January 09, 2008

What is it this time, you ask? Unsurprisingly, given the election season now entering full bloom, it is some types of drug marketing, according to a couple of disgruntled former employees of Amgen, who now are immersed in arbitration proceedings after having been fired for... well, it's not quite clear. The LA Times reports today that the two are accusing Amgen of requiring sales staff to engage in "aggressive and possibly improper marketing practices to boost Enbrel sales beyond its approved uses." (Enbrel is an expensive psoriasis treatment.) One former employee "contends that the company required salespeople to gain access to patient medical information in doctors' offices and market the drug directly to patients, many of whom may not have needed the medication."

It's not quite clear why the doctors would allow the drug reps to look through patients' files. But the larger policy issue that arises out of such cases as this one is whether off-label drug use, as prescribed by a doctor not being bribed by a pharmaceutical producer, is useful for patients. The evidence---crude, indirect, but compelling--- is that it is indeed. This is not very surprising given the powerful incentives of the FDA to approve drugs too slowly and for too few uses.

And so beware newspaper articles sympathetic to the argument that it is "improper" for the private sector to find ways to serve the interests of patients more fully. Once we allow bureaucrats to define the boundaries of propriety, we will have taken a long step toward serfdom, higher drug prices, and increased human suffering.

Posted by Benjamin Zycher at January 9, 2008 01:14 PM

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