The Price of Not Knowing
The last few years have seen a big push in various quarters to restrict the interaction between physicians and pharmaceutical company representatives. Harvard University, for example, declared that pharma reps could not visit doctors at its affiliated health institutions without a written letter of invitation laying out explicit terms for the visit. The Veterans Administration has developed a litany of restrictive regulations, even dictating where pharmaceutical representatives are allowed to stand and wait for a doctor.
The rationale for these restrictions is, of course, the notion that physician judgment and independence will be clouded by meeting with a company representative that has an interest in bringing attention to a particular product.
What if, however, by closing the door on these interactions, physicians are also shutting out knowledge that is critical to patients?
A Temple University professor of healthcare management and marketing has asked that question, and the research his team developed has just been published in the Journal of Clinical Hypertension. The upshot of their findings is that doctors who restrict access to pharmaceutical representative are slower to adopt new therapies and also less responsive to negative information about potentially-harmful medications.
This is a comprehensive study analyzing the clinical decisions of over 50,000 physicians. It found that physicians with more restrictive pharma access policies took 1.4 to 4.6 times longer to being prescribing an innovative new drug for Type 2 diabetes and were four times slower to reduce usage of an older diabetes treatment that had received FDA warnings for cardiovascular safety.
This is an issue that warrants and will continue to be the subject of discussion within the healthcare community. Some of the most important healthcare innovations of the past century have come as a result of physician-industry collaboration. In protecting physician independence and attacking potential conflict-of-interest situations, we have to be careful that the pursuit of some perceived standard of purity doesn’t undermine patient care. Information has incalculable value and there is a price for not having it.
