Increases in both the cost of healthcare and in public concern about the quality and accessibility of care have focused greater attention on the interaction between healthcare professionals and certain industries. Although there is considerable overlap in purpose, healthcare product manufacturers and healthcare professionals act according to different principles and have allegiances to different ultimate authorities.
In the covenantal relationship between a practitioner and her patient, the practitioner pledges to use her training and experience solely for benefit of the patient. This principle extends to the very common clinical situation in which the practitioner, utilizing his specialized knowledge and skills, acts as the patient’s “purchasing agent” by prescribing a drug or device product that is not accessible to the patient except through a state-licensed practitioner.
Manufacturers, although they have an abiding interest in the health of individual patients, serve the entire population, as opposed to meeting the specific needs of an individual. Their ultimate allegiance is to shareholders of the company to whom they have pledged to earn the best possible return on the shareholders’ investments.
In an ideal world the needs of both patients and shareholders would perfectly overlap. However, with competing products possessing different levels of safety, efficacy, and cost, not all corporate needs and desires can possibly align with each individual patient’s needs. Manufacturers, because of the pressure of their commitment to shareholders, have an inherently broader view of the applicability and appropriateness of their products than do independent-minded clinicians, who must compare competing products and make the best decision for each individual patient.
Competing manufacturers will spend approximately $30 billion this year to influence practitioners to use more of their products. Healthcare product promotion, especially unbridled prescription drug marketing and promotion, is so competitive that the practices of the manufacturers—and the tacit acceptance by practitioners—have escalated woefully out of line with the needs or desires of individual patients and the general public; some have described the state of the marketplace as unflattering to both manufacturers and practitioners.
The goal of this policy is to change the culture of the relationship between healthcare product manufacturers and our healthcare practitioners in order to reassure the public that:
- we place our commitment to patients as the highest priority and we make judgments on their behalf that are unsullied by the excesses of the marketplace;
- we healthcare professionals will not be a part of costly marketing and promotional initiatives that are designed to influence our behavior and thereby interfere with, or appear to interfere with the covenantal relationship we have with our patients and add unnecessary costs to the healthcare system which are ultimately paid for by our patients.
Healthcare product manufacturers and marketers are essential not only for the delivery of current products, but also to develop new and better products to improve the human condition. As a leading academic health center and a research intensive university we pledge to work with the industry in a transparent and socially beneficial manner to jointly pursue our shared goal of improving the health and welfare of our society.