Improper dealings between drug firms and doctors criticized

Senior Health Ministry officials told the Knesset State Control Committee on Monday the ministry will tighten supervision and even consider prohibiting entry into hospitals by pharmaceutical representatives.

Testimony followed last week’s exposé by Channel 10’s Raviv Drucker that showed drug company lobbyists “rewarded” hospital and community health fund doctors with gifts and trips abroad when they prescribed their drugs, and “punished” those who gave patients drugs from competing companies.

“I have not received a good answer from any of the speakers why we should not completely forbid the entry of propagandists into the hospitals,” said committee chairman MK Shelly Yacimovich of the Zionist Union.

“We are committed to correcting the deficiencies... to prevent this phenomenon, and new regulations will be issued before the end of this year,” said ministry director-general Moshe Bar Siman Tov. “We view the findings of the investigation with seriousness. They also disclosed a severe violation of trust between the patient and the doctor. We require reporting by companies that donate to medical institutions. But the problem is that the donors’ names are given but not the doctors who receive donations.”

He added that existing regulations are incomplete because they apply only to government hospitals and those owned by Clalit Health Services and not to other hospitals or to community health fund clinics.”

Regarding the entry of workers into medical institutions, Bar Siman Tov said, “It is clear that we need to create the right balance, since those bodies contribute to the medical institutions to carry out medical research, and we do not want to harm these donations. We struggle with the question of whether we should go a step further, not to prohibit contact between a pharmaceutical lobbyist and a physician, but at least to set rules for the manner in which their meetings are held.”

Ethical rules agreed upon four years ago stipulate, “The doctor will not accept, and the pharmaceutical company will not give, any personal benefit, except for gifts of marginal value only.”

“There is no need for physicians to receive information on medications from the pharmaceutical companies,” said Prof. Jonathan Halevy, director-general of Shaare Zedek Medical Center in Jerusalem and four-time chairman of the health basket committee. “I support the ban on the entry of drug company lobbyists into hospitals.”

Drucker said his investigation exposed relations between the pharmaceutical companies and doctors. “We discovered many documents showing how the lobbyists manage doctors’ profiles, what they prescribed and how they got each doctor to cooperate.” Maybe one in 100 doctors is not in contact with the lobbyists, he added. “Not all are corrupt, but it the norm that the lobbyists come into the hospital and clinic when they want, on the doctors’ time, and are given access to the pharmacists’ computer as if it were theirs.”

Yacimovich added: “We saw on the program the symbiotic relationship between the companies and the doctors. The lobbyists meet with doctors, receive medical information about nurses and reduce consumption and registration of drugs. The conduct we were exposed to in the investigation borders on bribery. If a doctor changes the registration of a drug in return for being sent to medical conferences abroad at the company’s expense or meals at a fancy restaurant, it is a betrayal of the patients’ trust and a criminal offense. The excuse that doctors need to keep up with the information about the drugs by consulting with lobbyists is ridiculous and unacceptable. It does not make sense that the source of the doctors’ information will be through representatives of companies with business interests.”

Dr. Yitzhak Papo, a surgeon, said: “What we saw on the show was the tip of the iceberg, because the reason for not enforcing the procedures is that there are too many interested parties who want to continue the situation. There should be real regulation with sanctions.”

The committee chairman asked for practical proposals to change the situation to be presented at the committee’s next meeting.