New efforts are being made to reveal the links between doctors and drug firms, but they may bring little change.
Two drug executives walked into a bar.
No, this is not the start of a joke. The workers for Roche, a Swiss pharmaceutical firm, had been dining with doctors after a medical conference. At the bar, according to an anonymous complaint in a recent report by a British industry watchdog, they bought the doctors drinks — “shots of varying colors flowed like hot lava,” the report says. One executive danced onstage, prompting bar staff to throw him out.
Roche maintains that its managers ran into the doctors and did not buy them drinks. Even so, the evening hardly seems like the finest moment in the history of ties between doctors and drug companies.
That relationship is a poorly regulated muddle. At one extreme, firms work with doctors to create new treatments. At the other end of the spectrum, firms bribe doctors to prescribe their drugs. The U.S. Justice Department has wrung huge settlements from companies facing such charges.
American regulators have just released rules to implement a so-called “sunshine law” designed to improve transparency. France passed a similar law in 2011. Firms in Britain are planning voluntary disclosures.
America’s health care market, the world’s biggest, is particularly busy. In 2012 pharmaceutical companies spent more than $24 billion marketing drugs to doctors, according to Cegedim Strategic Data. According to a 2012 survey by the consultancy Deloitte, 35 percent of doctors accept food, entertainment or travel from the drug industry, while 16 percent receive consulting or speaking fees.
In most states doctors take regular courses to maintain their licenses. In 2011 drug and medical-device companies sponsored nearly a third of the medical training tracked by the Accreditation Council for Continuing Medical Education.
Such chumminess has long raised fears about undue influence. In 2008 two health-industry groups set tighter, voluntary standards for companies. In 2009 America’s Institute of Medicine, an advisory body, urged much stricter regulation to prevent conflicts of interest.
Legislative action has been slow, though. The “sunshine law,” passed as part of President Obama’s health-reform plan, is the first national requirement for transparency. Each year drug and medical-device firms must disclose payments and other “transfers of value” to doctors. They also must report research fees and doctors’ investment interests. The first filings will appear on a public database by Sept. 30, 2014.
The rule’s broader effects are uncertain. It does not limit firms’ interactions with doctors, but merely requires them to be reported. And the “sunshine law” also will provide drug firms with exhaustive data on how much they and their competitors spend to market drugs to each doctor.
Companies will not stop wooing doctors. They may simply get better at it.