Will new technology and new methodologies improve patient care?
Remember the French silicone breast implants at risk of bursting? And the defective metal-on-metal hip prostheses that led to recalls and warnings? That was in 2012-13! While the voluntary device manufacturers’ Code of Practice is pretty tight, much like the Medicines Australia Code, some drug or medical device manufacturers may still profit from sales while slow-moving systems first highlight then investigate claims that products could be or are damaging consumers.
All this before the weight of adverse opinion leads them to scuttle their product. Income from sales might exceed the cost of eventual legal payouts.
Rapidly advancing technology, slow and expensive approval, even slower investigation if things go wrong, and perhaps larger profits to be made if a product is PBS listed or TGA approved, can be a recipe for keeping a dud product going as long as possible. Fewer companies rely on brand loyalty these days so damage to a brand is not as important. Protection of product investment and share price is, to the market.
Doctors are caught up in this too. With US studies showing about 30% of patients don’t pick up newly prescribed medicines and we know compliance in Oz is poor, pharmaceutical manufacturers need to better target physician-patient engagement. Wearable devices, mobile apps, telemedicine, electronic medical records and other technologies have the potential to influence health outcomes, patient behaviours and treatment decisions.
The ongoing questions are: Will things on offer truly improve patient care? Is it what the patient wants? Or will it just make me look good?
Professional wariness about who gains access to Big Data and social media is not a bad thing. Unbridled access could put manufacturers in indirect contact with health consumers. This takes on greater importance with the rise of orphan drugs and the associated need for community pressures to get PBS listings.
The medical profession is meant to be on the patient’s side. But when we resist greater transparency under the Medicines Australia Code, have key opinion leaders spruiking what’s new or preferred, and doctors looking at their incomes rather than the community cost of their preferences, then why shouldn’t health consumers wonder?
Why shouldn’t they demand easier traceability of performance, regular checks on manufacturers, better clinical evidence and closer scrutiny of the relationships between product manufacturers and other providers?
Health is a hungry beast that must be fed. But we have to give it the right diet.
As an aside, my mobile number, freely available on the Medical Forum website, was fraudulently put into an online survey. This number then populated a list which I think was on-sold by a firm in Queensland that prides itself on the best online “live data”. Within 24 hours I received an SMS for an education product and phone calls from someone trying to sell me pet insurance, a new energy provider (not based in WA) and life insurance.
Doctors can register mobiles used for personal calls with www.donotcall.gov.au. It is well known that many people give false or misleading information when online forms don’t allow optional responses. This sort of behaviour does not auger well for the patient controlled electronic health record! Are we entering an age of misinformation?