Physicians’ Ties With Pharmaceutical Companies: Down, but not out
Medical doctors relationships with pharmaceutical industry representatives are insidious. Industry representatives seek to induce physicians to prescribe certain drugs through the use of free samples, sponsored lunch programs, educational symposiums, gifts, reimbursements, payments, and sales calls whereby representatives are armed with detailed prescribing data. Although this interaction remains highly pervasive, a number of attempts have been made to control the situation and offset the rising prescription drugs costs in the United States. First, Individual states have tried to legislatively bar the sales of prescribing data mined from pharmacy records to drug companies. Second, institutions such as hospitals and doctors offices have created policies targeted at lessening the interaction between physicians and pharmaceutical companies. And most recently, Senator Grassley helped push Congress to pass the “Physician Payments Sunshine Act” as part of the health care reform package, requiring drug companies to report and record physician payments to a searchable database. PhRMA, the industry lobby association, has responded to the pressure, revising its marketing code for drug companies to no longer distribute non-educational items (readno more drug pens and pads)!
To assess the impact of this sea of change, researchers at Massachusetts General Hospital, The University of Massachusetts at Boston, and Harvard Medical School conducted a study comparing the physician-industry relationship to a similar study conducted five years earlier. The findings, published in the November 8, 2010 Archives of Internal Medicine, reveal that physicians still have considerable interaction with industry representatives, although to a lesser extent than five years earlier. Of almost 3,000 physicians surveyed in 2009, 83.8% reported some interaction with industry representatives, compared to 94% five years earlier. 14.1% received industry payments in 2009 (compared with 28% five years earlier) and 70.8% received gifts (down from 83% five years earlier). All these findings represent a statistically significant and important decline. In short, pharmaceutical representatives still employ an armamentarium targeted at physicians, although most recently, policy holders are gaining a foothold in the battle. The impact of this change on drug costs and patient safety are uncertain, although, by most accounts, it is a positive influence on an important and timely medical, legal, and social issue.