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Comment by chuckadams | Hacker News Reader

Doctors who fail to disclose an interest should lose their license. The SEC doesn't tolerate such shenanigans for finance, why should the FDA permit it for drugs?

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Isn't the very fact a doctor is on social media saying how great a drug is a giant flashing sign that they are being paid to do it?

Lots of doctors from reputable places eg Mayo on X. Weighing in on things with media coverage like whether cholesterol drugs are a good treatment option. Possibly they're countering quakery from charlatans with good, measured opinion. That opinion could also be influenced by paying for their conference attendance, or just plain cash. Undisclosed, such payments would be far from obvious and radically change one's opinion on how convincing their case is or isn't.

The new weight loss drugs. Are they good? How serious are the side effects? How often are there problems? Is the risk low and benefits high? Are they good for cancer? Are they good to help alcoholism? Are they scary? Should I take them?

Much legit debate there and I'd rather know who is being paid for their opinion faced with the choice when trying to weigh probability in the face of imperfect information.

The Doctor could conceivably be a passionate professional who wants to share health information with a wider audience. You know, as opposed to a shithead shill. The fact that being a corporate mouthpiece is apparently the default assumed state is a condemnation of our current medical standards.

It's easy to imagine a stereotypical "When my patients find their pancreas swimming around in their fish tank, I recommend ACME Pancrease De-marination forceps". But the more important bit is the massive grey area. Let's say your kid plays with Bob's kid on their little league team, you've added each other on Facebook, you put out a post asking if anyone has any advice about your fish tank dwelling pancreas and bob chimes in because he's a doctor. Do you assume Bob is being paid then?

I assume 100% of people on social media are doing for other than altruistic reasons.

100%

Doctors who are paid to endorse a drug should lose their licence

Why is that? Surely you mean without proper disclosure.

Because it conflicts with their duty to their patients. Patients should be able to trust their doctor and not have to look for fine print disclosures in the middle of receiving treatment which may or may not impair them cognitively or emotionally.

Patients are often in a vulnerable position and we use laws to protect the vulnerable. Not only is the patient often impaired, but there is a massive information asymmetry naturally between an expert with years of post graduate education on a specific topic and a general member of the public. Many other fields that require similar amounts of training have strict codes of ethics regarding who they may take compensation from and how that is disclosed.

I agree, but i take it that this isn't about advertising to patients, but the general public.

Some doctors don't even have patients. Some work in drug development itself.

I think you can assume based on context that GP is referring to practicing physicians, not to research doctors.

You can tell because one has a clear conflict of interest and one does not.

Drug company employees who attempt to bribe a doctor should be imprisoned.

If you believe this you should vote for RFK Jr. He’s the only presidential candidate that has actually taken on industry. The VO has pledged to open up all the data in the FDA and CDC for transparency. We need this.

Yeah but then you’re voting for RFK.

US Gov't FDA and CDC can already be FOI'd.

Records from neither department will cover ongoing "bribery" of regular doctors by Pharma reps, so it's unclear how "we need this" to address that.

They can be FOIA'd, for all the good that will do you. They apparently have, according to the news, employees dedicated to deleting records before they can be FOIA'd, they use burner phones and private email accounts, and when caught the agency boss will say "I don't know who my personal assistant was working for when he did that" in front of Congress.

And get away with it.

In a matter that regarded some two million or so deaths in the US.

[0]: "Fauci concedes wrongdoing at NIAID, just not by him": '“That was wrong and inappropriate and violated policy,” Fauci said of Morens’s scheme to “disappear” problematic emails. “He should not have done that.”

Fauci’s chief of staff was in on the scheme. Emails show that Gregory Folkers intentionally misspelled the name of Kristian Andersen, a tactic Morens suggested to avoid FOIA, after Andersen received an $8.9 million NIAID grant, which came two months after he authored a paper arguing that it was “improbable” that COVID-19 had a lab origin.'

[1]: It's an image of an email from Gerald Keusch, who worked at NIAID.

[0]: https://www.washingtonexaminer.com/restoring-america/fairnes...

[1]: https://x.com/gdemaneuf/status/1797494390535160205

and how, exactly, does any of that have any bearing on

> Drug company employees who attempt to bribe a doctor

in the context of non US Government Pharma companies paying non Government doctors to spruik drugs on twitter and by prescription?

Because a huge part of the regulatory agencies’ monies comes from royalty payments from the companies they’re supposed to be managing.

And the obstruction of the FOIA process helps entrench the resulting corruption.

Payments from pharmaceutical companies to physicians are already publicly disclosed.

https://openpaymentsdata.cms.gov/

And if I'm not a US citizen and the drug company bribing the doctor isn't in the US? There's more places around the world, you know.

Then a thread talking what the FDA and SEC do is not a place where your experience is helpful.

> Doctors who fail to disclose an interest should lose their license.

I didn't realize all doctors are regulated by the FDA and SEC. The statement at the beginning of the thread doesn't specify doctors in the US.

As of their latest reporting I could find on the fda site, 3.3B out of their 7.2B budget comes from "user fees", so the more drugs are sold, the more they get back in user fees.

Pretty sure user fees are tied to new drug applications, not to sales. As in FDA validating your trial results is obscenely expensive and they make the companies who consume those services pay for them.

This is correct. It isn't validation or technical series. It is purely review.

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