[Congressional Record (Bound Edition), Volume 148 (2002), Part 14]
[Extensions of Remarks]
[Pages 20203-20204]
[From the U.S. Government Publishing Office, www.gpo.gov]


   GIFTS FROM PRESCRIPTION DRUG MANUFACTURERS? GOOD FOR PATIENTS--OR 
                           CROSSING THE LINE?

                                 ______
                                 

                           HON. DOUG BEREUTER

                              of nebraska

                    in the house of representatives

                       Wednesday, October 9, 2002

  Mr. BEREUTER. Mr. Speaker, this Member wishes to commend to his 
colleagues an editorial from the October 5, 2002, edition of the Omaha 
World Herald, entitled ``Plug the Flow of `Incentives' '' Gifts from 
drug companies do influence when and how much medicine is prescribed. 
This Member recognizes that physician-pharmaceutical interaction can 
produce some positive results, such as improved knowledge of treatment 
for complicated illnesses. However, interaction can also result in 
negative outcomes, such as increasing prescriptions for promoted drugs, 
while fewer generics are prescribed at no demonstrated advantage.
  As we consider adding a prescription drug benefit to the Medicare 
program and begin to examine ways to control prescription drug costs in 
the Medicaid program, it seems to me, that we need to ask the following 
questions:
  Are consumers obtaining good value for the resources expended on new 
pharmaceuticals?
  Are new prescription drugs on the market better, safer, and more 
effective than older drugs that have been on the market for quite some 
time?
  Does the Government have a role in determining more than simply the 
safety of new and established drugs?
  If so, does that role include evaluating clinical efficacy, 
convenience, and cost-effectiveness compared to current products?

                    Plug the Flow of ``Incentives''

       Pharmaceutical manufacturers have long realized that 
     doctors are key to the health of their bottom lines. Now, 
     using words like ``fraud,'' the federal government has 
     indicated it will try to shut off the flood of goodies that 
     drug makers pour over the decision-makers who are in a 
     position to prescribed their products.
       Financial incentives to doctors, pharmacists or similar 
     health care professionals given to induce them to prescribe 
     or recommend particular drugs or to switch patients from one 
     drug to another are common in the industry. But the practice 
     could break federal fraud and abuse laws, according to 
     officials at the Department of Health and Human Services. The 
     department is planning to set standards that would ban such 
     ``incentives'' for a wide range of medical, insurance

[[Page 20204]]

     and pharmacy workers who make drug decisions.
       The most notable underlying problem is the high cost of 
     many of the brand-name drugs that are pushed hardest by the 
     drug companies. These drugs, many of them with equally 
     effective, cheaper alternatives, are profit centers for 
     pharmaceutical companies. That means the companies are happy 
     to shell out for weekend trips, expensive meals or other 
     ``incentives'' for prescribing or switching patients to the 
     designated medication.
       Doctors, pharmacy benefit managers and others who please 
     the companies can be hired as do-little ``consultants'' to 
     the manufacturers, sometimes for outrageously high pay.
       The new standards aren't, in themselves, laws. Companies 
     that don't follow them, however, fact investigation under 
     federal fraud and kickback statutes, a Health and Human 
     Services official warned. A voluntary code of conduct adopted 
     last spring by the industry apparently didn't go far enough.
       Prescription costs are rising steadily. No reasonable 
     person would deny the industry a fair profit. But some of the 
     practices revealed by Health and Human Services are shifty, 
     deceptive and just plain unethical. We're glad to see the 
     feds trying to put a stop to what amounts to bribery of 
     medical decision-makers.

     

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