A D.C. lawmaker said Tuesday that the city's children could be at risk because of close ties between psychiatrists and drug companies, and he said he is likely to seek a strengthening of the District law that requires the manufacturers to disclose their contacts with doctors.
"We can't be casual about the prescribing of these drugs to young people. We have to be very careful," at-large Councilman David Catania said. "We can do this better."
A D.C. Department of Health and George Washington University report found that of the 172 physicians in the District who received at least $1,000 in gifts from leading antipsychotic manufacturers last year, 26 were psychiatrists.
Of them, only seven accepted Medicaid, though they received 66 percent of the gifts to psychiatrists. The physicians' names weren't disclosed under District law.
Studies show that D.C. physicians prescribe antipsychotic medications to Medicaid patients more than their peers in other jurisdictions. Nearly 10 percent of the District's Medicaid population received antipsychotic drugs in 2008, a rate that was nearly twice the national average.
Catania said he thought Medicaid's status as a government program left it open to particular targeting by drug manufacturers, who spent more than $85 million in 2010 marketing their products to District-based physicians.
"The pharmaceutical industry is very smart at sending money to where they get the greatest rate of return," Catania said. "Because Medicaid is an entitlement and it's essentially a bottomless pit of money, they have an incentive to try to increase prescribing among the Medicaid population because they know those drugs will be purchased."
Dr. Adriane Fugh-Berman, a Georgetown University pharmacology professor, said the manufacturers' marketing efforts spur action among physicians.
"Marketing clearly skews psychiatrists' beliefs about antipsychotics," said Fugh-Berman, who cited a study that found that 88 percent of physicians thought new medicines for mental health needs were more effective than so-called "first generation" drugs, even though research found they were not.
The American Psychiatric Association, an industry group, in 2010 reminded its members to establish boundaries between marketing meetings and decisions for patients.
"Contact with pharmaceutical representatives represents marketing and should be distinguished from balanced education and critical scientific information as a basis for prescribing," the group said.SClB