Should Doctors Participate In DTC?

Saturday, February 16th 2008
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There’s no doubt that the Democratic Congress is coming after big pharma after all the money the pharmacuticals pumped into Republican coffers over the decade prior, especially as Part D came into existence.

Once Democrats seized the committee chairmanships on Capitol Hill, the big drug companies sharply aligned with Republicans knew a period of reckoning was coming.

Now it has begun.

“We generally expected that when the Democrats regained control of Congress, that they would closely scrutinize some of the industries that they believed had been particularly favored by the Republicans and unreasonably benefited in certain ways,” said Bret Koplow, a pharmaceutical industry lobbyist at Patton Boggs.

“There was the perception that certain industries, including pharmaceuticals, were getting away with a lot,” he said.

And one of their targets is direct-to-consumer advertising, recently concerning physician participation in DTC ads.

Dr. Robert Jarvik is best known for the artificial heart he pioneered more than a quarter-century ago. Since then he had toiled in relative obscurity — until he began appearing in television ads two years ago for the Pfizer cholesterol drug Lipitor.

A Congressional committee, concerned that the Lipitor ads could be misleading, has said it wants to interview Dr. Jarvik about his role as the drug’s pitchman.

Some of the questions may involve his credentials. Even though Dr. Jarvik holds a medical degree, for example, he is not a cardiologist and is not licensed to practice medicine. So what, critics ask, qualifies him to recommend Lipitor on television — even if, as he says in some of the ads, he takes the drug himself?

Look, I don’t in full believe Robert Jarvik when he says that,

“Our ad campaign with Pfizer is an educational [one],” he said. “Lipitor is the most widely prescribed drug in the country. For every prescription there is a doctor writing it. It’s a huge vote of confidence.”

But what the hell is congress frothing at the mouth over? And what are bioethicists whining about?

“To have a celebrity physician associated with cardiac health telling me I need Lipitor and when it costs significantly more than a generic alternative that might be appropriate for me— that’s a physician motivated by a paycheck, not by patient health,” said Katie Watson, of the Medical Humanities & Bioethics Program at Northwestern University.

True, Dr. Jarvik cannot practice medicine having completed no GME and holding no medical license in any state (although he does have many other skills and credentials). But that is inconsequential.

I continue to be a huge supporter of the extension of rights to corporations. Certainly when it comes to free speech and advertising. I imagine in public perception Pfizer is just some big faceless corporation, but there are people making these decisions at the top, there are shareholders, who as individuals have every right to put factual DTC advertising out there. I’m really incapable of drawing the distinction of why a right to free speech shouldn’t extend to a corporate entity. A corporate entity which doesn’t exist except for the people who comprise it.

This little PR campaign in congress against physicians in DTC advertising is part of a bigger campaign towards severely restricting or banning all DTC advertising (not to imply a conspiracy or cohesiveness to the movement, but merely a turning of physician and legislator opinion). And that ain’t right.