Recent media reports are questioning the veterinary profession’s integrity by suggesting that the financial motives of drug makers have the potential to sway practitioners, whether on a farm or in a companion animal practice.
It’s an insinuation the American Veterinary Medical Association rejects.
So do veterinarians across the country, many of whom believe that two separate investigative news reports by the Indianapolis Star and Reuters have unfairly implied that the profession is wrought with conflicts of interest, ambiguity and nestled deep in the pharmaceutical industry’s pockets, leaving little room for integrity.
“The articles are heavy on conjecture and innuendo and short on facts,” wrote AVMA President Dr. Ted Cohn, in a letter Tuesday to the Indianapolis Star. “While you tried to paint a picture of veterinarians being beholden to pharmaceutical companies for monetary gain, you failed to cite even one specific case of impropriety or lack of professionalism. The same can be said for your suggestions that the AVMA annual convention ‘revealed just one of the many ways corporate money influences pet health care … threatening the objectivity of those prescribing drugs to your dog or cat.’”
He similarly addressed Reuters:
“Like every business, veterinarians must make a profit to stay in business. But to suggest that a profit motive would compromise our professional judgment without any supporting evidence is irresponsible. Veterinarians work tirelessly to earn the trust and respect of food animal producers, government agencies, educators, industry and the public. There is no evidence to suggest that a veterinarian’s prime motivation is anything other than to do what is in the best interest of their patients and clients.”
Drug makers featured in the news reports as well as the Animal Health Institute (AHI), a member group for pharmaceutical companies, also have weighed in. “Much of what is described in the Indianapolis Star article is the important process of veterinarians earning continuing education credits and keeping abreast of the latest developments and scientific advancements in animal health,” AHI spokesman Ron Phillips said in a letter to the newspaper.
The statement did not address a slew of philosophical questions raised by the Reuters and Indianpolis Star news reports. Can a free lunch buy a veterinarian’s allegiance to a brand of flea and tick preventative? How much influence is carried in speaker fees and tradeshow giveaways? Can veterinarians stand up to pharmaceutical prescribing pressures when tapped to guard the use of key antibiotics in farm animals?
Finally, why isn’t there transparency concerning the flow of money from drug makers to the veterinary profession? Federal law recently lifted the veil off payments from the pharmaceutical industry to physicians, teaching hospitals and researchers in human medicine. The Sunshine Act, a transparency clause in the Affordable Care Act that requires the public posting of payments and other valuables given by pharmaceutical companies, does not include the veterinary profession.
At a fraction of the size and scope of human medicine, some veterinarians say their profession isn’t worth enough to pharmaceutical companies to breed rampant unseen and improper affiliations.
Others disagree, especially given that most veterinarians both prescribe and sell pharmaceuticals, often relying on in-house pharmacy sales to offset a practice’s overhead. While critics say that arrangement is ripe for conflicts of interest, supporters say it’s necessary given that few pharmacists are properly trained in veterinary pharmacology — a problem that’s reared as more retail pharmacies get into the animal health business.
The three-part series published by the Indianapolis Star illustrated how drug companies wooed show goers last year during the American Veterinary Medical Association’s annual convention. Reuters pointed out in a recent news article that come 2016, veterinarians will act as gatekeepers of antibiotic use at food-producing farms, per a U.S. Food and Drug Administration mandate intended to curb the emergence of superbugs and antimicrobial resistance. At the same time, these veterinarians are paid by the farmers and, in some cases, the drug companies they’re supposed to be overseeing.
Both investigative news reports emphasize the fact that the veterinary profession is devoid of laws or regulations requiring the public disclosure of gifts — meals, scholarships, stipends, freebies, trips and other means of support — that drug companies are known to extend to veterinarians. The articles suggest that pharmaceutical companies hire veterinarians to speak about their products at continuing education meetings, often without telling the audience that they’ve been paid to speak.
Reuters dinged even the AVMA for a perceived lack of transparency, pointing out that while the association’s ethics policy calls on veterinarians to divulge any potential conflicts of interest, the group itself has failed to do so. According to the article, AVMA officials confirmed that the group received $3.3 million from drug companies during the past four years, but they only gave the information after being asked and would not disclose the donor specifics.
On the Veterinary Information Network (VIN), an online community, veterinarians railed against the notion of corruption in a profession that has long been considered by the public as trustworthy and noble. Many veterinarians, earning a fraction of what their human medicine colleagues earn while facing comparable education and tuition costs, say a love of animals is a bigger factor in becoming and being a veterinarian than the modest financial rewards.
Some VIN members welcomed the chance for transparency and introspection.
“Rather than deflecting the issue, it needs to be addressed,” wrote Dr. J. Scott Weese, an internist and microbiologist at the University of Guelph’s veterinary college. “... This isn’t meant to say that financial interests drive our decisions or that vets behave unethically. It’s a call to face the reality that these conflicts of interest are at least perceived.”
He added: “Continuing to be defensive and ignoring the concerns leaves the decision making to others. If we’re not able to say that we understand the concerns and are working to improve things, it’s much easier for regulators to make the decisions for us.”
Rep. Louise Slaughter, D-N.Y., wants to do just that. According to Reuters, she plans to introduce legislation to require public disclosure of drug company payments to veterinarians.