No Financial Contamination Here

The September 14, 2018 issue of The New York Times included an editorial titled “Medicine’s Financial Contamination,” prompted by the report that the (now former) chief scientific officer of Memorial Sloan Kettering Cancer Center had repeatedly failed to disclose payments from industry. The Times went on to say that even little gifts influenced doctors’ prescribing habits, and that (presumably larger) gifts and consulting fees were partly responsible for the opioid epidemic. The Times, which itself is increasingly supported by advertisements, including some from pharmaceutical manufacturers, also lamented the financial conflicts of medicine’s academic leaders, oncologists, psychiatrists, and FDA advisory committees.

How can our profession respond to these serious charges? In many ways, of course, but one small response might be to pay more attention to the critical drug evaluations of The Medical Letter. A unique nonprofit publication that does not accept advertisements or any form of commercial support, The Medical Letter is evidence-based and consensus-based. It is supported solely by sales of subscriptions, software, books, continuing education materials, licenses and, only recently, a limited number of donations from our subscribers. We do not sell bulk reprints of our articles to pharmaceutical manufacturers, who have repeatedly offered as much as $1,000,000 for reprints to distribute to physicians. Are we the only critical source of information on drugs that does not rely on the pharmaceutical industry for its continued existence? Could be.

Putting The Medical Letter in the hands of every prescriber and pharmacist in the United States could help minimize the influence of the pharmaceutical industry on prescribing, improve drug utilization and outcomes, and reduce drug-related costs. Your subscriptions and donations can make that happen.

Mark Abramowicz, MD

Jean-Marie Pflomm, PharmD

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  1. Nina Pierpont, MD, PhD says:

    Exactly true. Drug reps have given up coming to my door and I throw away what they mail. The pharmacy dept. at Johns Hopkins started putting the first page of the Medical Letter in our student mailboxes every 2 weeks at the beginning of the second year. Been getting it and relying on it ever since. Thank you.
    Nina Pierpont, MD, PhD

  2. Clifford Dacso, MD says:

    The integrity of the Medical Letter has always been unquestioned. When I use it as a source for patient education (often) I always proudly assert its financial independence as a bona fide,

  3. Michael Weissman, Ph.D., M.D. says:

    Good post!

  4. Scott Pace MD says:

    I agree.I have read every issue of the Medical Letter since 1975 and appreciate “the facts and only the facts”

  5. Richard Christopher Jr. M.D. says:

    Amen Brother

  6. PANKAJ PATEL, PharmD, FASCP says:

    There are very few organizations like TML left in the world anymore!
    The knowledge TML provides is definitely untainted b all means.
    Thank you for the stewardship.

  7. Influence of pharmaceutical industry on the physicians is pervasive. Majority of the research and the articles published in medical literature are funded by vested interest. I like many others do not trust the literature and even the editors are very likely suspects. Great many physicians are too busy too keep up with the available literature and pharmceutical representative may be the only source of learning what is new in therapeutics and then we all know what happens. Where is the busy physicians struggling with EMR etc. to turn?

    Mark, your point is true without reservation. The Medical Letter is a very reliable source and one of the few unbiased sources without reservation but it is not cheap. How to reach every prescribing physician is a challange when we are reluctant to spend money on our own education and have other priorites. Even free medical education sessions at medical institutions are very poorly attended by the practicing physicians, which is tragic. Thus a copy of Medial letter in every practicing clinicians hand may help but there is much more to it. I have retired from active practice for three years but I still value The Medical Letter.

    The Medical Letter usually gives the cost of most medications that it reviews but that is not enough. With astronomical rise in the cost of medication, just information is not enough. Just emagine the cost of insulin for one month used to cost less than twenty dollars and now it costs over six hundred dollars and not to forget other medications needed. There are hundreds of medications like that. If medical community can not stand up to the pharmaceutical industry forget about prescribing medications beyond the reach of the average citizen. Forget medications, just go for the unprocessed food (which is cheap) that you can afford, drink clean water off the tap (true for most of the country if not, boil it), excercise (which is free) and accept death when it comes. Death is natural and it has been acccepted as a natural event for millions of years. We are in the pockets of pharmaceutical/medical complex and they control us. It will take a revolution and not just comments like mine.
    Birendra Singh Huja
    P.S. Please excuse the tone of comments and errors in spelling as this issue ignites passions.

  8. Renato Fraggetta says:

    This is reliability! With my compliments.
    Renato Fraggetta, M.D.

  9. neal H. Steigbigel, M.D. says:

    Certainly integrity is now and always has been central to our survival– when it is now so often threatened. TML helps in substantial ways to uphold that in the field of medicine. Fine note, Mark!
    Neal H. Steigbigel, M.D.
    Contributing Editor, TML

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