美國麻州的州參議會議員(Massachusetts State Senator )THERESE MURRAY最近提出一項法案,禁止藥廠贈送任何禮物給醫生。
長久以來,藥廠為了促銷推廣他們的藥,或搏得醫生們的好感,常常會送一些小禮物給醫生,包括印有藥名的筆、杯子、便利貼等等。這些小東西通常不是很貴重,但是難免還是有利益衝突的爭議。畢竟醫生有可能無意間受到這些禮物的影響,改變開藥的習慣。而醫生開藥應該基於病患的最佳利益,不該受藥廠的影響。
麻州議員THERESE MURRAY的提案讓人想到1999年Dr. Goodman等人推動的No free lunch活動。該活動鼓勵醫師拒絕藥廠的贈與,不論贈與的大小。另一方面,在藥廠這一頭,從今年一月一日起,已經有藥廠自願主動自我限制小禮物的發送,但是這種作法被部份人批評為沽名釣譽,因為他們雖不送小禮物,仍可能熱衷於利用其他手段影響醫師的開藥習慣。
也有人把藥廠送的小禮物當作一種收藏,例如加州的一位心臟科醫師Dr. Jeffrey F. Caren就把他收藏超過1200支的筆展示在他的診間。
(圖片出自這裡。)
如果THERESE MURRAY的法案通過,這些藥廠送醫生小禮物的習慣都將成為絕響。相關禮品業的損失可能會高達10億美元。而現有的收藏可能變成網拍網站上的搶手貨。
延伸閱讀:
Ban on gifts to doctors sought
No Mug? Drug Makers Cut Out Goodies for Doctors
Group Urges Ban on Medical Giveaways
For your info, Therese Murray is not a US Senator. She is only a Massachusetts State Senator representing the District of Plymouth. Her bill is part of an ill-conceived attempt at containing the escalating costs of health care in this state. It is based on her assumption that by accepting a pen, a postit pad, or a mug from a drug company, a physician is obliged to change his/her prescribing habits. This is pretty far-fetched already. And the second part, that this is the reason why the increase in expenditure for more expensive medicines, can only be described as being deranged. Physicians have no control over the pricing of the drugs. Worse, under the new law, not even the little samples of drugs, which we give to poor patients, are allowed. Instead, an application to the drug company on behalf of the patient is required even if the medicine is needed pronto.
The real reason for the high health care cost in this state lies elsewhere.
Eyedoc,
謝謝您的回應與指正,很抱歉我沒弄清楚Therese Murray是州參議員不是聯邦參議員。我已經修正。
您同時也指出了幾個重點,我深表贊成。首先,就算醫生接受藥廠的小禮物在某些人眼中具有一點道德上的爭議,但是,對大部分醫生來說,開什麼藥還是根據病患的病情需求而決定,一支筆或一個馬克杯並不會影響醫生處方的習慣。病患並不必對此太過擔心。
更重要的,當前醫療費用高漲的原因很多,想要用限制藥廠送醫生小禮物來限制醫藥費用,根本是緣木求魚。Therese Murray的法案中還有一些限制,例如醫生不可以把藥廠提供的免費藥物樣品提供給病人,有時反而只會損害病人的利益。
在台灣,也有很多個人或團體認為醫界有許多弊端,想要予以糾正。但是部份個人或團體的認知並不完整而失之偏頗,想出來的解決方法不但不能解決醫界的弊端,甚至製造更多問題。
That No Free Lunch Bill does sound crazy. Talk about solving the wrong problem! However, I think pharmaceutical companies should stop giving away pens and useless trinkets. Most of them go straight to the garbage can anyway. What a waste of resource (19 billion of it).
Great site.
You may be interested to know the new Massachusetts law has an unintended effect: Several groups have now canceled or re-considering meetings to be held in Boston, including the American Academy of Allergy, Asthma and Immunology, American Society of Gene Therapy, and the Heart Rhythm Society – because of the possible ban on reports by drug company scientists at the meetings (which can be regarded as advertisements, hence illegal).
Boston hosted 2,500 medical meetings in 2007-8. This new law will cause a huge financial loss to local businesses.
[…] 二月 9, 2009 由 misterclu 長久以來,醫生們常有機會參加藥廠舉辦的研討會,享用藥廠提供的餐點、接受藥廠贈送的小禮物,例如原子筆、便利貼等等。社會上一直有人對醫生與藥廠的關係有所疑慮,他們認為藥廠提供這些福利給醫師,要的不外乎希望醫生多用他們的藥,幫他們賺錢。部分病患因此擔心醫生開藥會受藥廠影響,犧牲病患的權益。至少這些額外的費用中將轉嫁於藥費上面,增加病人的負擔。 […]
Eyedoc,
Thanks a lot for your comment.
I have made a brief report on this in a new post.