| Drug company gifts influence MD prescribing Updated 6:09 PM ET January 21, 2000 NEW YORK, Jan 21 (Reuters Health) -- Gifts, meals and education programs paid for by pharmaceutical companies influence physician prescribing habits, a Canadian researcher reports. "The present extent of physician-industry interactions... should be further addressed at the level of policy and education," according to a report published this week in The Journal of the American Medical Association. Dr. Ashley Wazana of McGill University in Montreal, Canada, analyzed 29 studies of physician-industry relations. The studies examined the effects of specific actions such as accepting gifts, free travel, meals or samples from drug company representatives. Wazana reports evidence of four types of influence. Following drug company overtures to physicians, physicians prescribed a drug manufactured by the sponsor of a medical education program more frequently, hospitals increased their prescribing of a conference travel sponsor's drug, residents increased "nonrational" prescribing of a drug following a meeting with by a company representative, and attitudes about drug company representatives became more positive. The researcher noted that interactions between MDs and pharmaceutical representatives begin in medical school and continue at a rate of about four meetings per month. Wazana notes some positive results of physician-pharmaceutical representative interaction, such as improved knowledge of treatment for complicated illness. But most of the studies reviewed also showed negative outcomes, such as increasing prescriptions for promoted drugs, while fewer generic drugs are prescribed "at no demonstrated advantage." In an accompanying editorial, Dr. Robert M. Tenery, Jr., of the American Medical Association's Council on Ethical and Judicial Affairs, writes that the Council has attempted to police physician interactions with drug companies. The most egregious activities have stopped, such as awarding airline miles for prescriptions written, but recently the need for continuing medical education (CME) has driven a resurgence of drug company-sponsored junkets, he says. CME credit is a requirement for licensing in most states. Tenery notes that drug company money and influence "has permeated virtually all levels of physician CME in the form of complimentary meals and entertainment, consultation fees, and pseudo-CME courses." He concludes that physicians and the drug industry need to develop new industry-wide standards to prevent abuses of the system. SOURCE: The Journal of the American Medical Association 2000;283:373-380, 391-393. |
 |