Monday, April 30, 2007

The Ghost in the Machine

A very interesting read about the ethical issues in ghost writing can be be found over at medical humanities

As Daniel points out that up to ten percent of articles in medical journals may be ghost written is outrageous. But it is a natural conclusion of market driven health care, if your business is selling medication, then you want to ensure that people are prescribing your medicine... In a perfect world that will be because your drug is the best drug for the patient. In the real world though there are plenty of short cuts to ensure reasonable sales even if your product is perhaps not the best... While it is radical, one way to reduce this corruption of science would be to reform our health care systems and in particular the funding and creation of pharmaceuticals.

2 comments:

Daniel said...

David,

I'm not certain that the practice of ghost-writing is an inevitable consequence of market-driven health care, though admittedly it is not altogether unexpected given that the industry is literally the most efficient rent-seeker (and capturer) in the history of the corporation.

Still, even if it is only the prospect of rents that motivates firm behavior, the market may well refuse to bear certain practices. For example, one might think that drug companies would want new drugs to be available in the U.S. OTC rather than by prescription only, because presumably greater volume of sales would occur with the former.

However, this is actually not what happens, because research consistently shows that consumers deem drugs available by prescription to be more effective, and therefore both want them more than OTC drugs and are willing to pay more for them. The lower volume in sales of the prescription drugs as compared to OTC drugs in the same therapeutic class is made up for many times over by the increased rents captured by the more expensive prescription drugs.

The point of all of this is to suggest that the political economy may well exert downward pressure on some rent-seeking practices.

But, sadly, you may well be right. A professor of mine, commenting on a related phenomenon, remarked, "Every time I think we've hit the bottom of the barrel, I find something even more depraved."

In any case, thanks for the link!

David Hunter said...

Fair point, I guess it isn't inevitable because the market will only tolerate some behaviour and this looks like the sort of behaviour it shouldn't tolerate. On the other hand it is presently tolerating it which is why noise about it needs to be made.

Daniel said: "However, this is actually not what happens, because research consistently shows that consumers deem drugs available by prescription to be more effective, and therefore both want them more than OTC drugs and are willing to pay more for them. The lower volume in sales of the prescription drugs as compared to OTC drugs in the same therapeutic class is made up for many times over by the increased rents captured by the more expensive prescription drugs."

This is an excellent point, any idea whether converted drugs (ie prescription only medication which has become available over the counter fare differently?

"But, sadly, you may well be right. A professor of mine, commenting on a related phenomenon, remarked, "Every time I think we've hit the bottom of the barrel, I find something even more depraved.""
Having just been at a conference on public health ethics and listened to some truely frightening papers I have to agree with your professor!