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To the Editor.—
I agree with Dr. Nadasdi's observation on the heterogeneity of the medical profession; he is correct in interpreting my point to be that it is the practicing physician who has lost any influence he once had on the process of drug development and regulation.But Dr. Nadasdi himself over-simplifies things by assuming that key decisions in government and the pharmaceutical industry are controlled by medically qualified people. Health policy issues in government are firmly in the hands of such groups as the staffs of Congressional Committees, the Department of HEW, and the Office of Management and Budget. The real decision-makers in these groups are lawyers, administrators and economists. In the pharmaceutical industry, decisions are controlled by the marketing division, the financial department and the scientific research and development division. The decision-makers are business executives, market research experts, accountants and scientists.My point is that the input of
Wardell WM. Drug Development, Regulation, and the Practice of Medicine. JAMA. 1975;231(2):137. doi:10.1001/jama.1975.03240140011010