I was surprised to see Big Gun Russell Williams, President of Canada’s Research-Based Pharmaceutical Companies Letter to the Editor in the Halifax paper The Chronicle Herald March 22 in response to a news story about a talk I gave on Sunday in the rural community of North West Cove Nova Scotia. In his Letter to the Editor he writes, “we are… concerned with Dr. Vaughan’s comments that pharmaceutical companies pay doctors to prescribe their medications and subsidize the rent of doctors’ offices.” He goes on to explain that for 25 years their code of conduct prohibits companies from influencing how physicians prescribe.
It’s kind of interesting the head of the national organization in Ottawa felt the need to respond to a report of a talk given by a doctor in rural Nova Scotia. What Mr. Williams doesn’t say is that Big Pharma does pay physicians to participate in clinical trials, and clinical trials are all about getting new drugs into the local market. So, in effect they pay for key physicians, always selected for participation in clinical trials because their community peers look up to them, to try the new brand name drug on their patients. That’s paying to put people on drugs. Mr. Williams’ Code of Conduct is permissive.
His second point was a misinterpretation of what was actually discussed during the question and answer session after my talk. I mentioned that in many part of Nova Scotia local pharmacies subsidize the square foot rental fees for physicians, which can create an artificially low rental environment for physicians, which can make it difficult for some communities without that advantage to recruit physicians. I didn’t in any way imply Big Pharma had a role in this practice but I did say it was unethical because the local pharmacies recoup their subsidization of physicians rent through prescription fees to the public. So in the end, the public pays to subsidize the doc’s below market rent. In the end it’s the senior on fixed income and the poor who are subsidizing the artificially low rent for many physicians.
One has to look no further than the March 20, 2012 edition of the Canadian Medical Association Journal for an article by Dr. Ken Flegel, Senior Associate Editor, regarding the nefarious role Big Pharma plays in influencing physician prescribing by making brand name drugs easier for physicians to remember than generic names. The Code of Conduct permits this as well.
Mr. Williams’ disingenuous over reaction to reported comments of a talk in rural Nova Scotia makes me wonder if he “doth protest too much?” Or perhaps I should seek shelter from the Wrath of Big Pharma? Scary kids.