In response to
reader comments on Joseph Conn's "
Data-miners unite in Maine to block 'opt-out' Rx law":
I read with interest Narayanachar Murali's response to my piece on prescriber profiling. I was pleased that I was able to inform him about the American Medical Association's
Physician Data Restriction Program, but dismayed with the remainder of his comments about the allegedly "nefarious" activities of the pharmaceutical industry.
I encourage physicians to be mindful that they are doctors of medicine. Without medicine, the physician's therapeutic capabilities would be devastated.
The pharmaceutical industry has saved, prolonged and enhanced the quality of more lives than perhaps any other. To categorize its activities as "nefarious" strikes me as a tragic example of the rift between the pharmaceutical industry and the medical profession, which must be healed for the sake of the patient above all.
I was extremely disappointed that Murali, as a member of a profession extremely and justifiably critical of the trial bar, expressed litigious sentiments toward his national professional association. He should be aware that the AMA has not and does not make prescription data available to the industry, and that it has no control over commercial provision of such information. In fact, the AMA's database licensing activities generate non dues revenue that enable it to accomplish its mission while keeping Murali's dues at an affordable rate.
I was further disappointed in his perspective on pharmaceutical price controls and regulations. Free markets spur the innovation that have transformed medical care and made the U.S. the engine of growth for the worldwide pharmaceutical industry, making it one of the few American industries that has thrived in a global marketplace, unlike the automobile industry and other formerly dominant American businesses. The industry is already perhaps the most regulated in the world, first and foremost by the Food and Drug Administration. There is no shortage of pressure on prices—from generics, managed care, government programs such as Medicaid, and the media.
Some prescription drugs cost more in the U.S. than elsewhere, but not for long in most cases. The limited patent life of pharmaceutical products results in commoditization via genericization after just a few years of single-source availability. As time goes by, more and more staples of the formulary will be available for $4 at Wal-Mart. In addition, prescription prices must be considered within the context of wages. European drug prices may be lower, but so are gastroenterologists' incomes. Also, numerous programs are available from the pharmaceutical industry, government and other sources to provide prescription drugs to those who cannot afford them at low or no cost.
Murali prescribes "iron-fist" regulation of the pharmaceutical market; my second opinion is the "invisible hand" of the market, which has guided our nation to worldwide economic pre-eminence.
Terry Nugent
Vice president of marketing
Medical Marketing Service
Wood Dale, Ill.
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