Statement of Dr. Maxwell Finland, Associate Professor of Medicine, Harvard Medical School, Boston, Mass. Prepared for presentation before the Subcommittee on Antitrust and Mr. Chairman and Members of the Committee. My name is Maxwell Finland. I am a full-time physician at the Boston City Hospital where I hold the title of Physician-in-Chief of the Fourth Medical Service and Associate Director of the Thorndike Memorial Laboratory. These are units of the hospital for patient care, teaching and clinical investigation; they are part of the Department of Medicine of the Harvard Medical School where I hold the title of Associate Professor of Medicine. My particular investigative interests throughout nearly all of my professional career have been in the field of infectious diseases and their management. Since the introduction of antimicrobial drugs and antibiotics most of my investigative activities have been concerned with the study and use of these agents. As a physician I am concerned with acquiring information about the best and most up to date methods, including antibiotics and drugs, for use in the best interest of patients. As a teacher it is my duty to transmit such information to students and to other physicians, and to instruct them in their application for the benefit of their patients. As an investigator I have been concerned with determining the activity and evaluating the efficacy of new therapeutic agents and the optimum methods of employing them to increase the scope and effectiveness of the treatment of patients. Last September I appeared before this committee at your request and expressed my convictions, which I think are shared by most authorities in this field, at least in this country, concerning the use of antibiotics in fixed combinations. I also presented some personal views concerning the evaluation of new drugs and offered suggestions of some mechanisms whereby unbiased and reliable evaluations might be made of data presented to support claims of efficacy and safety of drugs and whereby the most reliable data could be gathered that would be useful to assist the FDA in its decisions on New Drug Applications. My present appearance before this committee is again in response to your request and invitation to present my views and comments on possible medical implications of some of the provisions of Senate Bill S. 1552, which deals with the manufacture and distribution of drugs intended for prescription by physicians. I would like to preface my comments on the provisions of the bill in question with a few general remarks which may serve as background to explain my attitudes and convictions concerning some of its provisions. First of all, I believe in our free enterprise system which offers adequate rewards for productivity and inventiveness and for unusual risks. However, I also believe that all industry has certain social responsibilities in addition to providing profits to investors, and that when unusual profits are achieved in a manner that is not in the public welfare that remedial legislation is called for. I agree with the chairman that the drug industry is in a somewhat unique position and that its social responsibility is greater than that of many if not most others. I am also of the opinion that the great majority of our leading manufacturers, particularly those who have been in the drug industry for many years, have recognized and tried to discharge their responsibility in the general interest to varying degrees. They have strived to maintain high standards in the products they manufacture and tried to produce better ones and improve their old ones. They have, in general, been honest in promoting their products and have tried promptly to verify and to keep physicians informed about difficulties encountered with their products. They have sought advice from the best available sources and usually have acted on such advice. Unfortunately there have been some who have not always been responsive to justifiable criticism. They have often been selective in the choice of data and advice which they accept and transmit or act on, and often bypass or ignore those who might give them honest, reliable and unbiased opinions that might be unfavorable to them. When they persist in ignoring such opinions they have at times put those advisors in the awkward position of having to go out of their way to point out these errors, sometimes at great sacrifice to their own greater and more fundamental interests which they feel might be more productive. More unfortunately, in recent years, as the opportunity for profits has increased and the competition has intensified, even some of the older and respected members of the industry have relaxed arme of their standards. Regardless of who the culprits are, all of them protest that the objectionable practices have been forced upon them by the actions of their competitors. That being the case, those who are genuinely concerned should certainly be pleased to have these practices scrutinized and should welcome any restrictions which would tend to correct them, and those who are responsible merely deserve to have the remedies forced on them. It is to be expected that some of the restrictions will not be very palatable, but since the members of the industry were unwilling or unable to hold their own members within the bounds which they know to be proper, some outside influence was inevitable. In this sense I presume that the bill under consider |