OCT 23 1967

HENRY M, JACKSON, WASH., CHAIRMAN

CLINTON P, ANDERSON, N. MEX. THOMAS H. KUCHEL, CALIF.

CARL HAYDEN, ARIZ.
GEORGE MC GOVERN, S. DAK.

LEE METCALF, MONT.

ALAN BIBLE, NEV, GORDON ALLOTT, COLO.

FRANK CHURCH, IDAHO LEN B. JORDAN, IDAHO

ERNEST GRUENING, ALASKA PAUL J. FANNIN, ARIZ.

FRANK E, MOSS, UTAH CLIFFORD P, HANSEN, WYO. ;

QUENTIN N. BURDICK, N. DAK, MARK 0. HATFIELD, OREG. “WCnifed Ht fes Den 3 fe
GAYLORD NELSON, WIS. COMMITTEE ON

INTERIOR AND INSULAR AFFAIRS

October 19, 1967

JERRY T. VERKLER, STAFF DIRECTOR

Dr. Joshua Lederberg
Stanford School of Medicine
300 Pasteur Drive

Palo Alto, California

Dear Joshua:

I hope you have been able to follow the progress of the drug
hearings since last May. I remember that you were somewhat
apprehensive that a "flavor of muckraking'' seemed to be in-
vading the atmosphere of the investigation.

Perhaps a small amount of that kind of quality is inherent to
the nature of the animal -- whether it is intended or not.
Many individuals, consumers, physicians, pharmacologists,
public officials -- all have agreed that some fat does exist
in the drug pricing structure. However, unfortunately, the
newspaper reporters prefer to write about mark-up rather than
the more esoteric approaches to the entire problem of drugs,
their manufacturing processes, distribution and selling prac-
tices and essential research.

Only last week the Squibb Drug Company demonstrated that even
a larger company cannot guarantee efficacious and unadulterated
drug products. I hope their case was an isolated one, but
others persist, as evidenced by the recalls from the shelves

of the major manufacturers.

My primary reason for writing to you is to ask for your view-
point concerning the value of a drug compendium. One that
would provide unbiased information to the doctor, where all
drugs -- indexed and cross annotated -- would appear, be
described showing side effects and contraindications.
Page Two

I think prices should be indicated and kept as current as
quarterly supplements would allow. The Physicians Desk
Reference is a poor substitute for the project I have in
mind. The pharmaceutical manufacturers now pay for inserts
which could be discontinued with the advent of a true com-
pendium.

Dr. James Goddard testified that the cost of a compendium
could be paid for with the money saved on the inserts.
Several drug companies have also endorsed the idea, but I
fear that the Pharmaceutical Manufacturers Association
opposes it.

Incidentally, Dr. Goddard gave testimony to another Congress-
ional committee last week and he stated that a large percen-
tage of drug company research is worthless, as evidenced by

the poor quality of new drug applications filed with the FDA.

Many distinguished witnesses have agreed that continuing
education of the doctor in therapy, prescription writing, and
therapeutics is of the utmost importance. Too many of the
practicing physicians have received no formal education and
very little informed advice in those fields upon leaving their
second year of medical school. Advice received fromthe drug
detail man certainly cannot be classified as unbiased or
completely educational. I think a way should be sought to
finance programs where the doctor can enroll in seminars to
relearn and to keep current with the latest drug developments.

A Milwaukee doctor wrote me that a new drug comes on the market
every day of every year. Who could possibly keep abreast of
this deluge of drugs -- good ones and bad ones.

I try to follow your articles, but the demands on my time pre-

clude a careful following of everything you say. I would be
happy to have any further appraisals of the hearings and the

brief comments in this letter.
(ee ee yours,

pA saline
U. S. Senator

GN: bcj