Dark side of the pharma industry

Dark side of the pharma industry

For the billions drug firms pour into research and development, it is not often that they strike a bonanza. For every hot seller like Lipitor, for lowering cholesterol levels, there are lots more forgettable pills and failed drug projects. But don't feel sorry for these drug firms the world cannot do without. What is little known is that the pharmaceutical industry spends twice as much on marketing and promotions as it does on R & D - with doctors, academic journals and medical conference organisers among the unexpected beneficiaries. This was discussed in the 2012 book Bad Pharma, which shone a light on questionable industry practices. The promotional budget in America alone is said to be US$60 billion (S$76 billion), far in excess of the annual sales of each of the world's top five drug companies.

Then it makes sense why a decision by British firm GlaxoSmithKline (GSK) to abandon practices which have been industry norms may not be as far-reaching as it seems. GSK will stop paying doctors for promoting its products and cease linking the earnings of its sales representatives to what doctors prescribe. Though overdue, the move may in fact have been forced upon some in the industry, at least in America, where such payments will have to be made public from next year.

It logically is good science to delink appropriate drug treatments from the overt or subliminal influence exerted on doctors by drug firms, through inducements which under customary law would count as actionable. Drug giants have also been fined for selling drugs for clinically unapproved uses, an extreme form of reckless endangerment of patient interests. This practice attracts criminal sanctions, but the industry will risk them for the bottom line. GSK incidentally is under investigation in China allegedly for bribing doctors and regulators to promote sales.

What GSK is now attempting by way of reform, the industry ought to follow. Will it? Doctors are not the only recipients of largesse through paid conference attendances, endorsements and resort junkets. As medical journals sustain themselves partly on lavish editorial supplements and truckloads of reprints of articles paid for by drug firms, it is clear how hard it is to dislodge the industry's hold. Journals are a vital conduit of information on drug trials and new products, as doctors could not possibly attend conferences endlessly to stay abreast of developments. The basis of laws to check corruption is that both giver and taker are culpable. So it should be in the drug business. Some regulatory bodies and medical associations have guidelines to deter inducements. If receiving them is criminalised worldwide, GSK's move could gain traction. Otherwise, advantage to the industry.

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