Dynamics and Ethics of the Relationship Between Physicians and the Pharmaceutical Industry

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Dynamics And Ethics of the Relationship Between Physicians and the Pharmaceutical Industry

Dr. Pankaj Gupta

Dr. Aaditya Udupa

The pharmaceutical industry, the medical profession and the patient have a unique, symbiotic relationship. The industry makes products which it cannot sell to the patient (consumer) directly. On the other hand, the medical profession cannot treat the patient without drugs produced by the industry. Thus, the industry and medical profession are interdependent with a common aim. It is crucial that this interdependency is based on the principles of beneficence, non- maleficence, patient autonomy and justice.

Understanding the Industry interaction with Physicians: Business dimension

The interaction between physicians and the pharmaceutical industry can be viewed in terms of supply and demand. The pharmaceutical industry has the money, which it can supply to physicians in various forms such as promotional gifts, entertainment, free drug samples, and funding for continuing medical education. The physicians have a demand for continuing education in order to discharge their professional obligations to their patients. It may seem that there is an overlap or duality of interest of both the pharmaceutical industry and physicians with respect to their encouragement of the effective and responsible use of drugs in treatment and care, the monitoring of their use, and the conduct of innovative research Notwithstanding this overlapping of interests, physicians and the pharmaceutical industry each have a different emphasis and they focus on different stakeholders. The pharmaceutical companies’ principal emphasis is the encouragement of the use of their products; the physicians’ primary emphasis is effective patient care. The primary stakeholder in patient care is the patient; while the principal stakeholder in industry is the shareholder (Komesaroff and Kerridge 2002)

Business ethics versus Medical ethics:

Business ethics are different from medical ethics. In the business climate it is common for industry to reward and entice their vendors in order to stimulate sales. The pharmaceutical industry has a similar culture, and at its interface and overlap with the medical profession, what the pharmaceutical industry formally considers normal business behavior, the medical profession considers unethical.

Medical ethics prompt physicians to consider that if current promotional activities such as inviting physicians to expensive dinners, parties, trips, entertainment and even office lunches were eliminated, the money saved could be used to lower the cost of drugs to the benefit of patients.

Implications of the Industry interaction with the Physician: Healthcare dimension

The Good: It should not be assumed that where a duality of interest occurs between physicians and the pharmaceutical industry, there will always be a conflict of interest. Dualities of interest constitute “conflicts” only when they are associated with competing obligations that are likely to lead directly to a compromise of primary responsibilities (Komesaroff and Kerridge 2002). A pharmaceutical company may inform a physician about a new product because this is the best product available for the treatment of a certain disease. In this case, it may result in a “win-win” situation for both. The pharmaceutical company incurs costs educating the physician about the new product, but may recoup these costs and make a profit on sales prescribed by the physician. The physician may obtain information he needs to give better care to some of his patients and they may benefit accordingly.

The Bad: Problems can and often do arise because the relationship between physician and pharmaceutical company is open to varying degrees of abuse. For example, the pharmaceutical company representative may practice selective disclosure when providing information. It is often called “putting one’s...
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