Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-31T23:05:35.688Z Has data issue: false hasContentIssue false
  • English
  • Français

Professional Organizations and Healthcare Industry Support: Ethical Conflict?

Published online by Cambridge University Press:  29 July 2009

Thomas K. Hazlet ,
Sean D. Sullivan ,
Klaus M. Leisinger ,
Laura Gardner ,
William E. Fassett  and
Jon R. May
Thomas K. Hazlet
Affiliation:
Food and drug scientist with the California Department of Health Services' Food and Drug Branch and is Ethics Committee Chair for the California Society of Hospital Pharmacists
Sean D. Sullivan
Affiliation:
Department of Pharmacy and Health Services, University of Washington Schools of Pharmacy and Public Health and Community Medicine, Seattle
Klaus M. Leisinger
Affiliation:
CIBA-GEIGY Foundation for Cooperation with Developing Countries, Basel, Switzerland
Laura Gardner
Affiliation:
Technology Assessment Group, Inc., in San Francisco
William E. Fassett
Affiliation:
Associate Professor of Pharmacy, School of Pharmacy, and Adjunct Associate Professor of Leadership & Policy Studies, College of Education, University of Washington, Seattle
Jon R. May
Affiliation:
National Association of Boards of Pharmacy (NAB)
Get access Rights & Permissions [Opens in a new window]

Extract

A good deal of attention has been recently focused on the presumed advertising excesses of the healthcare industry in its promotion techniques to healthcare professionals, whether through offering gratuities such as gifts, honoraria, or travel support2-6 or through deception. Two basic concerns have been expressed: Does the acceptance of gratuities bias the recipient, tainting his or her responsibilities as the patient's agent? Does acceptance of the gratuity by the healthcare professional contribute to the high cost of healthcare products? The California Society of Hospital Pharmacists was recently asked by its members to formulate a policy for an appropriate relationship between the Society and the healthcare industry, addressing these concerns. In formulating its policy, it became clear that the Society depended on healthcare industry support, gathered through journal advertising, fees for booths at its various educational events, and grants for speakers.

Type
Articles
Information
Cambridge Quarterly of Healthcare Ethics , Volume 3 , Issue 2 , Spring 1994 , pp. 236 - 256
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Notes

1. Chren, MM, Landefeld, SC, Murray, TH. Doctors, drug companies, and gifts. Journal of the American Medical Association 1989;262; 3448–51.CrossRefGoogle ScholarPubMed

2. Randall, T. Kennedy hearings say no more free lunch-or much else-from drug firms. Journal of the American Medical Association 1991;265:440–2.CrossRefGoogle Scholar

3. Randall, T. Ethics of receiving gifts considered. Journal of the American Medical Association 1991;265:442–3.CrossRefGoogle ScholarPubMed

4. Randall, T. Does advertising influence physicians? Journal of the American Medical Association 1991;265:443.CrossRefGoogle ScholarPubMed

5. Anonymous, . Pushing drugs to doctors. Consumer Reports 1992;57(2):87–94.Google Scholar

6. Hillman, AL, Eisenberg, JM, Pauly, MV et al. , Avoiding bias in the conduct and reporting of cost-effectiveness research sponsored by pharmaceutical companies. New England Journal of Medicine 1991;324:1362–5.CrossRefGoogle ScholarPubMed

7. Wilkes, MS, Doblin, BH, Shapiro, MEPharmaceutical advertisements in leading medical journals: experts' assessments. Annals of Internal Medicine 1992;116:912–9.CrossRefGoogle ScholarPubMed

8. The Society's Purposes and Mission Statement includes items on fostering optimal and responsible use of drug-related technologies, increasing the cost-effectiveness of their use, prevention of improper or uncontrolled drug use, and contribution to educational programs. California Journal of Hospital Pharmacy 1993;5:27–33.Google Scholar

9. Graves, J. Frequent-flyer programs for drug prescribing [letter]. New England Journal of Medicine 1987;317:252.Google Scholar

10. The Upjohn Diabetes Cognitive Services Reimbursement Program [letter dated 20 August 1992]. Kalamazoo, Michigan: The Upjohn Company.Google Scholar

11. Waud, DR. Pharmaceutical promotions-a free lunch? New England Journal of Medicine 1992;327:351–3.CrossRefGoogle ScholarPubMed

12. Banks, D. Conflicts of interest in pharmaceutical advertising: an FDA perspective. Presented at Ohio State University College of Pharmacy, 22–23 04 1991.Google Scholar

13. See note 7. Wilkes, , Doblin, , Shapiro, . 1992;116:912–9.Google Scholar

14. Stern, RS, Arndt, KA, Baughman, RB. Consensus reports from the convinced: manipulating the information transfer process for drug promotion [letter]. Journal of the American Medical Association 1991;265:30.CrossRefGoogle Scholar

15. Kessler, DA, Pines, WL. The federal regulation of prescription drug advertising and promotion. Journal of the American Medical Association 1990;264:2409–15.CrossRefGoogle ScholarPubMed

16. See, for example, correspondence to New England Journal of Medicine following Waud's article (see note 11) on pharmaceutical promotions: “The idea that accepting a shirt-pocket protector valued at 50 cents will sway the clinical judgement of a division chief is patently absurd”. New England Journal of Medicine 1992;327:1686–8.Google Scholar

17. Avorn, J, Chen, M, Hartley, R. Scientific versus commercial sources of influence on the prescribing behavior of physicians. American Journal of Medicine 1982;73(1):4–8.CrossRefGoogle ScholarPubMed

18. Soumerai, SB, Avorn, J. Principles of educational outreach (“academic detailing”) to improve clinical decision making. Journal of the American Medical Association 1990;263:549–56.CrossRefGoogle Scholar

19. See note 15. Kessler, , Pines, . 1990;264:2409–15.Google ScholarKessler, DA. Drug promotion and scientific exchange. The role of the clinical investigator. New England Journal of Medicine 1991;325:201–3.CrossRefGoogle ScholarPubMed

20. Bero, LA, Galbraith, A, Rennie, D. The publication of sponsored symposiums in medical journals. New England Journal of Medicine 1992;327:1135–40.CrossRefGoogle ScholarPubMed

21. Lazenby, HC, Letsch, SW. National health expenditures. Health Care Financing Review 1989;12(2):1–26.Google Scholar

22. Hurwitz, MA, Caves, RE. Persuasion or information? Promotion and the shares of brand name and generic pharmaceuticals. Journal of Law and Economics 1988;31:299–319.CrossRefGoogle Scholar

23. Leffler, K. Persuasion or information? The economics of prescription drug advertising. Journal of Law and Economics 1981;24:45–74.CrossRefGoogle Scholar

24. Feldstein, PJ. Health Care Economics. 3rd ed.New York: John Wiley & Sons, 1988. It should be clear that, for prescription drugs, the “consumer”-the person making a selection-is not the patient, but rather, is the prescriber, acting as the patient's “agent”.Google Scholar

25. Tirole, J. The theory of Industrial Organization. Cambridge, Massachusetts: MIT Press, 1988.Google Scholar

26. Benham, L. The effect of advertising on the price of eyeglasses. Journal of Law and Economics 1972;15:337.CrossRefGoogle Scholar

27. See note 23. Leffler, . 1981;24:45–74. Leffler described the “opportunity cost” of time spent learning about the advantages and liabilities of a new drug. The prescriber could obtain information through reading scientific literature, by attending scientific meetings, from promotions (adver-tisements, detail persons), or through actual practice with patients. The information source with the lowest opportunity cost for community-based practitioners is promotions.Google Scholar

28. See note 25. Tirole, . 1989.Google Scholar

29. Gutfeld, R. FDA seeks scrutiny of drug industry's role in education (Food and Drug Administration guidelines to prevent drug companies from illegal promotions). Wall Street Journal 1992 11. 25: B3(W), B7(E), col. 4.Google Scholar

30. Food and Drug Administration. Draft Policy Statement on Industry-Supported Scientific and Educational Activities. 57FR56412–414.

31. See note 5. Anonymous, . 1992;57(2):87–94.Google Scholar

32. Deakin, EB, Maher, MW. Cost Accounting. 2nd ed.Homewood, Illinois: Irwin, 1987.Google Scholar

33. Brigham, EF. Financial Management. Theory and Practice. 4th ed.Chicago: Dry den Press, 1985.Google Scholar

34. Sutton, J. Sunk Costs and Market Structure. Cambridge, Massachusetts: MIT Press, 1992.Google Scholar

35. Moore, SD. Ciba chooses marketing over betting on super drugs. Swiss company uses reformulation, savvy selling to extend products'; lives. Wall Street Journal 1992 07. 14: B4, col. 3.Google Scholar

36. Grabowski, HG, Vernon, JM. Pioneers, imitators, and generics-a simulation model of Schum-peterian competition. Quarterly Journal of Economics 1987;491–525.CrossRefGoogle ScholarSee note 5. Anonymous, . 1992;57(2):87–94.Google Scholar

37. Gorecki, PK. The importance of being first. The case of prescription drugs in Canada. International Journal of Industrial Organization 1986;4:371–95.CrossRefGoogle Scholar

38. Kohler, H. Intermediate Microeconomics: Theory and Applications. 3rd ed.Glenview, Illinois: Scott, Foreman and Company, 1990.Google Scholar

39. See note 25. Tirole, . 1988.Google Scholar

40. Pellegrino, ED. The metamorphosis of medical ethics. Journal of the American Medical Association 1993;269:1158–62.CrossRefGoogle ScholarPubMed

41. Beauchamp, TL, Childress, JF. Principles of Biomedical Ethics. New York: Oxford University Press, 1989.Google Scholar

42. See note 1. Chren, , Landefeld, , Murray, . 1989;262:3448–51.Google Scholar

43. Rawls, J. A Theory of Justice. Cambridge, Massachusetts: Harvard University Press, 1971.Google Scholar