Physician and blogger Roy Poses from Health Care Renewal posted a good question on PostScript ahead of the After Heparin convening, and despite the delay (apologies!), it seems worthwhile addressing here.
About the convening he wrote:
I am glad someone is putting on a conference on this topic, but am surprised that the roster of presenters is so dominated by industry. Shouldn’t there be more representation of health care professionals and consumers/ patients? Shouldn’t there be some representation of experts in ethics and law enforcement?There’s no question, industry was a big presence around the table, but as we pointed out here, it hardly drowned out other significant voices; those of federal and state regulators, consumers, law enforcement, and independent academics and standards-makers. In fact, nearly all parties commented on what a broad range of key interests were represented.
Three representatives from national consumer groups—Community Catalyst, Consumers Union, AARP—joined the roundtable both days, and drove home the importance of better securing the drug supply for patients, whose health is their reason for being in business, and whose health it is that’s put at risk by safety gaps in the drug supply.
“As a consumer rep, I still look to the FDA," said AARP’s Ahaviah Glaser. “But it’s got to be group accountability.”
The Pew Prescription Project itself, which convened the After Heparin roundtable, prioritizes consumer interests—its mission is to “promote consumer safety through reforms in the approval, manufacture and marketing of prescription drugs” and to conduct nonpartisan research around those issues.
The American College of Physicians was at the table, as well. I think Poses is right that prescribers and other health care providers need to speak up on this issue, as they are some of the most powerful voices able to articulate what’s at stake when they can’t guarantee the complete safety of medicines--one of the main instruments of their practice.
“If we can’t trust where our drugs are coming from, that’s so fundamental,” said Cleveland Clinic cardiologist and attendee Harry Lever. “If my patient isn’t doing well, the first thing I think about now is: maybe it’s a drug.”
In fact, the convening was remarkable for the degree of consensus forged that the system needs to change in bold ways, and fast, because public health is at risk.
And this common call for group accountability made it critical that representatives from points all along the supply chain—from raw chemical makers to the pharmacists—were there, engaged in the conversation about making our medicines safer. And that’s why, from my seat in blogger alley, After Heparin was such a positive step forward.
Change, like the products they make and sell, must originate with members of the supply chain--in the factories and audits and warehouses and ultimately the board rooms--though the conversation made it clear, too, that members of industry cannot make these fixes without a strong regulatory hand.
Yet sustaining improvements in the system will depend on them too. So their willingness to get in the conversation with regulators, consumers and policymakers in a public way, and to agree that the drug supply risks are big and require cooperation to address, was no small thing.
And I think all that invites, rather than precludes, more patient and provider involvement and voice.
--Kate Petersen, PostScript blogger