The Influence of Big Pharma Money: Read All About It!

By: Jadon Webb, M.D., Ph.D.

We should be clear up front: big pharma has produced incredible, life saving treatments for innumerable diseases. This is also true for mental health, pharmaceutical industries have produced most of the medication help for depression, treatment of generalized anxiety disorder, help with ADHD, treatment of bipolar disorder, schizophrenia, and so on. We can all be very grateful for this!

But in the meantime, it is also clear that big money can influence health care provider decision making. Gifts and payments from pharma companies have the potential to influence how a provider prescribes, for instance. If it didn’t, companies would not spend billions marketing to providers! 

Not all advertising is bad, of course, and to some extent can even be helpful and necessary to keep up with current treatments. But just the same, in mental health there are many drug treatments that are aggressively marketed, sometimes possibly beyond the actual advantage they may offer a patient over much cheaper generic alternatives. And the difference in cost between generic vs new medications can be enormous, sometimes a difference of 10 or even 100 fold!

In other words, newer and flashier medications are not always better. But it is often hard to know for sure which treatments are best for you, and if a newer drug is better, which is why expert consultation with a provider can be so useful. 

It is also important to trust your provider, and understand what biases they may have in prescribing. If a provider receives significant compensation from a certain drug maker, it is important to keep this in mind when considering what treatment to try next.

The government provides a searchable database so you can see what your provider received from the pharmaceutical industry. It is easy for patients to use:   

https://openpaymentsdata.cms.gov/

Keep in mind that small “payments” happen all the time, and can show up even if a drug rep brings lunch to a practice. It is almost impossible to avoid these small interactions from time to time, especially if working in a larger health care system, and it does not necessarily suggest anything nefarious. Larger payments can also be totally benign, as many physicians even help with drug development trials, and may also have good conflict of interest policies in place so that their prescribing stays ethical and consistent. 

If your provider receives large, consistent payments related to any prescribed to you, it may be worth asking your provider about this, and how they ensure that any financial conflict of interest is discussed and handled properly.

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