Drugmakers woo med students

Product pitches to future doctors raise concerns

June 03, 2007|By Chris Emery | Chris Emery,sun reporter

Medical student Clarence Lam marveled at the feast that a drug company sponsored this spring at the Inner Harbor's upscale Capital Grille.

The night's appetizer was seafood, the entree was filet mignon and dessert was cheesecake.

"They paid for everything," recalled Lam, 26, who attends the University of Maryland School of Medicine. "They even covered the wine."

Like other drugmakers, Novartis Pharmaceutical Co. sponsors such events to woo practicing doctors and to promote its products to future physicians such as Lam. It's a common marketing tactic that is raising concerns on medical school campuses nationwide. Medical scholars and student groups have called for tighter restrictions on industry access to the nation's medical students.

The Association of American Medical Colleges has a task force investigating the issue, and several medical schools have adopted policies that restrict such marketing. Officials at UM and the Johns Hopkins School of Medicine are considering similar rules.

Experts say drug companies spend about $19 billion a year marketing to doctors. How much of that goes to physicians in training isn't clear, but students say they often receive small gifts, free meals and invitations to events paid for by the pharmaceutical industry. Sometimes the invitations come from the doctors who teach them.

Critics say such early exposure to marketing perks produces doctors whose treatment decisions might be tainted by biased information and the doctors' financial interests. For evidence, they point to highly publicized cases in which the relationships between doctors and the industry put patients' lives in jeopardy.

Last month, Purdue Frederick Co., the parent company of the manufacturer of the painkiller OxyContin, admitted misleading doctors about the drug's addictive properties. A 2002 report by the Drug Enforcement Administration traced 146 deaths to OxyContin overdoses.

The New York Times has reported on doctors who received millions of dollars for prescribing anemia drugs, despite warnings that the drugs might shorten patients' lives.

Industry's defense

Drugmakers say such cases are extreme and argue that most doctors and companies follow the rules. They say company representatives provide important guidance on drugs and are sufficiently restrained by industry and federal guidelines.

"Pharmaceutical marketing is one of several important ways for health care providers to receive the information they need to make sure medicines are used properly and patients are safely and effectively treated," Ken Johnson, senior vice president of the Pharmaceutical Research and Manufacturers of America, wrote last month in a statement responding to the OxyContin and anemia drug cases.

Experts also note that many medical breakthroughs are the result of research collaboration between physicians and drugmakers. Some argue that doctors can look past the hype to make unbiased decisions about treatments. Meanwhile, medical schools and professional organizations have begun efforts to limit industry access to students.

In a paper published in January in the Journal of the American Medical Association, a group of prominent scholars called for academic medical centers - medical schools and affiliated teaching hospitals - to take the lead in eliminating conflicts of interest between doctors and the pharmaceutical industry. They called for academic centers to adopt stringent guidelines, including a ban on accepting gifts and free meals from industry representatives.

Research suggests that "the impulse to reciprocate for even small gifts is a powerful influence on people's behavior," they wrote.

They also argued that medical schools should prohibit faculty members, students' role models, from accepting speaking fees as part of industry promotional campaigns. Doctors can be paid thousands of dollars for promoting a drug at such engagements.

Since the paper was published, at least seven medical schools have adopted stricter policies, including those at the University of Pennsylvania, Yale University and Stanford University. The policies vary by school but follow the suggestions of the JAMA paper to some degree.

Last summer, the Association of American Medical Colleges formed a task force to produce guidelines for its members.

"A lot of medical schools are actively deliberating," said Dr. David Korn, the AAMC's senior vice president for research policy.

Korn said the AAMC probably won't release those guidelines until summer 2008 because experts have not reached a consensus.

Also pushing for tighter restrictions is the American Medical Student Association, which sponsors a "PharmFree" campaign urging students to refuse free meals and gifts. "The drug companies have made institutions feel that they need them, but we think they don't," said Justin Sanders, a student at the University of Vermont College of Medicine and the campaign's coordinator.

Schools lack policies

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