Should the financial ties between doctors and drug companies be completely cut, or are healthy alliances between the two possible with the common aim of improving human health? A debate in this week's PLoS Medicine discusses whether the influence of drug company money on doctors is always a corrupting one.
The relationship between doctors and drug companies has been the subject of intense scrutiny in recent years, with some commentators arguing that the public health mission of doctors is incompatible with the pharmaceutical industry motive to maximize profits for shareholders. Emma D'Arcy - the co-founder of www.myphid.com, an international networking site that allows healthcare workers and the pharmaceutical industry to communicate in a transparent way - disagrees that relationship is fundamentally incompatible. She suggests that "authentic alliances" between doctors and the drug industry can be formed with the common aim of improving human health and safe and effective medicines. Pointing out that the drug industry remains an important source of funding for scientific meetings and continuing medical education, she outlines three ways in which healthy collaboration can be encouraged without needing to further regulate the industry. These include: teaching medical professionals to distinguish between clinical information and promotional material; ensuring transparency from both parties through networking sites such as www.myphid.com; and encouraging industry and doctors to follow an "everyday credo" to make sure interactions ultimately benefit the care of people living with disease and further medical scientific understanding.
Ray Moynihan of the University of Newcastle, New South Wales, Australia, argues that transparency is not enough to ensure that physicians' prescribing behaviour is not distorted by pharmaceutical influence. He cites evidence collected on the site of the non-profit group Healthy Skepticism (www.healthyskepticism.org), including a systematic review demonstrating that studies sponsored by pharmaceutical companies were more likely to have outcomes favouring their sponsor, and calls for the medical profession to disentangle itself completely from the money it accepts from the pharmaceutical industry. He highlights the case of pharmaceutical industry distortion of continuing medical education, in particular the ability of doctors to gain professional credits and company sponsored events. Giving examples of education for doctors in Australia where sponsors have even determined topics and speakers for seminars, he concludes that there should be a complete ban on all industry funding of continuing medical education, whether direct or indirect. Complete disentanglement is a healthier alternative, argues Moynihan, and strategies such as the American Medical Student Associations "PharmFree" campaign, which has advocated the severing of financial ties, prefigure "a future where fewer doctors will be prescribing under the influence of industry."
Funding: Emma Darcy received no specific funding to write this article. Ray Moynihan received a commissioning fee from PLoS to write his Viewpoint.
Competing Interests: Emma Darcy is the co-founder of www.myphid.com, an international professional networking site for the pharmaceutical industry and the medical community. She has worked with many pharmaceutical companies, medical societies, and medical education communication companies and is a supporter of open and transparent interactions between all. Ray Moynihan has declared that he has no competing interests.
Citation: D'Arcy E, Moynihan R (2009) Can the Relationship between Doctors and Drug Companies Ever Be a Healthy One? PLoS Med 6(7): e1000075. doi:10.1371/journal.pmed.1000075
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University of Newcastle
School of Medicine and Public Health vNewcastle, New South Wales 2308
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