Last Friday, the Globe got its mitts on the draft regulations for the pharmaceutical company gift ban. Monday morning I wrote a post decrying the lack of a disclosure requirement for pharma companies disclose how much and to whom they're paying for clinical trials. State Department of Public Health chief John Auerbach was kind enough to take a few minutes with me yesterday to give the department's case.
Auerbach attests that the disclosure requirement would simply drive clinical trial business out of the state. He says the result of such an action might be comparable to Massachusetts losing stem cell research business after Gov. Romney restricted such research in the Commonwealth. He concedes that Massachusetts is in a strong position for clinical trial business; but says that trials treating such common diseases as diabetes and certain kinds of cancer can be done any number of places.
Well, maybe. And maybe not. I also talked with Lisa Kaplan Howe of Health Care for All, who points out that Minnesota and Vermont, for instance, already have gift bans in place. And disclosure advocates have been pushing for a Minnesota-style disclosure requirement. (Minnesota, in fact, is considering expanding their disclosure law to include device makers.) So Massachusetts would not be alone. She also claims that the fear that companies would have to share critical information with competitors is overblown: Companies have analysts that find out what kinds of drugs competitors are testing, in any event.
Look, if you make the case that Massachusetts would be giving up business, and therefore not reap any public-information benefit from such a disclosure requirement anyway, I guess you might concede the state's point. But I don't believe PhRMA when it says it would just pull out of Massachusetts. They cry wolf so often they must be dehydrated. They didn't pull out of Minnesota. They won't pull out of here. They need what we've got; Gov. Patrick sweetened the pot for them with the biotech bond bill; and I just don't think that disclosure is the business-climate WMD that PhRMA would like us to believe.
If anything, research in which payors and payees are completely public ought to be more credible than that which is shrouded in mystery. Drug cos might be able to say, “Our research is credible and transparent — the state made us do it that way.”
In any event, disclosure is a very, very mild form of regulation — as Sen. Marty of Minnesota says, “”Disclosure isn't enough, but it's a good first step.” And the further the state goes towards taking medicine out of the realm of folkways n' marketing, and towards providing real information to the public, the more likely we are to get a handle on costs.
ADDENDUM: This cracks me up: nofreelunch.org. Awesome. There is, indeed, no such thing as a free lunch.
Another update: Public hearing dates and emails, thanks to the Dept of Public Health:
January 9, 2009
9:00 AM
Henry I. Bowditch Public Health Council Room
250 Washington Street, Boston, MA 02108
January 12, 2009
1:00 PM
UMASS Medical School, Amphitheater I, 2nd Floor
55 Lake Avenue North, Worcester, MA 01655
Or comment to: Reg.Testimony@state.ma.us. They say: “Please submit electronic testimony as an attached Word document or as text within the body of an email and type “Pharma / Med Device Regulation” in the subject line. All submissions must include the sender’s full name and address. The Department will post all electronic testimony that complies with these instructions on its website.”
Everyone is always trying to get the “man”.
<
p>Pharma is in business to make money and everyone should know it. Hospitals are in business to make money as are Doctors, lawyers, judges and politicians.
<
p>Pharma is also very secretive about their products and even the therapeutic areas they are working on since the market is so competitive. I can’t understand why anyone would want to get in the way of all the great research Pharma does, as well as other medical research. Because of the investment and the risk these pharmaceutical companies have taken, people like me will live longer on drugs they have developed, surgeries based on medical equipment they have developed and techniques based on new research.
<
p>Why do we act so suspiciously of the same people who will be saving out lives?
Hopefully that helps.
what are you talking about? The health care saves lives so PhRMA can do what it wants?
a huge aging population is what’s killing our healthcare system, not drugs.
…and change a few other words in your post, back date it 6 months, and your wisdom and keen insight is well illustrated. Who needs regulation? All the suspicious “anti-business” people on this site need to get out of the way and let the “man” do what the “man” thinks is best.
We’re in a tough time with the economy and people in the administration are nervous. We placed a large investment in biotech and it’s a key building block to our recovery, they got nervous with PhRMA’s threat as dumped the plan as soon as they balked. I’ve said it before, but I’m very disappointed in that decision. There was an opportunity to reduce costs and address the conflict of interest issues and they walked away.
For pharmaceuticals to be successful, they need the backing of the top-tier physicians who speak at meetings, write papers, and generally drive standards of care. Harvard is probably the most important source of these docs. Payments for clinical trials and other pharma-related activities make up much or most of the take-home compensation for these doctors, sometimes reaching more than a millions dollars per year.
<
p>I can’t imagine that pharmas would risk the wrath of this top tier group that they desperately need. Business will continue, but the most embarrassing payments will drop somewhat.
<
p>Another note: while the behavior of pharmaceutical (and doctors) makers is sometimes not what we’d like it to be, pharmaceuticals make up only 10% or so of all medical spending in the US – and it’s probably the most cost-effective money that we spend here. Pharmaceuticals must actually be tested for safety and efficacy before being marketed – this is not true of most other practices in medicine.