the amount of restrictions on pharmaceutical companies contacting physicians to sell a product is only going to complicate things more. The job of a pharmaceutical company is to create a drug and then market it so that it can be used in the health care world. If more restrictions are added some clever group of representatives is going to find a way around it. I think instead of banning and ruling out certain methods some guidelines and thought could be adapted. My naive self wants to believe that my doctors haven't prescribed me things or given me a sample because they have been bribed by a pharmaceutical representative, but in reality I know that they have probably been swayed by them before and as prescribers if the pitch sounded reliable and good they probably took the reps word for it. I don't necessarily think that is a bad thing providing that the information the rep shared was accurate, relatable, and as objective as possible. After all whether a prescriber, nurse, tech, pharmacist, researcher, or sales rep all play a crucial part in the health care role of working towards the best outcome for our patients and community. I think if we viewed these sales reps as necessary component to the medicinal world then they would not feel the need to bribe doctors with "extras". All the focus should be what is best for the patient. A doctor shouldn't be tempted to pick on medicine over the other based off of a gift they may or may not get from a pharmaceutical company-but I don't doubt that it happens. I'm sure it easy to get wrapped up in those moments thinking of the opportunities that could be provided for you if you prescribed the drug knowing it may not be the best choice, but at that moment you are making the choice to uphold the oath you took to enter the medical profession. People will always find their way around the rules, it is up to us to work with each other as to not undermine each other but find a balance as to what is acceptable keeping the first priority as the patient.
I think that healthcare professionals should draw the line when pharmaceutical companies begin to bribe them with gifts and payments for their time. I think that it is okay for pharmaceutical companies to visit if all they are going to do is tell the doctors information about their drug. I also think that the line should be drawn when patients feel there may be conflict. They may have better insight to what is conflict than the doctor because they haven't dealt with the pharmaceutical company and so don't feel like they have an obligation to them. I agree with the article's stance because I feel like the companies do try to bribe doctors and don't have the best interest of the patient in mind like they should. I like the idea of having vouchers for patients to use to try a drug instead of the representative giving the sample directly to the physician. I feel that this should be an organizational policy because individuals may have difference in opinions of what is considered a gift and may not feel like they are being bribed. I think that if a pharmaceutical company gives a physician anything whether it's free samples, gifts, or money then it should be declared a conflict of interest. There should be an organization that physicians can tell whether a compnay is giving them gifts so that the company can be reprimanded and told not to do that anymore.
Sarah Martin
I think the regulations by organizations like American Medical Centers(AMC) will better serve the purpose but this should not completely ban the giving of gifts by Pharmaceutical representatives. I still think that samples are not a bad idea at all because the Physicians will actually be able to hand in the medication to the patient instead of the vouchers where it is possible that the patient may fail to get the medicine from the pharmacy.
Physicians should ultimately decide how much influence that these gifts should have on them. The statement that when you practice any habit it becomes part of your professional life is very true so the influence of gifts on Physicians should be addressed as part of Professionalism in medical schools.
Physicians will therefore learn how to evaluate their moral values and ethics when they place their own motives above that of caring for their patients.
- Vida Ohene Agyeman
In my opinion, I don't believe that any health care provider should receive any gifts from any pharmaceutical company because this would be unethical. The drug that a provider prescribes should be based on what is best for the patient, not based on which company gave them the best gift or bought them the best dinner. This not only dangers the integrity of the physician but the patient's safety as well. Receiving gifts "pose challenges to the principals of medical professionals." I believe that the health care provider is not holding themselves to the professional oath they took when they accept bribes from drug reps. A doctor should be able to realize when they are being manipulated by a sales rep and should understand that by allowing this, a patients health and safety are on the line. This being said, I don't think putting more restrictions on drug companies is going to make any dramatic difference. Like any other business, the drug reps will find a way to get their message out and push whatever drug they are trying to promote. It is up to the integrity and moral standard of the physician to maintain the promise they made in giving the patient the best care possible, all influences aside.
I agree with Matt Ferro in that the ultimate goal of medicine should be in the best interest of the patients. I feel that samples and other items can be beneficial as long as the do not cross the line and start becoming “bribes.” I think that this is where we draw the line from productive marketing to a marketing driven business. Physicians should not prescribe a drug because of its positive kickbacks from these drug companies. The drug should be prescribed because it is the best possible drug for the patient and nothing else should have any influence.
After reading the article, I realized that physicians are somewhat dependent on drug companies to pay for their trips to conferences and to pay for their continuing education credits. I realize that this is a responsibility one takes on when becoming a medical professional. However, conference attendance is not required for medical professionals. Attending conferences is typically a great way to meet other professionals and come away with knowledge that you wouldn’t otherwise gain from a typical day.
Also, the article talks about the fact that the gifting practice is not regulated. It is an honor system. This is unacceptable to me. I do not agree with the gifting practice; but I realize that some things might not change. If this is going to take place and if there are such concerns for the practice of “marketing” to physicians, there should be a regulatory body to mandate and maintain these practices.
In reference to whether the line needs to be drawn where we as medical professionals see conflicts of interest or where patients see conflicts of interest, I feel that there is no question that the responsibility of regulating incentives and gift giving falls on us. For the most part, patients are ignorant about how the healthcare machines runs. These are business people, patents, teachers, seniors, and the like. For many of them, all they know is that they feel bad or that their doctor tells them they have “high sugar.” They depend on medical professionals to be looking out for their best interest and should not have to question the motives behind the new prescription they just filled.
As far as the tone of the article, I think it was very good. I feel that the authors of this work are very passionate about their position, but that this position is evidence based and researched. I do however disagree with their conclusions. Although the metaphor only loosely fits, I feel that what their marketing and industry involvement prohibition may replicate the ramifications that alcohol prohibition did. I feel it is much better to regulate than to ban. By completely severing the accepted relationships between drug companies and physicians, there may be pressure on the drug companies to forge under the table relationships that are entirely unregulated.
Although I believe that there does indeed need to be a mechanism in place to ensure patient care is evidence based and unbiased, I think it can be dangerous to completely antagonize the drug companies. The medical field needs these companies to research and develop cures and innovative treatments for disease; without them we will merely be treading water rather than advancing. Physicians and AMCs need to work out their complicated relationships with these companies rather than shutting them out.
I feel that drug representatives should be able to promote their drug to other physicians however, they should not be allowed to give any kind of gifts. I do not think that it is right for drug reps to try and persuade physicians by giving gifts. The only tools that they should use to try and persuade the physician, in prescribing their drug, is information showing that their drug will be effective. The physicians decision on which drug to prescribe to a patient should not be determined by if the drug rep is a good friend of theirs or what kind of gifts were given to them. The physicians decision should rely solely on which drug they feel will work best in this patient.
Jeff Auten
I do not see anything wrong with physicians receiving free samples or small gifts, but there needs to be stringent regulations, like mentioned in the article. Everyone likes free gifts, but a line needs to be drawn between simple gifts and bribes. Ultimately, the physician must be a professional and make sure the patient's needs come first. This means not allowing outside sources to influence the decision making of physicians. Regulations will help minimize this outside pressure and keeps gifts within reasonable limits (minimizing the amount of gifts and the cost of the gift).
-Curtis Austin
I agree with Curtis- a line needs to be drawn between giving a physician a gift and giving the physician a bribe. A pen is a gift but an all-expense-paid cruise is a bribe. Physicians should not take gifts into consideration when prescribing a medication. Instead, the decision should be based on which drug fits the patients needs the best.
I do not agree that all gifts should be denied to providers. There should be limitations, but not extremely strict limitations. There is nothing wrong at all with offering pens and other small office items to physicians. I do not believe that a small favor, such as a pen, will have a major effect on a physician’s prescription writing, however much more extravagant gifts may, and those should be limited. I believe everyone already knows where the line needs to be drawn. A company should not do something so extravagant for a physician to the point where a physician feels that they should alter their prescription writing. In feasible moderation, gifts are not a bad idea. Let’s be honest, the gift is there to get their name out there and leave an impression, isn't that what we are all trying to do? However, if I wanted to make a lasting impression on a possible employer it would be completely insane of me to send him on a cruise for two. The key is moderation.
-Brittany Rector
I don’t think increasing regulation of pharmaceutical industries would solve conflicts of interest. If there is any further regulation, I think that it should fall on the shoulders of academic medical centers. The article emphasizes the importance of these nonbiased institutions and argues that they have leadership potential over medicine. Receiving information from AMCs would be first-hand information as they perform extensive independent research. They would provide nonbiased and reliable information to a physician, which lends itself to an altruistic environment.
Though I do not believe in the abuse of gift-giving by pharmaceutical reps to healthcare providers, I also believe that it is ultimately the responsibility of the healthcare provider to decide to what extent they will allow the giving/exchange of gifts. Healthcare providers have the ultimate responsibility of using their own professional judgement (as pharmacists do) to decide what is best for their patients. If they decide to decline offers from pharmaceutical reps, then the drug reps should be undersatnding and respect the healthcare providers' decision. That said, I don't think that more restrictions should be placed on pharmaceutical companies. They too are advertising drugs that are ultimately meant to help patients' lives. If there is a conflict of interest, it is up to the healthcare provider to identify it and act accordingly.
I don't think that gifts or free samples should hinder the doctors from prescribing the best medication for the patient. If that medication is the best for that patient then they should prescribe it. However, if the doctor knows that by taking the gift that they are more likely to prescribe it without thinking if it is the best medication or not then they should not accept the gifts. They will just have to put extra time in to research the new medications that are out there to better server their patients.
Just like we discussed for the last topic, I think that actions of pharmaceutical representatives should be regulated and controlled. The job of a pharmaceutical rep should be to educate the medical community about new, available drugs and not to try to push doctors to prescribe a certain brand. Maybe HR of the company the rep is going out to see should have to pre-screen the rep and the intent for their visit. I honestly think this would be hard to control but regulation is needed in this area. We need to look out for patients first. This rep-physician relationship causes more work for pharmacists in the long run because we have to work harder to make sure a medicine was prescribed for the right reason as well as be sure the patient is receiving the best medication therapy possible.
I think that drug sales reps should be able to continue to give simple gifts such as pens and notepads. However, I don't think there is a need for extravagant gifts because that seems more like bribing the doctor to prescribe their particular drug rather than doing what is best for the patient. This is where conflict of interest comes into play. It is the physician's responsibility to do what is best for the patient, not choose a drug that gave them a free tie. It is great to get the name of the drug out there with little free gifts. There should just be tight restrictions monitoring what drug reps can and can't give. They are just doing their job. It is ultimately in the physician's hands to put the patient first.
-Corrine Sharpe
I believe that the act of pharmaceutical sales representatives and other salespeople attempting to persuade doctors and other medical officials to endorse their products, without full knowledge of the pharmaceutical product, is highly inappropriate. In a way, sales representatives are buying out doctors in order to push their drugs onto patients through providers in order to receive commission for doing better business for their company. I could not possibly advocate this as a professional because, many times, salespeople (who are sometimes pharmacists or doctors) are not being fully honest when they recommend drugs to patients and other providers because they choose to disregard or downplay many of the adverse side effects to make the drugs sound more appealing to buyers. This seems to be a violation of the hippocratic oath that doctors and pharmacists take to help their patients to the best of their ability. Some of the medications being vouched for are often much more expensive for patients and may not work as well as alternatives, which seems to be great for the pharmaceutical industry but less than acceptable for patients we aim to serve. A professional must look at every possible alternative and weigh options for patients in order to maintain the best health and quality of life for patients.
Drug reps have a job to do just like health care providers and pharmacists. It's just that their job requires them to sell a product despite the consequences. It's a little less glamorous than saving/improving lives, but its still a profession. Having said that, drug reps should take into consideration the needs of the patient. There is nothing wrong with being well informed and passing this information on to those who will prescribe and dispense these products. Its not all about pushing product. The distribution of gifts to health care providers should be limited. It would be more beneficial if the rep offered gifts pertaining to his/her product i.e. pens, spatulas, notepads, etc. It's pretty hard to see the validity in offering a steak dinner no matter how tasty it may be.
I feel that there should be some limits on how many perks and free gifts should be given to prescribers because this would take away reasons for drug companies to be able to charge so much money to patients for their drugs, becasue it would eliminate much of the overhead costs to roll out each product. I don't think that all perks and free gifts should be eliminated, though. I think it is ultimately the prescriber's responisibility to make ethical decisions on what to prescribe, despite any persuasive efforts and gifts recieved. I think the decision to prescribe a drug therapy to a patient should be based solely upon unbiased research evidence of that particular drug's efficacy.
Evan Palmieri
I think that the prescribers must be conscious of all the options available for medications and not specifically the ones whose company gives the most and best presents. The article calls for the ban of the gifts completely but I believe it should simply be very limited. I believe by limiting the gifts to notepads and pens, all companies will be able to reach most of the doctors. By evening out the distribution and appeal to the doctors, there will be less of one drug overpowering the prescribers. If everyone is equally able to promote their product evenly, then there will be no stand out drug in the prescribers mind.
It is also the prescribers’ responsibility to be able to divide the gifts from their medical judgment. They should know the differences between the medication , even possibly consult a pharmacist, to determine the best treatment for the specific patient whether it is the pushed drug or the less advertised generic.
I believe that gifts from pharmaceutical companies to physicians should be banned permanently. There are many reasons why I believe these gifts should be banned. For example, as a physician, your primary goal is patient care. I believe that many physicians’ choices of medications are persuaded by these so-called “gifts” from the pharmaceutical reps. I find this as a major problem. Instead of focusing on how to save the patient money while prescribing appropriate medications for these conditions, many physicians are choosing more expensive and/or less effective medications due to the persuasiveness of these gifts given by the drug reps. Now, you may say, “how can a simple gift such as a pen persuade a physician to choose a particular drug”. Studies have been shown that even small gifts such as a pen remind physicians of that particular drug and are likely to prescribe it since they are constantly seeing it. It’s also shown that small gifts can make a strong influence. In my opinion, anytime a patients health is in the equation, physicians must have a clear mind and should not be persuaded in any way that would cause the physician to choose more expensive drugs or less effective drugs.
Incentives are not a bad thing. They are actually needed in every aspect of a profession for the person to want to do their job and to do it the best they can. I don’t necessarily agree with drug reps buying big gifts for physicians, but small gifts here and there provide physicians with more incentive to prescribe those drugs from that company that will be the best therapy plan for the patient.
-Jessica Osteen
I think that the amount of money a company spends on gift to promote a drug should be a decision that a company makes. If they want to use all that money to push their product and make their product more expensive, then let them. If they are smart and care about the pockets of patients that will ultimately be using their product, they will limit the funding for gifts. Therefore, I don't think there should be specific regulations on gift giving.
-Amy Miller
I don't think giving out gifts should be eliminated completely but I do believe there should be some form of restriction as to the kinds of gifts drug reps can give out. These gift are complimentary, therefore I do not think physicians should allow these gifts to influence their decision making process,as to what kind of drug to prescribe. As health care professionals, we should always make decisions and judgments that will work in favor of our patients, that would positively contribute towards their health and quality of life. For example, they should prescribe drugs that are cost effective when possible as this is likely to increase compliance and ultimately improve their health. Not only do we have to draw a line when we realize that there is conflict of interest but we should also be willing to look deeper and draw a line when someone spots it out. We should put our responsibilities as a healthcare provider first before our personal or company interest in any given professional situation.
Amie Freeman
I think that it is the responsibility of the prescriber alone to make decisions as to what to give to patients. They should research the drugs themselves from non-biased sources and make decisions that way. It should not matter on how many meals or free gifts they receive. The gifts are fine for marketing but then it is the duty of health care providers to see how well the medications actually work and their side effects. The patient should always be the priority.
-Emily Heubel
Advocating for more restrictions, regulation, rules, checks, oversights, changes and other limitations on the already oversaturated rulebook for healthcare providers may sound altruistic but in the end, it will only cause more problems.
To begin, professions who operate with the highest moral code will not need such rules since they will have the best interests of their patients in mind regardless of what is "brided" to them. Second, if laws against such gifts are implemented and a healthcare provider accidentally breaks one of them, will society be doing justice by harshly punishing him/her? Also, who will decide where the line will be drawn between what is "right" and what is "wrong"? One person may say receiving free cheap pens is unacceptable while finding seminar dinners at the most expensive restaurant in town to be totally fine. I'm sure this person will encounter lots of resistance to his/her opinion. And last, drug companies are way too clever to be stopped from pushing their products and will definately find a number of ways to run around it. If they can't spend money on taking doctors to lunch, then they will spend that same money in ads on TV commercials, magazines, etc...
In short, more regulation against providers will only add burden to our heavy shoulders and should not be imposed on us. Overall, very little benefit will result from it while lots of problems will definately surface.
i personally think the pharmaceutical company is just like any other business which it is so natural for them to target physicians, their biggest customer, to promote their drug products. However, their market is directly related into patient. Patients must remain top priority in healthcare system, and if drug reps' gifts can affect physicians to prescribe certain drugs, there must be solid regulation that controls and monitor healthcare providers.
This topic of conflict of interest is one I find compelling. From the outside looking in, there appears to be a whole lot of unethical behavior going on. However, the end result we have to consider is the health impact of the patient. The article provided, and the cited material in the article are not sufficient or compelling enough to show a need for a change. Yes, there are doctors who compromise their ethics in medical care, and perhaps prescribe a medicine that they would not have had their not been a professional relationship between them and a pharmaceutical company. What if that medicinal change was needed to improve the health of a patient? Does the medicinal change aid in patient care more than having an adverse effect? These are the real question that needs to be answered, and will take a great deal of research to be answered. So far, it is my opinion that that has not been answered. We do not need to create demons just for the sake of having regulations. If the time comes where regulations are needed to protect the patient, then that will be the obvious course we take.
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