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Healthy Skepticism Library item: 18749

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: news

Tan EL
Drug companies influence prescribing, study finds
Reuters 2010 Oct 19
http://www.reuters.com/article/idUSTRE69I6DK20101019


Full text:

Doctors tend to prescribe drugs that pharmaceutical companies promote to them and patients end up paying more but not always getting the most suitable medicines, researchers reported on Wednesday.

An analysis of 58 studies in several countries found that information from drug companies influenced the decisions doctors made, and not necessarily in a positive way.

“You couldn’t say that information from pharmaceutical companies benefited doctor’s prescribing, which is what pharmaceutical companies claim,” said Geoffrey Spurling of the University of Queensland in Brisbane, Australia, who led the study.

“Many doctors claim they are not influenced and having done the review, that is not supported. You have to say that at least some of the time, doctors are influenced,” he said in a telephone interview.

Several of the researchers in the study are members of Healthy Skepticism, an international nonprofit research, education, and advocacy association set up to “reduce harm from misleading health information.”

The report found that doctors who accepted briefings or other information from drug companies were more likely to prescribe those products.

Thirty-eight studies showed that exposure to drug company information resulted in more frequent prescriptions, while 13 did not have such an association, Spurling and his colleagues wrote in their report published in the U.S.-based Public Library of Science journal PLoS Medicine, here:doi/10.1371/journal.pmed.1000352.

None of the studies found that doctors prescribed a drug less often because of promotional or informational materials. More than half the studies were conducted in the United States. Other countries included the United Kingdom, Canada, Denmark, France, Estonia, Turkey and Australia.

SPENDING PAYS OFF

“The companies don’t spend this money with drug detail people if it doesn’t work,” said Dr. Sid Wolfe of the U.S. advocacy group Public Citizen, which has campaigned against such drug company activity.

“Most doctors get most of their information about drugs from the drug industry.”

Such detailers often bring lunch to a doctor’s office, or invite physicians to sporting events or other entertainment while they deliver their briefings.

Spurling singled out a study in Britain of more than 1,000 general practitioners that found that those who met drug salespeople more often tended to prescribe more costly drugs.

But that did not guarantee that patients got the most suitable drugs.

Spurling cited studies that found that doctors’ prescriptions were of a lower quality when compared against standard guidelines and those recommended by expert panels.
For example, official U.S. guidelines in the United States advise doctors to use the oldest, cheapest generic drugs to treat high blood pressure and diabetes before turning to newer, patented and often more dangerous prescription drugs.

The researchers called for regulation on the amounts of money that pharmaceutical companies may spend on promoting their products. In 2004 alone, drug companies spent $57.5 billion on promotion in the United States, they said.

“We need more regulation on promotional information. We couldn’t find any benefit,” Spurling said.

Doctors also need more information from a variety of sources such as universities or accrediting organizations, he said.

“A good doctor keeps up with practicing medicine by reading the literature, peer-reviewed journals,” Wolfe agreed.

“If they don’t have time to do that, and rely on drug company detailers, they are not practicing good medicine.”

On Tuesday, the investigative journalism group ProPublica, along with several news organizations, reported that seven big drug companies had paid more than 17,000 U.S. doctors many thousands of dollars to talk to other doctors about the companies’ products.

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909