Feb 19 2007

Chemo Drugs and Doctor Profits

Last week I “met” Julia Schopick, a patient advocate who has some good information for you at www.honestmedicine.com. After Julia read my misdiagnosis story, she sent me a link to this MSNBC story by Rehema Ellis called “Cancer Docs Profit from Chemotherapy Drugs.” I almost fell off my chair when I read it!

If you know my story, then you know that after I proved I didn’t have cancer, I dropped in to visit the original oncologist, the one who had been so insistent I begin chemo. Throughout the ordeal he had been arrogant, pushy, and at one point lost his temper with me because I would not start chemo until I was very sure chemo was the only treatment that would help me (and even then, I had mostly decided not to suffer through it anyway). I accused the oncologist of insisting I undergo chemo because it was the only way he could make any money from me. It was a guess — a remark made in defense and anger — and now? Turns out I was probably right.

Think of it this way: there are at least two decisions about chemo treatment that need to be made. The first decision is — is chemo the right treatment or not? And the second decision is — what is the right protocol (types of drugs, amount to be given, length of treatment) for this patient?

In the first question: is chemo the right treatment — the patient may have some input, but it’s mostly the doctor’s call. (My situation was just way too unusual.) Regardless of how benevolent a doctor is, the decision you are asking him/her to make is: do I want to make more money? or don’t I? — Profit? or no profit?

In the second decision, about the right protocol — the patient has almost NO input because it is almost impossible for the patient to gain the background knowledge needed to know about the drugs, how much is required, how it will be delivered, etc. So in that case, the real question to the doctor becomes: less profit-margin? or more profit-margin? If drug A costs me $100 and I can sell it for $150, and drug B costs me $100 but I can sell it for $200 — which drug do I want to administer to this patient?

Are you kidding me?

When doctors are allowed to profit by the drugs they prescribe, then there is no way a patient can ever be sure s/he is getting the best treatment possible for his/her circumstance! The assumption has to be that the doctor will want to administer the drug which will be most profitable.

I don’t care how much a doctor cares, I don’t care how benevolent a doctor is, a doctor is a human being with office overhead, a staff to pay, a mortgage at home, med school loans to pay, not to mention malpractice insurance, etc….

A doctor cannot be objective when s/he can profit from the drugs they prescribe or any other tests or treatments they order. Some can be more objective than others — but no — never completely.

Do you hear that Dr. H?

I need to give some thought to what to do about it. Any suggestions? Sounds like a good project to sink my teeth into. Thanks for the heads-up Rehema.

………………..
Want more tools for sharp patients?
Sign up for Every Patient’s Advocate once-a-week or so email tips.
………………..

2 comments

1 ping

  1. Trisha:

    You can’t imagine how honored I was when I logged onto your blog today and saw your posting. You already know how much I admire your work – so today’s posting was doubly flattering. I am very glad you feel that I added to your knowledge (which is already impressive!).

    In your post, you ask for suggestions as to how to get involved in making changes to a system where doctors make money when prescribing certain meds. I am so excited about this! As you probably know, this is a huge concern of mine, too.

    Also, I am sure you know that doctors are influenced in other ways – not only by buying a drug wholesale and selling it to their patients at marked-up prices. This, by the way, is apparently a problem mainly with oncologists. Other doctors aren’t allowed to do this, to my knowledge.

    But there are other influences on doctors to prescribe certain meds. One is the fact that they are wined, dined and “penned” and “penciled” to death with both small and large gifts by drug companies. In fact, many of their (“educational”) seminars are paid for by Big Pharma. (Please see Adriane Fugh-Berman, MD’s article, “Doctors Must Not Be Lapdogs to Drug Firms” at http://301url.com/fughberman .)

    And then, there is the (I think) much larger problem that so many of the doctors who conduct the studies for pharmaceutical companies are on Big Pharma payrolls. David Armstrong has written several wonderful “Wall Street Journal” articles exposing this terrible problem. Two of his best may be found at http://www.301url.com/wsj_jama1 and http://www.301url.com/wsj_jama2 . (I have shortened both URLs.)

    Inspired by Armstrong’s excellent detective work, I wrote a 3-part article for my site, entitled “The JAMA Controversy” (http://301url.com/jama-all), in which I quote from these WSJ articles, and go on to give my own thoughts on the situation.

    My conclusion: In this particular case – and unfortunately, in many similar cases – the medical journals that publish the Pharma-financed studies too often close their eyes to the fact that the doctors who conduct the studies are sometimes not really objective.

    So, is it only when prescribing chemotherapy drugs that doctors are unduly influenced? Not really.

    A sad state of affairs.

    Again, Trisha, thanks for your vote of confidence. Maybe together, we can help to change things.

    Keep up the GREAT work!

    Julia Schopick
    http://www.honestmedicine.typepad.com

    • gpawelski on February 18, 2008 at 9:29 am

    Selling cancer chemotherapy with concessions creates conflicts of interest for oncologists

    http://www.healthyskepticism.org/news/2007/Jun.php

  1. […] , Self Help , Medical Commentary , Medical News , Medical  A couple weeks ago I wrote about oncologists who recommend chemo to their patients and then profiting from those chemo drugs they’ve recommended.  One doctor I talked to said […]

Comments have been disabled.

%d bloggers like this: