Drug makers courting doctors hard
A voluntary plan to curb the U.S. pharmaceutical industry’s courting of doctors appears to have had little effect.
A study published last week in the New England Journal of Medicine reports that 94 percent of doctors have a relationship with drug companies.
“We now know that virtually every doctor in the United States has some form of relationship with the pharmaceutical industry,” said Dr. Eric G. Campbell, lead researcher on the study and a faculty member at Harvard Medical School. “They are common. A quarter receive honoraria or some form of payment for their services, and that was much higher than we expected.”
The guidelines approved by the American Medical Association, the Pharmaceutical Research and Manufacturers of America and other groups call for gifts that are modest in cost and primarily for the benefit of patients. Meals are supposed to be inexpensive and are not to include doctors’ spouses.
Several studies have found that the number of contacts between doctors and industry sales representatives has increased since 2000.
Another study shows clearly, that that the real effectiveness of pharmaceutical sales visits lies primarily in the “relationship-building” that occurs during those visits. Aside from free drug samples, the representative will often bring a gift —- lunch for the doctor and his or her staff, new pens and coffee mugs, offers to attend an educational conference. As a result, the doctor feels subtly, even subconsciously, indebted to the representative. This can lead to higher prescribing.
“manus manum lavat” – one hand washes the other, as the latin adage goes? Mind, the wash is our health!
N Engl J Med. 2007 Apr 26;356(17):1742-50.
A national survey of physician-industry relationships.
* Campbell EG, Gruen RL, Mountford J, Miller LG, Cleary PD, Blumenthal D.
Institute for Health Policy, Massachusetts General Hospital-Partners Health Care System and Harvard Medical School, Boston, MA 02114, USA. firstname.lastname@example.org
BACKGROUND: Relationships between physicians and pharmaceutical, medical device, and other medically related industries have received considerable attention in recent years. We surveyed physicians to collect information about their financial associations with industry and the factors that predict those associations. METHODS: We conducted a national survey of 3167 physicians in six specialties (anesthesiology, cardiology, family practice, general surgery, internal medicine, and pediatrics) in late 2003 and early 2004. The raw response rate for this probability sample was 52%, and the weighted response rate was 58%. RESULTS: Most physicians (94%) reported some type of relationship with the pharmaceutical industry, and most of these relationships involved receiving food in the workplace (83%) or receiving drug samples (78%). More than one third of the respondents (35%) received reimbursement for costs associated with professional meetings or continuing medical education, and more than one quarter (28%) received payments for consulting, giving lectures, or enrolling patients in trials. Cardiologists were more than twice as likely as family practitioners to receive payments. Family practitioners met more frequently with industry representatives than did physicians in other specialties, and physicians in solo, two-person, or group practices met more frequently with industry representatives than did physicians practicing in hospitals and clinics. CONCLUSIONS: The results of this national survey indicate that relationships between physicians and industry are common and underscore the variation among such relationships according to specialty, practice type, and professional activities. Copyright 2007 Massachusetts Medical Society.
PMID: 17460228 [PubMed – in process]