Morals and Medication

Money and medicine have always been a duo that rarely see eye to eye. Doctors are trained to prescribe their patients with the correct medicine and the accurate dosage that fits their condition. It’s possible that this truth can be tainted when money is entered into the equation. There have been several occurrences of pharmaceuticals manipulating doctors into promoting their product with no concern for the patient’s health. Money is the base of the enticement of doctors. Lately doctors are frequently forced to make moral decisions regarding which is more important the patient or their own bank account. My grandmother goes to the hospital every two months for a checkup, and she has noticed that her doctor continually changes her medications. My suspicion for her doctor grew when I discovered that he prescribed her generic brands. Could her doctor be promoting these drugs for his own benefit? I began to wonder, what extent do doctors jeopardize their patient’s health by promoting pharmaceutical products? My interests in this issue sparked my mission to put pharmaceuticals and doctors in the hot seat. It seems as though doctors and pharmaceuticals have their priorities in disarray, putting their own interest before the consumer.

In order to establish rather or not patients were being put at risk I had to determine the legitimacy of the pharmaceutical drugs. I needed to find evidence of proper testing and safety precautions taken by the industries. This led me to the discovery of an article in the Journal Sentinel. It was a salient example of the Medical professional involvement in promoting pharmaceuticals. The article involved the case of faulty data of medical tests dispersed at the authorization of Richard Page (the chairman of department of medicine at UW). He contributed to a study (published in the New England Journal of Medicine) regarding the prescription drug Multaq. The drug treats the disorder called Atrial Fibrillation, when the heart skips or has an irregular beat. Over two million Americans suffer from the disorder. Page’s work on the study along with lending the respect of his name to the paper was instrumental in the Food and Drug Administration approving the marketing and sale of Multaq to the public. The drug company that makes the drug Sanofi-Aventis stands to gain millions of dollars in revenue. Richard Page stated that he trusted the drug company. It was confirmed that he did not see the infant stage data. The Chairman still gave the nod of approval for selling and marketing the drug. “These companies, if they were falsifying data, wouldn’t be kept in business if that were found out,” Page explained. Journal Sentinel May 30.His logic, on not being privy to raw data stats, was that the company (Sanofi-Aventis) would not be a reputable company if they had a tarnished record. So he was not concerned with Sanofi-Aventis providing fraudulent results. The Federal Drug Administration did receive unstudied raw data from the drug company. Its findings challenged differences in the Chairman’s study vs. what was received for submission from the drug company. The study originally started with 4,300 participants, the results showed there was not a momentous result in lowering cardiovascular fatalities. Another 328 subjects were added to the test. After adding the extra 328 subjects ( beyond the project deadline date) a total of 5 deaths were recorded from the placebo assemblage. I consider five deaths to be a red flag in any instance yet the study team along with the company deemed the drug a success. The FDA ruled the results invalid. Yet the drug was passed to sell to the public. Records show that Dr. Page was involved in lending support for the drug, and was paid consultant fees by the drug company. This case portrays the relationship between medical professionals and pharmaceuticals as, conniving, heartless and boarder line corrupt. My understanding is that money is the main interest of the drug company and the doctor. This was rather unsettling to me. The patient is left at the mercy of the doctor’s conscience; in this case Page relinquished his ethical thinking for money.

Unsatisfied and partially in disbelief I needed more info. I came across the GPHA and the PR-Inside website on pharmaceutical reports. I found interesting statistics. In 2007 generic pharmaceuticals made a total of 58.5 billion dollars, the pharmaceutical industry as a whole made 315 billion. With the growing number of people using pharmaceutical products, the industry’s profit has sky rocketed. It may be perfectly plausible to trust that pharmaceuticals carry out all proper testing of drugs because they can afford to do so. The drug companies definitely can’t afford to get caught not testing products correctly because they would lose all credibility along with profit. Proper testing would mean that the drugs are safe to use and the doctors would have every right to prescribe them. After Analyzing the statistics my prior judgment on pharmaceuticals and the risks the drugs have on patients had lighten a bit.

Is it safe to claim that the relationship between pharmaceuticals and doctors are mischievous, if the doctors are trained well enough to make competent decisions on prescribing drugs for their patients? The most common connection doctors have with pharmaceuticals is through online training of a certain condition or disease. The online courses are often sponsored by pharmaceuticals naturally the drug company exposes their product to the doctors. It’s up to our trusted doctor to make the decision rather or not to prescribe this drug. In a sense it could be that the doctors are simply doing their job and consumers are magnifying the situation. If this is the case than doctors endorsing a pharmaceutical product to their patients can be just as risky as it would be to prescribe any other drug.

Although these ideas generated in my head I still remained skeptical. Stagnantly I decided to do more research and I stumbled upon the AHCJ (association of health care journalist) blog June. 16th, 2010 by Pia Christensen. Susan Rust Journal Sentinel reporter in collaboration with Journal sentinel reporter John Fauber reported on pharmaceuticals funding college class courses that are partial to advocating the use of prescription drugs over natural remedies. The study confirmed doctors were being paid. Pfizer one of the largest drug companies invested over $12.3 million in a web based course for doctors outlining how to get clients to discontinue smoking. The drug Chantex has been documented to have serious side effects (unusually high amount of suicides). Yet the side effect was not noted in the course for Doctors. Pharmaceuticals target doctors who are all required to take continued courses. This is how the pharmaceuticals reach the majority of doctors. For Example Wisconsin physician are required to take 30 credits every 24 months. The Journal of the American Medical Association confirms Drug companies have escalated their investment in physician’s education from $302 million in 1982 to over $1.2 billion dollars in 2006. It is confirmed that the drug companies pay over half the cost of the course. Ethical questions are raised again and again regarding the role the medical profession plays in Pharmaceutical getting drugs to the market.
A Boston News report Team 5 investigation uncovered Health Insurance Companies providing cash enticement to physicians who have their patients changed from named brand drugs to generic drugs. The payoffs are not illegal. Yet the method could have serious negative results. If the doctors patients are not told he or she is being paid for recommending a generic drug is this ethical? An article on the CMPI (Center for the medicine in the public interest) reveals a case that involves the drug Lipitor which lowers cholesterol, (my grandmother was recently switched suddenly to a generic brand of which her doctor told her cost less.) The Michigan Insurer Blue Care Network compensated physicians (2400 physicians) 2 million to change from Lipitor to generic Zocor. Records document the physicians were paid $100 per client that changed during the period of Jan 1st to March 31st 2007. Yet patients were not told how the physician benefited. ( Article: Express Yourself by Peter Pitts June 16, 2010.) I recently asked my grandmother if she felt better taking the generic alternative to Lipitor. My grandmother believes she felt better taking Lipitor. She was accustomed to taking Lipitor in the evening. She slept well afterward. In my grandmothers opinion the generic drug makes her feel somewhat dizzy or anxious. I asked her if she thought her physician was paid to have her switch medications. She said that she would ask the physician on her next visit. She wants the prescription that is best for her not what is best for the physician’s pocketbook.
Doctors promoting certain drugs after taking compensation from Insurers or Drug companies raises the ethical question, what about the Hippocratic Oath?

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“Doctors’ role in drug studies criticized – JSOnline.” Milwaukee Journal Sentinel – Breaking news, sports, business, watchdog journalism, multimedia. N.p., n.d. Web. 16 July 2010. <

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