The doctor gets a gift, you have to buy more medicines. The study's conclusions may worry patients

Contacts between doctors and pharmaceutical companies under the microscope

An international team of scientists analyzed research on contacts between pharmaceutical companies and prescribers. The authors wanted to check whether they are related to changes in the number and costs of prescribed drugs and to what extent the treatment meets the real needs of patients. They compared the practices of people who had such contacts with those who did not have them or had fewer of them.

The study results were published in the Cochrane Database of Systematic Reviews. The authors mainly took into account visits of representatives of pharmaceutical companies to doctors in their offices, financing of training and conferences for doctors by these companies, providing meals for doctors during such events, giving gifts, paying remuneration for consultations and participation in advisory boards of companies, and providing free drug samples to be given to patients.

Promoted prescribed drugs recommended by doctors to patients

Among the analyzed publications, most (62) concerned payments and gifts. Their results indicated that doctors receiving such services from the pharmaceutical industry prescribed more drugs, especially products promoted by a given company.

They were also more likely to choose treatment that was later assessed as inappropriate, i.e. unnecessary for the patient or potentially harmful. The costs of prescribed preparations were also higher, which affected both the health care system and patients.

In the USA, more than half of doctors accept gifts

In the United States, where companies are required to report payments made to physicians in a public database, just over half of all licensed physicians accepted payment, including free meals, from a pharmaceutical company. This is important because it shows that companies are focusing their marketing resources on doctors who will provide the highest return on investment by prescribing more promoted drugs (...) - noted the co-author of the review, prof. Quinn Grundy from the University of Toronto (Canada).

She added that this is a common phenomenon, although many doctors still do not take advantage of these offers and remain independent of the influence of this industry.

The 16 studies included in the review concerned advertising and educational activities aimed at doctors, i.e. primarily visits by representatives of pharmaceutical companies to their offices. Such contacts were associated with more prescriptions and less appropriate treatment choices and higher costs, although these findings were somewhat less certain. In turn, the data regarding free samples did not allow certain conclusions to be drawn.

You can fight it

The researchers also examined the results of eight studies on policies limiting conflicts of interest in medical facilities. It was about, among other things, o restrictions on visits by sales representatives and acceptance of gifts and drug samples. As the results showed, such policies promoted more appropriate drug prescribing and may have reduced the number of drugs prescribed.

According to prof. Grundy, this proves that it is possible to create work environments that support physician independence. However, these actions should be taken at the level of medical facilities and entire healthcare systems, rather than leaving this responsibility to individual doctors.

The researcher also emphasized that people issuing prescriptions need independent information based on scientific evidence.

Medical organizations, professional associations and universities educating doctors should be more aware of the marketing of pharmaceutical companies, better recognize its influence on doctors' decisions and introduce rules that limit it - conclude the authors of the study.