For the pharmaceutical industry to be accused of less-than-ethical behavior is nothing new. Pharmaceutical manufacturers are businesses that, like any other company, are motivated by profits and competition. A successful drug can become a multi-billion dollar seller, and pharmaceutical companies have been known to use nefarious means to push their products. One need only look in the news to find numerous examples of pharmaceutical companies committing instances of health care fraud or withholding information about a drug’s dangerous side effects. Now, we can observe a new development in what pharmaceutical companies withhold: not just information about potentially dangerous drugs, but also information about potentially dangerous physicians.
With the average American visiting pharmacies to fill 12 prescriptions a year, the number of prescription drugs that we take is staggering. And our physicians are not always competently prescribing those drugs. Purdue Pharma, which is best known as the producer of the painkiller OxyContin, has recently been the center of controversy due to its hesitancy to release a list of 1,800 potentially rogue physicians. The list is comprised of the names of physicians that Purdue has identified as potential overprescribers of OxyContin. Though Purdue has come under pressure to release its entire database, it thus far has divulged only 8 percent of its names.
One would hope that Purdue and other pharmaceutical companies would be ethically guided by their prominent role in our health care system. These companies may be primarily driven by profits, but it is impossible to ignore that their products affect millions of people across the country. Prescription drugs, when used correctly, have the ability to reduce pain and enable a longer and healthier life. On the other hand, the same drugs can have devastating side effects if used incorrectly. Some drugs, such as OxyContin, may lead to addiction. A basic sense of morality, then, should prompt companies like Purdue Pharma to release the names of doctors who may be using their drugs in ways that are not necessarily beneficial. Sadly, Purdue Pharma seems to be neglecting its ethical responsibilities.
Purdue says that it has no business regulating doctors — a reasonable policy since its job is to produce drugs, not directly control how those drugs are used. Physicians themselves must ultimately make judgment calls on which situations most require the prescription of particular drugs. That being said, if Purdue has reason to suspect that some physicians are abusing the prescription of their product, they need to divulge that information. Patients have the right to know if their doctor is not acting in their best interests by prescribing unnecessary narcotics. Additionally, doctors who are prescribing OxyContin for non-medical reasons should face the proper consequences. Pharmaceutical companies do not have to directly regulate doctors. But they should use any information that they have already collected to help relevant organizations maintain a proper standard of conduct for physicians.
If Purdue Pharma does not release the names of the doctors who are suspected of overprescribing, then governing bodies would be right to take action. To start, more medical boards should put pressure on the company to divulge the names of the physicians practicing in each board’s respective state. Though some agencies, such as the California Medical Board, have not been able to acquire physician names, the Nevada Board of Medical Examiners has successfully received a list of suspected overprescribers. It is thus possible that Purdue will begin releasing more names if it is put under sufficient pressure. If, however, medical boards are not successful, then state legislatures should place pressure on Purdue (California’s is already doing this).
To be fair, not every physician on Purdue Pharma’s list may be a definite overprescriber of OxyContin. Physicians’ reasons for prescribing OxyContin are varied and depend on their patients. Perhaps a doctor sees an abnormally high number of patients with severe pain or helps to treat patients with cancer. For both those groups, OxyContin can greatly improve a patient’s quality of life. Thus, Purdue’s releasing their list should not be encouraged to spur a witch hunt against those doctors who appear on it. Rather, releasing those names should be promoted because it is a step towards greater transparency in the healthcare system. The doctors whose names have been flagged could be investigated and either cleared of wrongdoing or rightly indicted for overprescribing. Either way, the public would gain more information regarding the physicians’ practices.
Indeed, transparency in our health care system is more necessary now than ever before. The cost of American health care is ridiculous: we spend more on health care than any other comparable nation. Doctors who overprescribe medications are part of that problem, because they act contrary to both a patient’s medical and financial interests every time they recommend an unnecessary treatment or drug. Overall, pressure should be placed on all pharmaceutical companies — not just Purdue Pharma — to release information about overprescribers of various different kinds of drugs, even if those drugs are not as dangerous or addictive as OxyContin.
Alex Yahanda is a senior associate editor for The Cavalier Daily. His columns run Wednesdays online and Thursdays in print.
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