If you guys don't care for money give it to us. If it's such a burden we'd be glad to take it off your hands.

You said "There is much tighter regulation" over pharmaceutical companies in the country over which the Union Jack flies free (as compared to U.S.). Is that right?

How does your evaluation compare with the British Medical Journal's (BMJ)? Read and find out. "BMJ concluded that doctors and drug companies are 'entwined in an embrace of avarice and excess, an embrace that distorts medical information and patient care'2003."

You would have to agree that passing laws to achieve a tighter regulation that is true in appearances only, but not in actual result would mean that your doctors and professors are engaging in the same kind of behavior that you decry as being MAINLY a U.S. characteristic. The quote is from the full article below and has interesting things to report about the pharmaceutical industry. Since you are studying for a Master's in pharmacy would some of your professors be from the pharmaceutical industry?

I listed my reasons for my conclusion. Here is the article. What conclusions do you draw?


PATIENTS PAY FOR PHARMA PERKS
By Kathleen Barrington-Sunday June 29, 2003

Late last year, about 40 doctors attended an overnight conference at the luxury Sheen Falls Lodge in Co Kerry.
The five-star hotel boasts that its "rooms and suites are particularly spacious and well appointed - a melange of palewoods and complementary fabrics, expensive marble bathrooms and views of either the waterfall or bay."

It also offers salmon and trout fishing on the River Sheen, clay pigeon shooting, floodlit tennis and a health and fitness centre with gymnasium, jacuzzi, sauna, plunge pool and steam room.

A night at Sheen Falls does not come cheap. Even in low season, the most basic room costs €260. But the doctors did not have to worry about the cost. Lundbeck, a pharmaceutical company that makes psychiatric and neurologial drugs,was picking up the tab.

The lavishness of Lundbeck's hospitality is not unusual. Phar mac eutical companies regularly invite doctors to attend functions at fine hotels and golf courses.

A glance through the social pages of the medical trade press in recent months confirms the picture.The pages of the Irish Medical News, Medicine Weekly and Pharm Views are littered with photos of doctors mingling with executives from the leading drugs companies at social, educational and charitable events ranging from golf classics to conferences to gala dinners.

In recent months, sponsors of such events included Abbott Laboratories, Organon Laboratories, Astra Zeneca, Eli Lilly, Bristol Myers Squibb, GlaxoSmithKline and Lundbeck.

With state expenditure on medicines having doubled over the last five years to €629 million, and the private medicines bill similarly soaring, even the medical profession is beginning to ask if their relationship with Big Pharma has become too cosy.

A recent report from Forfas found that pharmaceutical product inflation in Ireland was particularly anomalous in an EU context at 5 per cent, compared with an EU average of just 1 per cent.

Against that background, the taxpayer and the private patient could be forgiven for asking if it is they who are ultimately picking up the tab for the doctors' free lunches.

The Irish Pharmaceutical Healthcare Association (IPHA), the lobby group for the Irish pharmaceutical industry, advances several reasons for the soaring drugs bill.

They include: demographic trends; new treatments; an increase in chronic illnesses; the expansion of eligibility to state drug schemes; increasing research and development costs and the fact that Ireland had historically one of the lowest levels of drug consumption in the European Union.

The IPHA does not, however, mention that aggressive marketing by pharmaceutical companies targeted at the medical profession may have a role to play in driving up the national drugs bill.

There is also mounting evidence that the relationship betwe en phar mac eutical companies and doctors is influencing prescribing patterns.

The British Medical Journal last month devoted an entire issue to probe the relationship between doctors and pharmaceutical companies.

In a strongly-worded editorial headed "No more free lunches", the BMJ concluded that doctors and drug companies are "entwined in an embrace of avarice and excess, an embrace that distorts medical information and patient care".

The BMJ found evidence that drug companies influence doctors' prescribing habits, either through discussions with sales representatives or through sales drives dressed up as medical education. It quoted a British research group that found that doctors who have frequent contact with drug representatives are more willing to prescribe new drugs, do not like ending consultations with advice only, and are more likely to agree to prescribe a drug that is not clinically indicated.

And things aren't much different here, according to Dr Richard Brennan, chairman of the Irish College of General Practitioners.

"The pharmaceutical industry very definitely influences prescribing," he said. "They wouldn't be inviting you to the K-Club if they weren't getting a return on their investment."

Brennan said that while most GPs like to think they are not being influenced, the reality was that a meal or a round of golf did influence their choices. Brennan estimated that, in Ireland, on average each GP meets a drug company rep about once a week. And he said research had shown that the "practitioners with the most contact with drug reps are more willing to prescribe".

Brennan called for the establishment of an independent agency that would advise doctors on the cost and benefits of new drugs. This would reduce the doctors' reliance on drug companies for such information. He also said it was time to revisit the code of marketing practice for the pharmaceutical industry.

The code, which was drawn up in consultationwiththe Department of Health and other interested parties, gives drugs companies carte blanche to throw money at doctors, other health professionals and patient groups for social and educational purposes.

Brennan said he was very concerned about the sponsorship of the profession's own meetings by the pharmaceutical industry. He said the education committee of the Irish College of General Practitioners was working on draft guidelines to ensure the industry could not influence the choice of speakers at meetings endorsed by the college.

Brennan pointed out, however, that doctors had come to rely on pharmaceutical companies for support as postgraduate doctor education was very badly funded.

He said he was also concerned about the drug companies' sponsorship of patient groups. Earlier this month, The Sunday Business Post revealed that the Asthma Society of Ireland was sponsored by GlaxoSmithKline, maker of a leading asthma drug Ventolin.

According to Brennan this is not at all unusual. He said the drugs industry sponsors many patient groups resulting in increasing pressure on the state to supply patients with certain drugs. "It may be good medicine, they may be good products, but the net effect is a cost to the health budget."

Brennan suggested that patient groups and post-graduate education should be funded by the National Lottery.

He said he was worried about the sponsorship by pharmaceutical companies of staff in GP's practices. Brennan said he knew of a doctor who had dropped the services of an asthma nurse funded by a pharmaceutical company after the doctor took the view that his patients were being recommended that company's products.

Other doctors have said they were aware of instances of doctors asking pharmaceutical companies to cover some of the cost of installing software packages for use in doctors' surgeries.

At a time when the Minister for Health, MichealMartin, has declared his intention to encourage the use of cheaper, generic drugs, several doctors mentioned the problem of drugs companies replacing cheaper drugs with similar, more expensive ones.

For instance, Limerick GP Dr Mary Gray cited a decision by drugs company Schering to withdraw a low-cost contraceptive pill, which it replaced with one that is almost four and half times more expensive.

Gray said Schering withdrew Microgynon at a wholesale price of 99 cent for 21 pills. Schering recommended that doctors instead prescribe Microlite, which wholesales at €4.42 for 21 pills.

Gray said Microlite is made of exactly the same ingredients as the earlier, cheaper product. She said the composition of the new product differed slightly from the original, but added that the difference was "not clinically significant".

Gray said that, apart from a letter she wrote to the Irish Medical Times, the cheaper product had disappeared off the market "with no fuss" earlier this year.

Some doctors hold the view that the power of the pharmaceutical companies has succeededinstifling debateon the kind of issues raised by Gray.

Earlier this month, a survey published by Caf Medical, which monitors ad spending in medical titles in the Republic, found that drugs firms spend almost €10 million a year on ads in medical publications targeted at doctors, pharmacists and other healthcare professionals.

Limer ick GP Terry Lynch is a pyschotherapist and author of Beyond Prozac, which has sold over 6,000 copies in Ireland. He was one of many doctors who wrote to the BMJ supporting its strong editorial line on the relationship between the drugs industry and doctors.

Lynch said the relationship has "become so cosy that many doctors fail to see the conflict of interest which exists between both groups".

He said the relationship "has ensured that issues which favour the pharmaceutical industry get considerable medical media coverage, while issues which do not enhance the pharmaceutical industry receive less priority in the medical media and medical education. This relationship leads to censorship regarding what doctors are educated about. It has to stop. It is insidious, pervasive, and fundamentally unethical in my view."

Lynch said he was worried this had caused doctors to emphasise drugs solutions rather than psychosocial solutions for psychiatric patients.

Earlier this year, the Minister of State at the Department of Health, Tim O'Malley, accused some pharmaceutical companies of adopting "very aggressive" sales techniques to get psychiatrists to use their products.

A spokesman for the IPHA said that as the healthcare debate intensified, people were looking for "easy scapegoats". Brian Murphy said that only 10 per cent of health spending goes on drugs, compared with 70 per cent on payroll costs. He said Ireland had to increase its expenditure on drugs in recent years as the country had the poorest life expectancy in western Europe.

He also insisted that doctors generally reacted favourably to contact with drugs companies. This is at variance with research published in the Irish Medical Journal last year.

The research, by R Quinn and Conor O'Neill, found that "general practitioners do not value their interactions with pharmaceutical representatives.They regard it as promotional, not educational activity and believe that they are presented with biased information. Positive aspects (social, and receiving information) do not compensate. The content of e du c ational me eti ng s should be decided by GPs alone. More directly promotional meetings are valued less, except when they are fairly lavish, in which case they are harder to resist."

Pharmaceutical codeof marketing practice

* In the case of educational events, any hospitality extended must be `secondary' to the primary purpose of the event

* Drugs companies are specifically allowed to offer `corporate hospitality', with no monetary ceiling placed on this

* The code states: "Corporate hospitality must never be such as, on a reasonable view, it might give rise to the inference that the scale and costs of such hospitality could adversely affect the costs of medicines to the patient or taxpayer"

* Drugs companies may sponsor the travel expenses of health professionals attending overseas international scientific conferences (according to one consultant, many consultants availed of this provision to travel first class to conferences worldwide)

http://archives.tcm.ie/businesspost/2003/06/29/story266132708.asp