Good Morning, Sunshine?
Some companies in the pharmaceutical industry are patting itself on the back for its self-mandated reporting of speaker fees and consultancies to docs. Eli Lilly led the charge, followed by Merck, according to the NYT. With certainty, the other pharma titans will jump on the bandwagon in no time.
My question: will these lists be posted on docsforsale.com? Or perhaps VH1 will make a new show hosted by Robin Leach called "The Fabulous Life of Pharma Industry Docs" and the rest of us can watch as those lucky enough to get those gigs are flown around the world to Maui and Hong Kong, and Grand Cayman to talk for an hour and "attend a conference for 3 days." That's a show I would watch. Those clinical oncology conferences can get wild!
Disclosure is the first step for sure--but without any kind of metric to assess how much money is too much, how far on a private jet is too far--simple disclosure will not move us toward the real moral goal: reigning in out-of-control industry spending on consultancy and speaker fees for physicians and other health professionals who run the trials and promote the drugs coming to market and who are biased by the perks they receive.
Even if the Sunshine Act, a bi-partisan bill designed to require a nationwide registry for all pharma companies, comes to pass, a registry cannot have the teeth to really make the kind of change we really need in the industry. Sunshine may be the first step, but it cannot be the last.
Summer Johnson, PhD
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It's a great & complicated topic.
Unfortunately, it's not even clear that disclosure is effective.
There's evidence from empirical psychology that disclosure can actually be counter-productive.
See, e.g,:
Cain, Daylian, M. George Loewenstein and Don A Moore. “Coming Clean but Playing Dirtier: The Shortcomings of Disclosure as a Solution to Conflicts of Interest”, in Moore et al, eds. Conflict of Interest: Challenges and Solutions in Business, Law, Medicine and Public Policy.
Basically the argument is that a) disclosure often leaves us uncertain how to *respond* to the disclosed conflict-of-interest, and b) professionals who disclose may then feel more free to allow bias into their professional opinions because, after all, they've *disclosed* their bias. That's not to say that disclosure is, overall, a bad thing. There may be non-consequentialist reasons in favour of disclosure -- e.g., that patients or others have a *right* to certain information.
- by Chris MacDonald on Sep 26, 2008 at 12:37 PM | link