[Congressional Record Volume 152, Number 13 (Tuesday, February 7, 2006)]
[Extensions of Remarks]
[Pages E76-E77]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




   INTRODUCTION OF THE PRESCRIPTION DRUG SAFETY AND AFFORDABILITY ACT

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                       Tuesday, February 7, 2006

  Mr. STARK. Mr. Speaker, I rise today to introduce legislation that 
will bring some sanity back to prescription drug marketing, and help 
bring down the astronomical costs of prescription drugs. The 
Prescription Drug Safety and Affordability Act will force manufacturers 
to educate physicians instead of spending billions of dollars wining 
and dining them.
  As Congress begins to investigate its own ethics, we should also shed 
some light on the immoral relationships between the pharmaceutical 
industry and physicians. Golf trips and lavish meals aren't just for 
Members of Congress. Though its hard to imagine, physicians may 
actually get more lobbying perks from the drug industry than Members of 
Congress do.
  For far too long, the pharmaceutical industry has jeopardized patient 
safety and inflated prescription drug prices by using tax-deductible 
dollars to underwrite their so-called ``physician education'' efforts. 
According to a recent report in the Journal of the American Medical 
Association, JAMA, there is a clear conflict of interest when doctors 
become too cozy with pharmaceutical companies.
  Drug companies annually spend about $10,000 on every single physician 
in the United States trying to entice doctors to prescribe their drugs. 
That adds up to nearly $8 billion in annual spending by drug companies 
marketing their products to physicians. It is not unusual for doctors 
to receive lavish meals, all expense paid ``educational'' trips to posh 
resorts, and lucrative consulting deals from pharmaceutical 
manufacturers. Every single dollar spent on these unnecessary gifts is 
tax deductible for the drug industry as a general business expense.
  The Pharmaceutical Research and Manufacturers of America, PhRMA, 
pretended to discourage these improper marketing ploys by issuing 
conflict-of-interest guidelines in April 2002. After announcing the 
guidelines with fanfare, they then paid the American Medical 
Association to ``educate'' their members on these guidelines--that is, 
they gave doctors financial incentives to promote ethical guidelines 
that called for an end to financial incentives! It is obvious that 
PhRMA is not serious about ending the practice of giving financial 
incentives to doctors.
  Regardless of what PhRMA may say, the marketing tactics are still 
working. It is clear from the JAMA study that self-policing won't work. 
``Although physician groups, manufacturers, and the federal government 
have instituted self-regulation of marketing . . . current controls 
will not satisfactorily protect the interests of patients.''
  Doctors swayed to prescribe a certain drug because of their financial 
ties to drug companies put their own personal interest above the health 
and safety of their patients.
  This must stop now. My legislation will curb unnecessary spending 
physician gifts to the benefit of all patients.
  The Prescription Drug Safety and Affordability Act is a simple way to 
ensure pharmaceutical companies' behavior matches their rhetoric. This 
bill eliminates the tax-deduction that pharmaceutical companies 
currently receive for spending on physician gifts. The bill 
specifically exempts free drug samples, as that is often the only means 
by which uninsured patients can get medications.
  Unnecessary physician gifts from the drug industry unduly influence 
prescribing, increase drug prices and corporate profits, and endanger 
patients who get the wrong prescriptions for the wrong reasons. By 
removing incentives for pharmaceutical companies to lavish gifts of 
dubious public value on physicians, I hope

[[Page E77]]

that pharmaceutical companies will either redirect those funds toward 
research and development of lifesaving drugs or reduce the prices of 
prescription drugs for seniors and all Americans.
  The American Medical Student Association has endorsed the 
Prescription Drug Safety and Affordability Act. This group of future 
doctors--not yet beholden to the drug industry--recognizes the 
importance of this bill and the problems physician gifts cause in the 
doctor-patient relationship. I am pleased to submit their attached 
letter of support for inclusion in the Congressional Record.
  I urge my colleagues to join me in support of the Prescription Drug 
Safety and Affordability Act. Prohibiting the drug industry from 
lavishing unnecessary gifts on physicians is a nonpartisan issue that 
should receive bipartisan support. If we can clean up Congress there is 
no reason we shouldn't clean up health care. It is time to stop using 
taxpayer dollars to fund marketing campaigns that put profits above 
patients.
                                          American Medical Student


                                       Association Foundation,

                                     Reston, VA, February 1, 2006.
     Hon. Pete Stark,
     House of Representatives, Cannon House Office Building, 
         Washington, DC.
       Dear Representative Stark: On behalf of the 60,000 
     physician-in-training members of the American Medical Student 
     Association (AMSA), we would like to offer our strong support 
     for the Prescription Drug Safety and Affordability Act. The 
     impact of pharmaceutical marketing on the professional 
     behavior of physicians is very concerning to the future 
     physicians of America. AMSA has long advocated for physicians 
     to protect their independence from the pharmaceutical 
     industry.
       We applaud the Prescription Drug Safety and Affordability 
     Act as a way to reduce the financial incentives for promoting 
     drugs. The pharmaceutical companies spent $7.3 billion on 
     detailing to doctors in 2004, more than twice what was spent 
     in 1997. These gifts to physicians contribute to the high 
     cost of medications for our patients. Taxpayers should not 
     further subsidize this behavior through the deductibility of 
     drug company promotions to physicians.
       Gifts from the pharmaceutical industry have an eroding 
     effect on the doctor-patient relationship. Numerous studies 
     have documented how those gifts influence the prescribing 
     behavior of physicians, often in ways that deviate from the 
     recommended treatment guidelines. However, the most obvious 
     evidence that gifts influence physicians in the fact that 
     drug companies would not spend billions of dollars on pens, 
     meals and honorarium if it didn't work.
       Since 2002 AMSA has been entirely independent of funding 
     from drug companies in our meetings and publications, and we 
     have called for other physician groups to follow our lead. 
     Last month the Journal of the American Medical Association 
     published recommendations from leading academicians that 
     academic medical centers--where physicians are trained--
     should be entirely free of pharmaceutical representatives, 
     industry sponsored meals and free samples. We applaud the 
     institutions of medical education for taking this step.
       AMSA's PharmFree Campaign (www.amsa.org/prof/pharmfree.cfm) 
     has been cited in major medical journals, making AMSA a 
     leader in removing the pharmaceutical companies' influence in 
     the practice of medicine. In 2005, AMSA launched the 
     Counterdetailing Campaign where medical students teach 
     physicians to use non-biased sources of information about 
     prescription drugs. Time magazine and USA Today have featured 
     AMSA and our Counterdetailing Campaign. Through AMSA, medical 
     students continue to lead the drive to protect the doctor-
     patient relationship from outside influences.
       The Prescription Drug Safety and Affordability Act will 
     remove the unhealthy influence of the drug industry from the 
     practice of medicine. AMSA is proud to support your efforts 
     and leadership in this issue. If we can help in any way, 
     please contact Chris McCoy, Legislative Affairs Director at 
     703-620-6600 x 211.
           Sincerely,
     Leana S. Wen,
       National President.
     Christopher P. McCoy,
       Legislative Affairs Director.

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