Wednesday, November 21, 2007

A Tipping Point for Pharma Ethics?

Pharma is the Jekyll and Hyde of health care. At their best, drug companies develop research-based treatment breakthroughs and do well by doing good. At their worst, as described in the Senate Finance Committee report on Avandia that I discussed in yesterday’s posting, greed strangles ethics.

A story on the front page of the business section in today’s New York Times leads me to believe that we are approaching a tipping point for Pharma ethics. The headline reads: “After a Trial, Silence – Cardiologists Question Delay of Data on 2 Cholesterol Drugs.” The story describes vigorous pushback from cardiologists against Merck and Schering-Plough for a suspicious delay in reporting the findings from a drug trial and for changing the criteria for evaluating outcomes in midstream.

The doctors who are quoted – including the chief of cardiology at Walter Reed – fear that pharmaceutical companies are, once again, cooking the books. The words “fraud” and “deceit” do not enter the story, but the implication is there.

There is nothing complicated about the ethical issues involved. Either the cannons of openness and scientific honesty are being followed or they are not. What stands out for me is the degree to which the reporter understands that this could be another Avandia or Vioxx story in the making, and how much space the Times devotes to it. The Senate Finance Committee report on Avandia was similarly blunt and hard hitting.

When media, legislators and their staffs, physician leaders around the country, and movies like “The Constant Gardner,” speak in unison, and when liability lawyers are waiting in the wings to hit Pharma with yet another class action suit, we have a powerful force emerging. The lure of blockbuster profits from blockbuster drugs draws out every technique of wild west capitalism, but at this point the pushback is too strong to be chilled out by a public relations campaign.

The pharmaceutical industry has a history and traditions to be proud of. Polls of public trust put pharmacists near the top. The fact that massive profit potential has led to corrupt practices isn’t surprising. But more drug scandals would be bad ethics and bad business, and would irrevocably taint the industry.

I predict that the pharmaceutical industry feeding frenzy is coming to an end. If we are truly at a tipping point we have to thank the whistle-blowers and determined activists who have fought so vigorously for good health system ethics.

1 comment:

Jim Sabin said...

For an excellent further discussion of this topic, see Howard Brody's 11/23 posting on his drug industry ethics blog (