Healthy Skepticism Library item: 14671

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Kissane K.
Drug firm's offer to doctors under fire
National Times 1986 Sep 28

Full text:

A drug company is offering computers to doctors who enrol patients in a program monitoring the effects of a new blood-pressure treatment. The company, E. R. Squibb, has been attacked by doctors, who say its general marketing of the drug, Capoten, is overly aggressive and raises serious ethical problems. Capoten’s move into the medical market of Australia has also been accompanied by offers to doctors of imported Christmas hampers, red wine and books.

The earlier presents were offered as prizes to doctors who answered questions about the drug; the latest, the computer, is for doctors who, by Christmas, enrol 20 patients in a program evaluating Capoten’s efficiency and side-effects.
Squibb says the clinical study is genuine and that the computers are needed to collect its data. A company spokesman says the computers will be on loan only, to be taken back when the evaluation is over. Doctors who responded to the offer received letters making this clear.

However, one Melbourne GP, Dr Peter Rankin, says he has twice been told by company representatives that doctors could keep their computers. Either way, Rankin and other doctors are concerned at the potential conflicts of interest such offers raise. The Squibb offer has raised questions about when a trial becomes a marketing exercise.

Dr John McEwan, secretary of the Australian Adverse Drug Reactions Committee, says this kind of evaluation can be useful, as it involves monitoring many more people than were tested in pre-sale clinical trials, and although it is not compulsory for individual doctors to repot adverse reactions they discover, it is for the manufacturer.
But Dr Peter Lynch, Victorian president of the Doctor’s Reform Society, says Squibbs’s computer offer “crosses the line”. He says its evaluation program does not have stringent scientific checks.
Lynch says the society believes doctors should never accept free gifts. “Its either a potential or an actual conflict of interest.”

The Victorian president of the AUstralian Medical Assoication, Dr John Matthew, says the AMA has no official view on whether doctors should accept gifts. He says, however, the situation might be covered by the requirement that doctors never allow their judgement about what is best for their patients to be influenced by any other consideration. “That doesn’t say you can’t receive this or that from another person,” he says. “It just means you shouldn’t allow it to influence your judgement.”

Capoten, which is the first of a new class of drug, is more expensive than the more traditional ‘betablocker’ blood-pressure treatments. It costs $71.21 for 90 50 mg tablets, compared to $11.40 for 100 50 mg tablets of Betaloc, for example.

Lynch believes pharmaceutical companies dominate doctors’ post graduate education in drug use. “Vested interests have too much of an effect on health care provision and health care patterns,” he says.

He says he would like to see more independent committees, such as the one established to advise doctors on the prescription of antibiotics.