Big Pharma

As the field of medicine is becoming more industrialized and more impersonal, the hospitals and physicians within it are becoming more machinized as well. With the advent of the 21st century research physician, gone are the traditional doctors carrying their black bags making their way from house to house. The growth of new technologies to fight disease parallels a steady decline of the patient's reliance solely on the doctor's knowledge. The informed patient now has access to online resources such as WebMD that further creates doubt on a doctor's competence. Who then is treating the patient? The doctor or the industry and technology?

In high school, my sister and I both worked in physician offices. I worked in a cardiologist's office as an insurance/billing assistant while my sister worked as a receptionist in a general practitioner's office. When we came home from work, she would gossip about Lisa and the lunch she brought from Atlanta Bread Company, which she mentioned wasn't as good as the lunch Nancy brought Tuesday from Bonefish. Then she would laugh because she didn't put drug reps she didn't like (or as I read it- who didn't bring free lunch) on the general practitioner's schedule. It was interesting to see how much influence my 16-year-old sister had working at the office yet what was more interesting was that she was choosing to help perpetuate one of the largest industries in the world- the pharmaceutical industries.

The pharmaceutical industry recognizes that deep pockets can increase their revenue, but what bothers me the most is not the detailing and the huge sums of money that go to drug reps, doctors, direct-to-consumer advertising, and other forms of marketing. The biggest moral problem for me is the market that pharmaceutical industries are catering to. Although it is important to develop new drugs for diseases, more and more drugs are being developed that can be marketed to a large population in order to make a profit.

Besides the drugs, pharmaceutical drugs are using their deep pockets to influence doctors, whom they know patients trust, to speak on behalf of their drug or prescribe their drug for off-label uses to a larger population and a wider range of problems. In the end, pharmaceutical industries have control in creating a market for their drug. About 50-60 years ago, drugs were being made that were not disease specific and were just "trial-and-error" to see what they could be prescribed to. Nowadays, regulations have made drugs specific to certain diseases, but I believe this is just a formality and that there is a new "trial-and-error" in the methods of pharmaceutical industries- marketing and advertising. As much money as the industry says they spend on R&D, the money spent on marketing and advertising is probably triple that amount if not more. Who should be held accountable?

I see the FDA as more of an advisory role, than regulatory. With over half of its funding coming from pharmaceutical industry user fees, how can one trust a federal agency that is technically being funded by the very industry it is designed to regulate? How can this be fixed? One idea is for Congress to appropriate more funds to the FDA. I have even heard the idea that the Food and Drug be separated in FDA. That way, 70% of the funds will not be unevenly distributed to food regulation. I also think that the FDA should more carefully regulated marketing and direct-to-consumer advertising. Whatever the answer may be, there needs to be action taken to curb the pharmaceutical industries' growth.