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Scott Gottlieb, M.D.
Medical treatments are becoming
increasingly more individual, with respect to both disease and patient.
They are also becoming more complex, and precise diagnoses and close
monitoring are needed to optimise their use. In this environment,
consumers and doctors need to work more closely with product
developers. Yet increasing regulation of the drug industry is
restricting its ability to disseminate the results of its clinical
studies. This risks shrinking the opportunities patients have to
improve their health. In the face of regulatory steps to restrain their
scientific speech, drug makers need to take new steps in their
relationship with doctors and patients and establish transparent
guidelines for those interactions. They should also focus more squarely
on matters of advancing science, monitoring for safety, and improving
Science not marketing
The existing mistrust means
A large part of the industry’s current problems stems from the way
its relationship with academic physicians and medical institutions has
evolved over the past few decades. Formerly, the industry depended on
academic doctors to conduct basic and clinical research. Now more of
that work is done in house. As a consequence, the relationships
forged with the academic medical community are often based on marketing
related activities. This feeds the regrettable perception that drug
makers ally themselves with medical thought leaders to advance
marketing goals, not science, and that information they generate cannot
Relationships should be predicated on genuine scientific work. This
doesn’t mean that drug makers should stop engaging leading physicians
to help companies generate and share information about new advances,
but that they need to engage with doctors who had a role in discovering
those advances rather than those with no or little link to the
underlying science. The latter creates the unfortunate appearance that
opinions are being rented; the former is unassailable, as a scientist
is the most appropriate champion for his work.
As patients are taking an increasingly active role in treatment
decisions drug companies need to take new steps to improve health
literacy and patient education while they continue to invest in better
ways to monitor the performance and safety of their products.
Unfortunately, the existing mistrust means that policy makers continue
to create restrictions that impede the ability of drug companies to
speak to patients. This creates information asymmetry and denies
patients the opportunity to receive truthful, non-misleading
information about new products, thus hurting health outcomes.  It
also leads to a regulatory edifice that makes it harder for drug
companies to monitor the performance of their drugs by talking directly
with patients and makes it harder for them to provide targeted
information to patients on proper use of prescription drugs. The bottom
line remains that the drug firms remain one of the few actors in this
marketplace with the financing and incentives to share and collect
information. Under proper regulation, public health imperatives should
compel us to make better use of these resources on behalf of patients.
Scott Gottlieb, M.D., is a resident fellow at AEI.
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