According to a report in the The Wall Street Journal yesterday, the drug industry is gearing up to fight a provision in the stimulus bill. The provision will spend $1.1 billion on research that compares medical treatments on effectiveness and cost, also known as comparative effectiveness.
Since the 90s, the federal government has allowed pharmaceutical companies to dominate drug information to consumers by allowing direct-to-consumer advertising and generally loosening FDA regulations on the boundaries about what pharma companies can say to consumers. At the same time the federal government rarely funded any research that compared one drug to another. To no ones surprise, given the pharmaceutical industry's obligation to generate profits, the industry rarely funded comparison studies and when they did the comparisons did not treat less expensive but similar drugs fairly (or if they did they only published results favoring their products). Now the federal government proposes to level the playing field by funding studies that give consumers an answer to a question they ask every day, "how does this product compare to a similar product?" Anyone selling a product wants consumers to believe their product is one of a kind, deserving of whatever price they want to charge for it.
Doing a good job of comparing drugs, devices, and health services will cost many millions of dollars and be constantly criticized by health companies who sell them. The funding provided in the stimulus package would allow the federal government to organize neutral, credible efforts that would inform consumers. An opportunity would be created for some of the country's best and brightest researchers to work without the oppressive industry manipulation so common now in drug research. Buyers and sellers would need to approach each other differently—more like a truly competitive market where both have access to the same information and the information is trustworthy. Hopefully some in the industry will realize that a fair market is preferable to one in which one company after another announces billion dollar settlements for deceptive marketing on a weekly basis.
We should prepare ourselves for a nasty debate. Like the financial services industry, the pharmaceutical industry is used to having its way with the federal government. Consumers should be wary of the snake oil arguments the industry makes. When it comes to the pharmaceutical industry we should all recall good advice provided in another era by a Washington insider, "Follow the money."
—John Santa, M.D., M.P.H., director, Consumer Reports Health Ratings Center
Read Dr. Santa's blog on the financial relationships between doctors and the pharmaceutical industry.