Pharmas Cap Money for Docs & Profs

From the Financial Times: GSK to publish level of doctors’ advisory fees

GlaxoSmithKline is to make public the level of advisory fees it offers to doctors and medical academics, and will strictly cap the payments they can receive in the US to $150,000 (£88,000) a year each.

Andrew Witty, chief executive of the UK-based pharmaceutical company, said he was introducing tougher new rules to impose a cap “without exception” on such payments and promised to publish the amounts.

His commitment comes at a time of growing concern that the widespread practice of payments by pharmaceutical companies may help unfairly influence “key opinion leaders” in the medical community, in a way that biases their judgments and recommendations for particular treatments.

Eli Lilly and Merck made similar moves last month.

It’s worth reminding ourselves what this is all about: fear of conflict of interest. A conflict of interest is “a situation in which a person has a private or personal interest sufficient to appear to influence the objective exercise of his or her official duties as, say, a public official, an employee, or a professional.” (MacDonald et al “Charitable Conflicts of Interest.”  Journal of Business Ethics 39:1-2, 67-74, August 2002). The fear here is that pharma payments to docs & profs could be sufficient to bias, or to appear to bias, the prescribing habits of docs and the research done by profs. Part of the plan being announced here is not just a limit on payment but a process for making payments public. Disclosure is one of the “standard” mechanisms for dealing with conflict of interest.

What’s the goal of disclosure? That’s debatable. There’s evidence that disclosure doesn’t affect people’s behaviour, at least not for the better. (See Cain, et al “Coming Clean but Playing Dirtier: The Shortcomings of Disclosure as a Solution to Conflicts of Interest”, in Moore et al, eds. in Conflict of Interest: Challenges and Solutions in Business, Law, Medicine and Public Policy. 2005) Patients may not know what to do in the face of a disclosure that their physician gets money from a drug company, and doctors may be more cavalier about their conflicts, which after all they’ve disclosed. On the other hand, ethics isn’t all about direct outcomes. Regardless of whether disclosure is effective at achieving some goal, it may well be that patients and others have a right to that information.

Hat tip to the indispensable Ed Silverman @ Pharmalot.

~ by Nancy Walton on October 25, 2008.

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