Harmful side-effect: Drug companies mix profit and medical education
Saturday, June 16, 2007Pittsburgh Post-Gazette
A byproduct of revelations on heavily marketed drugs that turned out to have lethal side-effects is a dirty little secret of the medical profession: Half of doctors' continuing medical education is apparently financed by pharmaceutical companies.
Most states require doctors to spend a minimum number of hours each year to update their medical education to retain the license to practice. Such continuing medical education traditionally was organized and presented by universities and medical associations.
But Daniel Carlat, a professor at Tufts Medical School in Boston, said this week in a New York Times oped piece that that is changing. He wrote that the pharmaceutical industry paid for one-third of such continuing ed a decade ago. Now it's half -- some $1.12 billion worth.
It is indeed possible that a lecture on the treatment of diabetes paid for by GlaxoSmithKline would have mentioned that its highly promoted drug, Avandia, had been shown in some tests to damage patients' hearts, just as Merck might have come clean on the side-effects of Vioxx and Eli Lilly on Zyprexa.
Professor Carlat said, however, that the drug firms get around rules by the Accreditation Council for Continuing Medical Education against paying doctors to promote particular drugs by working instead through what are called medical education communications companies. The pharmaceutical firms pay the companies, which then organize the courses, which doctors are then paid to lead.
What can happen now -- doctors receiving "education" that is thinly masked advertising for drugs, paid for by the drug makers -- is not in the best interests of the patients. Nor should the practice be ethically acceptable to doctors.
We agree with Professor Carlat that continuing medical education should be returned to universities and medical associations. Hospitals and physician practices should assure the public that such a policy governs the doctors working under their umbrella. Pharmaceutical companies' financing of such teaching should be prohibited and any continuing education financed by a drug company should not count for credit when weighing the renewal of a doctor's license.
Recent experience shows patients need greater protection, and legislatures should provide that through changes in state law. Congress also needs to improve patient safety by passing a tough reauthorization this year of the Prescription Drug User Fee Act, which makes the drug approval and review process of the Food and Drug Administration more open and accountable.
It would have been nice if doctors and drug companies had provided those assurances themselves, but that has not turned out to be the case. Instead, money talked and patients' health paid the price.