Page images
PDF
EPUB

The general assumption of the industry appeared to be that physicians should be able to protect their own interests and the interests of the public could be left to such agencies as the Food and Drug Administration and the Federal Trade Commission. It was also argued that the medical directors of the pharmaceutical firms could provide adequate medical supervision of promotional material, Privately, medical directors have indicated that their judgments are frequently disregarded in the development and dissemination of promotional material,

By the spring of 1959, it became evident that the Council must find better means of reaching a position of influence and effectiveness. It was decided to discontinue the Insigne program and the consultative service on promotional educational material, and to devote the resources and energies of the Council to other approaches to its objectives.

As the Council was made up of medical educators it seemed natural to redirect efforts at reaching the educators and through them to create an awareness of the problems and a determination to increase professional influence in matters of health education,

It did not seem to the Physicians' Council that educators are adequately concerned about the drift of influence over the habits and beliefs of physicians into the hands of promoters of drugs and health products. Accordingly a study was conceived to gain objective evidence of the relative impact of the traditional sources of medical education (medical schools and societies) compared to the effect of promotional campaigns of industry, as far as current information and practices of physicians are concerned. Arrangements have been made to conduct such a deady under joint sponsorship of the Physicians' Council and the Bureau of

plied Social Research of Columbia University. A preliminary study is now derway and a grant application to extend it has been submitted to the tional Institutes of Health.

We have been concerned, as medical educators, with the vast resources ailable for promotion by the pharmaceutical industry in contrast to those ailable to the medical schools. It is estimated that the expenditure for omotion is nearly four times that for the medical schools annually. In dition, it is well to consider that the medical school experience is of years' duration; the promotional campaigns go on over the lifetime of a ysicians' practice.

A defense of the laissez-faire attitude by manufacturers is that 11 educated physicians will not be influenced by misleading advertising. is would seem feeble justification for purveying misleading literature. I is to the credit of physicians, however, that their sensibilities have en sufficiently offended by the lack of good taste, judgment and accuracy the barrage of promotional material directed at them, that they increasingly ve been protesting these transgressions.

In a democratic society, when practices develop which undermine the blic health and established institutions such as professional education this instance medical education - society through its governing bodies stomarily sets limits on such practices when voluntary restraint has not en effective. The members of the Physicians' Council, having explored ery possible alternative in an effort to improve the standards of promotion pharmaceutical products on a voluntary basis, has reluctantly concluded Lat legislation is necessary in the public interest. The provisions in etion 4, Part (7) of 8.1552 represent a satisfactory approach to this

problem in our opinion.

In a recent publication* by the Professional Relations Committee of the Pharmaceutical Manufacturers Association it is stated that, "One very important aspect of the work of the P.M.A., which, incidentally is in part a trade association and in part a professional association, is the avoidance of any act which could be considered illegal." Since appeals to moral and ethical standards have not been effective, the only course available would seem to be in the enactment of legislation which would assure minimum standards in the promotion of drugs to physicians,

*The Pharmaceutical Industry. J. Med. Education 36:24, Jan. 1961

STATEMENT ON SENATE BILL S1552

TESTIMONY OF DR. MARTIN CHERKASKY,
DIRECTOR, MONTEFIORE HOSPITAL

FRIDAY, JULY 21, 1961

I appear before you today on my own behalf as Director of Montefiore Hospital in New York City and on behalf of the Greater New York Hospital Association in vigorous support of Senate Bill S1552.

Montefiore Hospital is one of the large teaching hospitals in the city. We have 665 beds rendering treatment in all major clinical areas with the exception of obstetrics, In 1960, over 220,000 days of care were given to

12,000 patients. Last year, we received more than $1,200,000 from the Federal Government in research grants. Currently, over 160 young physicians as interns and residents are participants in our active medical education program. In addition, 30,000 persons in the community receive their total medical care on a prepaid basis from the Montefiore Medical Group, a group practice unit owned and operated by the hospital and affiliated with the Health Insurance Plan of Greater New York.

The Greater New York Hospital Association represents 82 non-profit voluntary hospitals, 14 non-profit voluntary homes and 22 municipal centers for a total of approximately 51,000 beds. The annual operating expenses for just the 82 non-profit voluntary hospitals in 1960 was $257,000,000. This group of hospitals and homes represented by the Greater New York Hospital Association is the largest individual group of hospitals, city-wide, in the country.

The extensive hearings held by this committee last year, the many articles in lay and professional journals, all have confirmed what many of us in the medical profession have known for years

[ocr errors]

that there are grave defects

in the whole system of the manufacture, promotion and distribution of ethical irugs. I think it is only fair for me to tell you what I as a physician, as a hospital administrator and as one deeply concerned with the overall problem of

of medical care would like to see happen in the field of prescription drugs. First of all whatever regulation we institute must encourage the kind of sound research and development we desperately need to devise the cures for the many serious disease problems which plague us.

I would like to feel secure for our hospitals and all of our doctors that when a drug is ordered, it will be of the quality, purity, potency and safety that it is purported to be.

I would like to make certain that our harassed and overburdened physicians are not confounded and confused by the conflicting claims, the myriad of names and the ever present pressure of the pharmaceutical competition for the doctor's brain and prescription pad.

I would like to see drug costs brought down to a reasonable level with reasonable profits for the manufacturer and dispensing pharmacist..not only to curb exaggerated costs but to prepare for tomorrow when new developments and inflationary trends will make all drug and medical care costs go up. This will further strain the already tried, voluntary hospital and medical care insurance programs as well as the ability of the individual citizen to meet doctor, drug, and hospital bills from his own resources.

The conditions that pertain to the ethical drugs at present do not satisfy the reasonable goals I have indicated. Bill S1552 goes a long way toward correcting the defects and creating a climate which will secure the public, emancipate the doctor and get the pharmaceutical industry back on the track. The legislation will help do this in the following ways:

[ocr errors][ocr errors]
« PreviousContinue »