Question 19


 Dear Fr. Matthew @ the Abbey,

When I go to my doctor's office, I see ink pens, drug samples etc. left there by pharmaceutical companies. I work in a medical building and see very well dressed drug reps carting in their goods all the time and employees there say that these reps sometimes bring pizza etc. for all the staff in their office. 

With all this promotion and goodies, I doubt whether people are receiving good medicine. For instance I read that the birth control pill has many harmful side effects. Just how influential are these pharmaceutical companies on what doctors prescribe? 
What's really going on and how does this all fit together?

 Dear JB, 

Pharmaceutical companies are a tremendously powerful lobby. Merck, for instance, stands to profit from the legislative push to require all young girls to be vaccinated with its Gardasil vaccine designed against the four most common Human Papilloma Viruses which cause cervical cancer. The state of Texas passed such a mandate recently. Another such example is the promulgation of artificial contraceptives to treat gynecologic disorders despite the lack of studies which demonstrate efficacy and the many studies demonstrating the harmful side effects. 

Pharmaceutical companies fund medical education and most medical research studies. Medical students and residents are showered with text books, monographs, stethoscopes, pens and all types of office and diagnostic products which advertise drug products. This continues throughout the careers of physicians. Most continuing educational programs are sponsored by pharmaceutical companies as are meal educational programs and "drug lunches." The meals serve a purpose to educate physicians and staff about new medications, and there would be virtually no research or continuing medical education without pharmaceutical company sponsorship. 

Behind all of this is marketing. Medical professionals have an obligation to cast a jaundiced eye toward the impeccably dressed smooth-talking representatives ("drug reps") and think critically about the scientific data before being influenced by the sales pitch and the free lunch. The federal government has passed legislation limiting the monetary value of gifts, but the marketing gurus have come up with a new approach: direct advertising to the consumer in print and media now recruits patients to "sell" their own doctors on the merits of a particular drug or product. 

Mary W. Martin, M.D., FACOG