As public trust in drugmakers and doctors is at an all time low, two Harvard professors have released a list of recommendations that they said should be taken in order to restore public confidence.
“We’ve seen a lot of transgressions — people who have taken advantage of the system for their own self-aggrandizement or profit. It’s got to stop,” said Dr. Harlan Krumholz of Yale University in New Haven, Connecticut.
Krumholz, alongside Professor Joseph Ross, came up with six proposals that would help drug companies and doctors regain public trust.
“The relationship between drug and device companies, the medical profession, and the public is at a critical juncture,” they wrote in the British Medical Journal.
“The public is well served when industry, clinicians, and academicians work together for the common good, generating new knowledge and ensuring appropriate and rapid dissemination of effective products to save lives and improve quality of life.”
Ross and Krumholz propose that the industry should do away with “promotional activities such as direct to consumer advertising and distribution of drug samples in settings where prescribing decisions are made.”
Secondly, they advise that doctors should not receive gifts, including notepads, pens or other promotional memorabilia.
“Small gifts may seem innocuous, but cognitive psychologists have shown that they have outsized influence.5 The value of the interaction between industry representatives and physicians should relate to information exchanged, not the gift received,” they said.
Third, they recommend that all clinicians, researchers, academic institutions, clinics, and hospitals should be completely transparent about gifts and payments from industry.
Additionally, physicians should fund their own education, therefore ending “industry sponsorship of continuing medical education.”
“Fifthly, industry sponsored clinical studies should be visible, accountable, and comply with mandatory standards set by institutional review boards, data safety and monitoring boards, and steering committees to protect patient volunteers,” they wrote.
And last, Ross and Krumholz advise that doctors and industry “defend free speech, and acknowledge that there is great value in the respectful exchange of ideas.”
“We need to overcome an unfortunate history of intimidation exhibited by some companies against physicians who have expressed opinions that did not favor their product,” they added.
Dr. Marcia Angell of Harvard Medical School in Boston said doctors should no longer be so closely linked to the drug industry.
“I believe there should be no relationship between the drug industry and either prescribers or patients,” wrote Angell, former editor of the New England Journal of Medicine.
“You might have to go down the local high school instead of playing golf in Hawaii, but the education would be better because it would be impartial,” she told Reuters Health.
Scott Gottlieb, a health policy analyst in Washington DC, said industry needs to be transparent in their interactions with doctors and patients, while focusing more on science than marketing.
“Relationships should be predicated on genuine scientific work,” he wrote.
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