Pharmaceutical firms’ long arms

Pharmaceutical firms, social security funds and doctors are all caught up in transactions outside the «institutional» framework, resulting in over-prescribing, a waste of public money, and worst of all, serious risks for the public. Ioannis Papadopoulos, associate professor of pharmacology at Athens University’s Medical School, spoke to Kathimerini about the issue. Are we talking about direct financial transactions between the firms and a sector of the medical community? Firms paying doctors a percentage of the sale of drugs prescribed to patients is fairly common. Particularly in the major social security funds, the phenomenon is extremely widespread, and the firms keep an eye on prescriptions arriving at pharmacies near the funds’ medical centers – naturally giving the pharmacists a cut – to check up on what particular doctors are actually prescribing. Rewards continue to arrive in the form of gifts, such as electrical appliances or trips to medical conferences abroad at luxury hotels; trips that individual doctors can rarely afford to attend. The influence of the pharmaceutical firms even extends to medical schools, with money being paid to students for events or excursions. What about the social security firms and hospitals? About 30 percent of the health budget is spent on medications and just 1 percent on preventive medicine. As a result, the funds, hospitals and health workers are turned into dealers, with the entire system affected. Doctors become writers of prescriptions rather than healers. Worst of all, they hand out prescriptions without giving the patient proper instructions. In a survey we made at a major public hospital in Athens, among patients prescribed antibiotics, we found that only in 2 percent of cases had the doctors given the proper instructions. Have you informed the authorities? The National Pharmaceutical Organization (EOF) is inadequate to the task and the ministry has turned a deaf ear. At present new drugs are being distributed to hospitals and social security funds by means of so-called «test research.» That is, a drug is given with the knowledge of the hospital management and the medical staff to test its efficacy. In such cases, the approval of EOF is required as well as the written agreement of the patients concerned. What actually happens is that no one bothers to inform the patient, who doesn’t know they are testing the drug. Moreover, instead of being paid for by the manufacturer, it is the hospital or fund that pays for it. That is, the patient pays to be a guinea pig.