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In this day of 24/7 media coverage and cyber-news, pharmaceutical companies have been the recent target of a Don Imus month. Let's quickly review what has happened and how it may bode for the future.

First, in late April, the prestigious New England Journal of Medicine published a comprehensive analysis of the systemic relationships that exist between pharmaceutical companies and physicians. The analysis of six specialties, according to USA Today, concluded that "virtually all doctors in a national survey of six specialties reported some sort of relationship—from free lunches to payments for consulting and lecturing—with medically related industries such as those for drugs or medical devices." The study was the subject of not only a cover story for USA Today and many other major newspapers, but also a lead segment of "NBC Nightly News."

Although any of us who have been in a physician's waiting room know the ever presence of drug sales representatives, the New England Journal of Medicine study was the first to document the extent and magnitude of the relationship on a national basis. I will attempt to avoid commenting on the ethical proprieties of the relationship as I, like many of my readers, have been the beneficiary of my fair share of drug samples. However, I think a more interesting issue emerges than merely the integrated relationship of the drug industry with the medical profession. That issue is transparency.



OxyContin and Drug Importation

Contemporaneous to this study was a guilty plea from the leadership of a major drug company that it had withheld damaging clinical trial information on the drug OxyContin. Additionally, a major vote was held in the U.S. Congress about the importation and re-importation of pharmaceuticals from foreign countries, with the lead congressional spokesmen being generous recipients of campaign contributions by pharmaceutical companies. Again, transparency becomes an issue.



Accountability to the Public

In an age in which news can be spread across the Web, and also the broadcast networks, in a matter of minutes, it should come as little surprise to the pharmaceutical industry or the medical profession that their business relationships, whether appropriate or inappropriate, are subject to heightened transparency and visibility. With the advent of Medicare Part D, the nation is investing huge amounts of its tax resources to provide pharmaceutical benefits to senior citizens. With the public dollars comes the public accountability, both the regulated version and the First Amendment version.



Progress?

Last year, Minnesota became the first state to create a Web site where physicians and their vendors must post the nature and extent of their business relationship for public viewing. Although I was initially taken aback by the implications of that public viewing, perhaps it is a positive sign of transparency in the ties between industry and medicine. But since the vast majority of medical progress is attributed to drug and device companies, rather than to public funding, let's hope that the new transparency is not an impediment to future growth and expansion.
Richard G. Cowart is chairman of the health law/public policy department of Baker, Donelson, Bearman, Caldwell & Berkowitz. He can be reached via
dcowart@bakerdonelson.com.


June 2007

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