The Influence of the pharmaceutical industry...

 

“Big Pharma” researches, produces and sells medicines.         They spend about a fifth of their budget marketing these products with the intent of selling as much as possible.                 Obviously they run on a business model, unrestrained by ethics.

We intend to demonstrate to our colleagues that

1 Doctors’ behaviour is influenced by pharmaceutical company marketing

2 This impacts negatively on patients: more expensive, medicalised, lower quality healthcare

3 Our relationship to pharmaceutical companies is something we can regulate - and other ways of financing education and research is possible. 

                                     

RESEARCH

Below is an overview of published research on the topic.

They provide good data to increase your own knowledge  and persuade sceptical colleagues.


How do Pharmaceutical Companies affect us??

  1. •I think this study (Physicians' behavior and their interactions with drug companies, Chren and Landefield, JAMA Oct 1990) is the the best at demonstrating that interaction with reps and having a financial relationship with the industry DOES influence how we prescribe. It doesn't rely only on a survey which is self reported, but on actual behaviour.

  2. •This (Physicians, pharmaceutical sales representatives, and the cost of prescribing, Caudill et al, Arch Family Medicine, May 1996) is worth mentioning as it shows that interacting with the Industry increases the cost of prescribing.  The industry is not just wasting its money, by buying us dinners - patients and governments are footing the bill.

  3. •The best study on sponsored education (The effects of pharmaceutical firm enticements on physician prescribing patterns Orlowski et al, Soc Sci Med, 1988) shows a massive rise in prescribing 2 iv drugs after attending an expenses paid conference

  4. •Pharma funds 90% of research. Does this affect results? This study (Conflict of Interest in the Debate over Calcium-Channel Antagonists, Stelfox et al, NEJM, Jan 8, 1998) convincingly shows that "yes, sponsored research tends to favour the sponsor's drug."


Accuracy: Are they telling us the truth?

  1. •People we’ve spoken with have found this study (The Accuracy of Drug Information From Pharmaceutical Sales Representatives Ziegler et al, JAMA 26th April '95) interesting. It analyses statements by sales reps and explores how much of what they say is untrue.

  2. •The Accuracy of pharmaceutical advertisements in medical journals, (Villanueva et al, The Lancet, 2003) is a comprehensive analysis of Pharma advertisements looking at the accuracy of their claims - 44% of claims were not supported by data that they gave as a reference!


The scale of our relationship

  1. •An interesting Overview paper printed in JAMA reviews all research that examined (1)the extent of the relationship with Pharma companies, (2) our attitudes to them and (3) the effects of this relationship on how we practice and prescribe.

  2. •If you're talking to medical students its good to mention this US study (Medical Students' exposure and attitudes to Drug company interactions) Frederick S. Sierles et al, JAMA. 2005;294:1034-1042.) that shows how students are also very entangled, influenced and indebted to the industry.


Patients' attitudes to our relationship with Pharma

If patients feel that we are influenced by drug companies we can lose their confidence, and be less able to give effective advice. A Comparison of Physicians and Patients' attitudes towards Pharmaceutical Industry Gifts shows that patients view gifts very differently to doctors....


Interesting articles

There are obviously a very large number of articles. Here are a few that will help get you started:

The Medical Profession and the Pharmaceutical Industry: when will we open our eyes is an easy introduction with references. The author looks at the evidence that we are affected by drug advertising, looks at the ethics of this, and offers suggestions as to how we might change this. Like a lot of work done in this area it's from Australia.

Who pays for the pizza? looks specifically at "Disentanglement" and reports on initiatives that have been taken to lessen the influence of Pharma advertising

Drug company sponsorship could be replaced at a fraction of the cost Many people will defend the role of drug companies by claiming they support continuing medical education. It's important to be able to answer this question. This article points to the fact that most of the money is spent on entertainment rather than education.


Presentations

  1. •This is the presentation given at the student conference in Napoli Influence of the Pharmaceutical Industry on Clinical Practice . All the studies it mentions have links above. Feel free to use or adjust it for your own talks.


Organisations who might be of help

1. No Free Lunch www.nofreelunch.org

2. Healthy Skepticism www.healthyskepticism.org

3. Neglected Diseases

4. Pharmaware is a new UK students’ initiative with aims to promote independence from the industy. They have links similar to this site