Thursday, December 20, 2012

Rant: Treatment Guidelines and Biopharma

Have you seen the recent analysis by the Milwaukee Journal Sentinel about biopharma’s influence on treatment guidelines?  If not, you should take a look at it here.

In summary, it reveals the startling fact that physicians who are on treatment writing committees are also often consultants to Biopharma and states that because of this there is a conflict of interest for the physicians.  I find these arguments incredibly frustrating and I think we as a community must push back against them strongly.

On the surface, the conflict of interest argument makes sense but when you scratch the surface a bit it falls apart.  By definition, treatment guidelines not only serve to support patient treatment but they are also used to define standard of care for reimbursement purposes - reimbursement not just for drugs but for all the aspects of treatment.  In general a practicing physician, even one that gets some income from Biopharma consulting, earns most of their income by being reimbursed for treatment they perform.   Some physicians have major financial stakes in treatment reimbursement but no one is (or should) suggesting that a doctor would push for an unnecessary or less effective treatment option just because it would likely be more lucrative to the doctor.  No one is claiming that the largest sources of most of these physicians’ incomes drive a conflict of interest.

But, when it comes to drug treatment, the newspaper story argues that this same ethic goes right out the window and the physicians become pawns to the big bad Biopharma companies.  This is ridiculous.  Physicians who consult to Biopharma generally do so because they are subject matter experts and want the drugs that are developed to most effectively treat their patients.  To imply that by providing that support to Biopharma they suddenly lose their ability to correctly judge what should or should not be in a treatment guideline is insulting to the professionalism of physicians.

As someone who has dedicated a big chunk of my career to helping Biopharma work better with physicians, I know that those physicians are professionals and will do what is best, not lackeys that will do as they are told.

What do you think?  Please leave a comment.

1 comment:

  1. It was interesting to see this study. However it is not surprising. Who would we expect to be on treatment guideline panels? Non-scientific experts who are not engaged in consulting and other activities with pharma? Of course not. The experts who know the science and data are going to be engaged with pharma, and are often the most knowledgeable in the therapeutic area. They should be the ones writing treatment guidelines. So we can only hope that these experts do the right thing: give unbiased recommendations AND disclose any conflicts of interest.


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