April 10, 2000 (San Francisco) -- One fact jumps out of the paper published in the January 19 issue of the Journal of the American Medical Association: the ignorance of residents (trainees) and practicing physicians regarding guidelines concerning their contacts with drug companies. According to three studies cited in the paper, only between 23% and 50% of residents knew of these policies, while 62% of doctors said they knew of at least one guideline. Clearly, an ongoing awareness campaign needs to be part of any new policy. Other proposed reforms include:
Physician associations, continuing medical education associations, and drug companies should develop one set of industry-wide standards regulating appropriate contacts and the involvement of drug companies in medical education.
Medical colleges should monitor and develop policies for medical students and residents attending company-sponsored conferences. Currently, they can accept travel scholarships from companies to attend such conferences.
Medical schools should develop formal courses to teach residents and medical students to critically analyze drug marketing techniques and product claims.
Physicians should disclose potential conflicts of interest and be guided in their actions by whether they would be willing to have their junkets, perks, and financial associations made public.
In 1997, when the FDA relaxed its rules regarding direct-to-consumer ads on television, drug companies began buying up airtime in record amounts. To counter pressure on doctors from patients responding to the ads, the March 6, 2000 issue of Health Affairs suggests the following reforms:
Drug companies should provide understandable, jargon-free product information that gives equal treatment to a drug's side effects and its benefits.
Individual physicians and medical associations should monitor consumer ads for accuracy and balance and should tell their patients about the purpose of such ads -- to bolster sales.
Congress should fund studies that examine how direct-to-consumer ads affect health care costs and the quality of prescribing.
The next time your doctor writes you a prescription, consider this: The medication may not be approved for your specific condition or age group.
But you probably shouldn't call the medical board. The practice, called "off-label" prescribing, is entirely legal and very common. More than one in five outpatient prescriptions written in the U.S. are for off-label therapies.
"Off-label" means the medication is being used in a manner not specified in the FDA's approved packaging label, or insert. Every...