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Conflict of Interests Between Doctors and Drug Companies
- The entanglement between doctors and drug companies is creating
controversy in both the public and academic worlds as it becomes
clear that the integrity of medical research and the prescription
habits of doctors are being influenced.
The close relationship between doctors and drug companies
is attracting increasing public and academic scrutiny, as
drug costs grow ever higher.
Despite evidence that information from drug company representatives
is often overly positive, 80 percent to 95 percent of doctors
see drug reps regularly. Many doctors also receive gifts from
drug companies each year.
In
the United States an estimated 80,000 drug company representatives,
backed by more than $19 billion of industry's combined annual
promotional budgets, are visiting doctors every day.
Evidence has shown that gifts from drug companies influence
doctor’s prescribing habits and have been associated with
an increase in prescriptions of the promoted drug. Nonetheless,
meals
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Forms
of Drug Company Conflicts of Interest
- Face-to-face visits from drug
company representatives
- Acceptance
of direct gifts of equipment, travel, or accommodation
- Acceptance
of indirect gifts, through sponsorship of software
or travel
- Attendance
at sponsored dinners and social or recreational
events
- Attendance
at sponsored educational events, continuing
medical education, workshops, or seminars
- Attendance
at sponsored scientific conferences
- Ownership
of stock or equity holdings
- Conducting
sponsored research
- Company
funding for medical schools, academic chairs,
or lecture halls
- Membership
of sponsored professional societies and associations
- Advising
a sponsored disease foundation or patients'
group
- Involvement
with or use of sponsored clinical guidelines
- Undertaking
paid consultancy work for companies
- Membership
of company advisory boards of "thought
leaders" or "speakers' bureau"
- Authoring
"ghostwritten" scientific articles
- Medical journals' reliance on
drug company advertising, company purchased
reprints, and sponsored supplements
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and expenses for travel or accommodation for industry-sponsored
educational meetings, which often highlight the sponsor’s
drug, are commonly accepted by doctors.
The industry has recently implemented a voluntary code to
address relationships with health care professionals. However,
many question the effectiveness of such codes considering
that if a company flies 300 doctors to a golf resort, reimburses
their costs, pays them to attend, and educates them about
the company's latest drug, in order to train them to become
members of the company's stable of paid speakers, the entire
activity would be in compliance.
Further, many professional societies rely on industry sponsorship
and their medical journals often rely on industry-funded research
trials, advertisements and industry-sponsored supplements.
Currently, an
estimated 60 percent of biomedical research and development
in the United States is privately funded.
However, there is an abundance of strong evidence that industry-sponsored
research tends to yield results that are favorable to sponsor
much more often than non-industry studies.
The many conflicts of interest have led one expert to say
that the medical profession is being bought by the pharmaceutical
industry.
Moreover, many experts agree that the entanglement between
drug companies and doctors is part of the reason for ever-increasing
drug costs and part of the reason why attempts to control
costs are undermined.
British
Medical Journal May 31, 2003;326:1189-192 (Part 1, Full
Text Article)
British
Medical Journal May 312003;326:1193-1196 (Part 2,
Full Text Article)
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