The article Efforts to Undermine Public Health: Health Advocacy Organizations and the Pharmaceutical Industry: An Analysis of Disclosure Practices in the Jan.13 issue of American Journal of Public Health focuses some much-needed attention on a serious and growing problem , which directly impacts the creation of rational health policy. It’s also good to see the wide media attention being given to the study, which has been flagged by venues across the spectrum, including healthcare sector analysis and investigative reporting blogs to mainstream business media and news reports.
It’s been interesting too,but not surprising to see, that a number of people are also sending identical comments to multiple venues which covered the story, some to decry the findings of the study, or to make off-topic remarks. The comments from the National Health Council , for example emphasized that it has a policy of requiring member groups to have internal disclosure policies regarding industry support received. The NHC itself has a listing of funding received in 2009 from its many “Corporate Partners.” However, just like with payments to physicians, merely acknowledging industry funding doesn’t mean that it does not influence the actions of the recipient, nor not create conflicts of interest. Unlike the significant body of research on the topic of influences on the prescribing practices of doctors (which have found that while many state that they themselves are not influenced by pharma gifts and perks, they believe that their colleagues are) , much less attention has been paid in the US to the phenomenon of industry support of HAGs and its impact on public policy.
Based on personal observations both as patient and a healthcare professional , I believe that the “don’t bite the hand that feeds you” phenomenon relating to HAGs, contributes to the present inaction on getting states and federal government to do something about the exorbitant and escalating price of medicines as a public health measure. Until the electorate actively protests what is going on, the lobbying power of the biopharma industry on Congress will remain in effect. While it is becoming more common to find media pieces highlighting complaints by provider and disease groups about the price of Rx drugs, along with the unaffordable co-pays for those insured, almost never do we hear patient advocacy groups demand that something be done about the situation. The only logical conclusions that seemingly can be made about the scenario is either that the public is incredibility naive about how the pharmaceutical and insurance industries function, or else HAGs have been so influenced by their pharma benefactors that recipients actually believe that the prices are justified by R & D costs, and that patient assistance programs ( PAPs) are a genuine access solution. Likely it’s some combination of factors. More about this later.
Since a requirement that HAGs disclose industry funding was dropped from Sunshine Act provisions incorporated in the ACA, it’s time start to address the problem by pressing the IRS to require that all 501(c)3 charities disclose their funders and amounts received from each. At the same time, much more public education is needed about “the ties that bind”, to paraphrase the title of a 1999 report on the topic by Health Action International.
In the meantime, those interested in starting to research industry links to patient and disease groups will find the following resources of independent organizations helpful:
Knowledge Ecology International
Medical professional and patient group funding by drug and medical device companies