Physicians Continue To Receive Gifts, Money From Pharmaceutical Industry Despite

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Physicians Continue To Receive Gifts, Money From Pharmaceutical

Industry Despite Voluntary Guidelines Against The Practice,

According To NEJM

http://www.medicalnewstoday.com/medicalnews.php?newsid=69120

Ninety-four percent of physicians have relationships with

pharmaceutical companies in which the companies provide them with

food and beverages, medication samples, and other gifts and

payments, according to a study published on Thursday in the New

England Journal of Medicine, the Pittsburgh Post-Gazette reports

(Fahy, Pittsburgh Post-Gazette, 4/26). For the study, Harvard

Medical School researchers in late 2003 and early 2004 mailed

surveys and a $20 check to a random sample of 3,167

anesthesiologists, cardiologists, family practitioners, general

surgeons, internists and pediatricians (Rubin, USA Today, 4/26).

More than 1,600 physicians responded to the survey. The study found:

83% of physicians received food and beverages from pharmaceutical

company sales representatives;

78% received medication samples (Gellene, Los Angeles Times, 4/26);

35% received reimbursement for the cost of attendance at continuing

medical education conferences sponsored by pharmaceutical companies;

28% received fees from the pharmaceutical companies for consulting,

speaking engagements or enrollment of patients in clinical trials;

and

7% received tickets to sports events and entertainment (Pereira,

Wall Street Journal, 4/26).

The study found that family practitioners met with pharmaceutical

company sales representatives " far more often " than other physicians

and were the most likely to receive food, beverages and other gifts,

the AP/Philadelphia Inquirer reports. However, cardiologists were

more than twice as likely as family practitioners to receive fees

from pharmaceutical companies, the study found. Physicians in

private practices were six times more likely to receive medication

samples and three times more likely to receive other gifts than

those in hospitals, according to the study (Chang, AP/Philadelphia

Inquirer, 4/26). The study is the first to examine the issue of

gifts to physicians since the pharmaceutical industry and the

American Medical Association each established voluntary guidelines

in 2002. The guidelines, prompted by concerns about potential

conflicts of interest, established limits on the value and the type

of gifts considered acceptable. The study found that some of the

gifts physicians received " clearly fell outside ethical guidelines, "

the Times reports (Los Angeles Times, 4/26).

Reaction

Lead study co-author , an associate professor of

medicine at Massachusetts General Hospital and Harvard, said, " Would

you care if this person was managing your 401(k) and you found out

they had financial relationships with mutual fund companies, if an

umpire was calling the World Series ... would anybody care if the

umpires were being paid by either of those two teams? If people

would be very concerned that it was happening in a baseball game,

you would be even more concerned if it was something like your

health " (Japsen, Chicago Tribune, 4/26). He added, " If the companies

didn't benefit from the relationships, they wouldn't be doing it "

(Los Angeles Times, 4/26). Study co-author Blumenthal, a

Harvard medical professor, said, " We all know that gifts and

gratuities create a subconscious sense of indebtedness, and they

improve the likelihood of a physician using that particular drug

company's brand of medicine. " Rothman -- president of the

Institute on Medicine as a Profession, which funded the study --

said, " Unfortunately, as things stand, it's going to be up to

doctors to clean up their act. " However, Stossel, a Harvard

medical professor not involved with the study, said, " If a physician

can be influenced into prescribing certain drugs just because he had

pizza with a pharmaceutical guy, then it's the fault of his training

and not the drug company " (Wall Street Journal, 4/26). Ken ,

a senior vice president for the Pharmaceutical Research and

Manufacturers of America, said, " Pharmaceutical marketing is one of

several very important ways for health care providers to receive the

information they need to make sure medicines are used properly and

patients are safely and effectively treated " (Ricks, Long Island

Newsday, 4/25). The study is available online.

Broadcast Coverage

Two broadcast programs reported on the study:

American Public Media's " Marketplace " : The segment includes comments

from (Moon, " Marketplace, " APM, 4/25). Audio of the segment

is available online.

NBC's " Nightly News " : The segment includes comments from a former

pharmaceutical company sales representative and Mohrer, a

New York physician who no longer allows pharmaceutical company sales

representatives into his office (Bazell, " Nightly News, " NBC, 4/25).

Video of the segment is available online.