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Healthy Skepticism Library item: 19862

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: Journal Article

Caudill TS, Johnson MS, Rich EC, McKinney WP.
Physicians, pharmaceutical sales representatives, and the cost of prescribing.
Arch Fam Med 1996; 5:(4):201-6
http://www.ncbi.nlm.nih.gov/pubmed/8769907


Abstract:

OBJECTIVE:

To evaluate the influence of primary care physicians’ attitudes toward and use of information provided by pharmaceutical representatives on prescribing costs in ambulatory practice.
DESIGN:

A mailed questionnaire collected information about physician demographic and practice characteristics and attitudes toward and use of information provided by pharmaceutical representatives.
PARTICIPANTS:

Kentucky physicians practicing primary care adult medicine (family medicine, general practice, general medicine; n = 1603).
MAIN OUTCOME MEASURE:

Relative cost of prescribing, based on physician responses to treatment choices for ambulatory clinical scenarios in primary care. A multivariable regression model assessed predictive relationships between independent variables and prescription costs.
RESULTS:

Four hundred forty-six returned questionnaires were suitable for analysis. No significant differences were noted in age, gender, days worked per week, or years since graduation between responders and a sample of nonresponders. A significant positive correlation was found between physician cost of prescribing and perceived credibility, availability, applicability, and use of information provided by pharmaceutical representatives (P < .01, Pearson’s Product-Moment Correlation Coefficient). Physicians in academic or hospital-based practice settings had significantly lower prescribing costs than physicians in nonacademic and nonhospital practices (P = .001, analysis of variance). Frequency of use of information provided by pharmaceutical representatives (P = .01, multiple linear regression) and the group practice setting (P = .02, multiple linear regression) remained significant, independent positive predictors of cost in the multivariable regression model.
CONCLUSIONS:

Frequency of use of information provided by pharmaceutical representatives and the group practice, nonacademic and nonhospital setting may be associated with increased primary care physician prescribing costs.

Keywords:
Attitude of Health Personnel* Drug Industry* Drug Information Services/utilization* Drug Prescriptions/economics* Female Health Knowledge, Attitudes, Practice Humans Kentucky Male Middle Aged Physician's Practice Patterns/economics* Physicians, Family* Prescription Fees Questionnaires Regression Analysis

 

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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