Gifts from pharmaceuticals influence providers prescription choices - metastudy
Gifts from drug companies do influence when and how much a
medication is prescribed, reported an article in the
Jan 19, 2000, Journal of the American Medical Association.
The article presented the research of Dr. Ashley Wazana of McGill University in Montreal, Canada who reviewed 29 other research studies concerning the relationship between the drug company representatives and health care providers (out of 538 studies considered). The studies observed how actions on the part of the drug company representatives affected the prescription habits of the providers. Actions studied included things like accepting gifts, free travel, meals or samples from the drug companies.
Wazana stated that pharmaceutical company promotions increased the number of prescriptions written in several ways. Following drug company overtures, health care providers 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, resident physicians increased "nonrational" prescribing of a drug following a meeting with by a company representative, and attitudes about drug company representatives became more positive.
Drug companies initiate meetings with health care providers while they are still in school, reported Dr Wazana and those meetings continue after graduation about four times a month.
Although education of health care providers in the treatment of complex illness was a positive effect of interactions with drug companies, most results of those meetings were negative, noted Dr Wazana. After meetings, health care providers seemed to prescribe more of the drugs being promoted at the meetings.
An example of this, was the promotion for Xenical, the fat blocker. Drug companies began meeting with health care providers, offering fancy dinner presentations of the drug, long before the public heard much about it. In a story reported by this writer, those meetings resulted in "a record number of Xenical prescriptions".
Here is an excerpt from my article, written June 1999:
(article by SueW, CIN HEALTH, June 6, 1999)
Having worked in a doctor's office, I observed that gifts from drug companies included attractive items such as clocks, pens and desk accessories and that several drug company representatives kept us well supplied in samples of their company's products.
The American Medical Association has attempted to police certain interactions and gifts, stated Dr. Robert M. Tenery, Jr., of the American Medical Association's Council on Ethical and Judicial Affairs in an editorial in the same issue of JAMA and some progress has been made. The Physician noted that practices such as awarding airline miles for prescribing certain drugs has been greatly decreased if not stopped, 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.
UPDATE: 2009: the Pharmaceuticals have greatly curtailed the gifts of pens etc to medical providers however are still giving free dinners and CMEs which advertise their drugs. Since they are allowed to run ads on TV, they have found it even more effective to go directly to the consumer. Although they are required to state the side effects and disclaimers on the ads, a recent survey found that most consumers do not hear the side effects and disclaimers.
As for Xenical, the pharmaceutical has managed to get a weakened version of it approved to sell over the counter. In our fat obsessed society, it has proven to be a hot seller.