Healthy Skepticism Library item: 15162

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

Granja M.
LIGAÇÕES PERIGOSAS - Os Médicos e os Delegados de Informação Médica [DANGEROUS LIAISONS – physicians and pharmaceutical sales representatives]
Acta Med Port 2005 Jan-Feb; 18:(1):61-68
http://www.actamedicaportuguesa.com/pdf/2005-18/1/061-068.pdf

Abstract:

O objectivo deste trabalho foi fazer uma revisão do que já foi estudado sobre a relação entre os médicos e os delegados de informação médica, nomeadamente, sobre como os médicos vêem essas relações, sobre a influência que essas relações têm de facto nos seus hábitos de prescrição e sobre as formas de melhor lidar com a situação. Para tal, utilizando os termos de procura indicados nas palavras-chave, foi feita uma pesquisa na Medline e no Índex das Revistas Médicas Portuguesas.

A maioria dos médicos acredita firmemente que é imune à influência dos delegados de informação médica, mas os estudos realizados apontam precisamente em sentido contrário. As relações entre os médicos e os Laboratórios Farmacêuticos, mesmo quando legítimas à luz da legislação vigente, levantam questões éticas e científicas. A frequência com que os médicos portugueses (especialmente os médicos de família) são visitados por delegados, aparentemente muito superior à de países como os Estados Unidos da América ou o Canadá, torna esta questão de primordial importância neste país.

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Interactions between physicians and detailers (even when legitimate ones) raise scientific and ethical questions. In Portugal little thinking and discussion has been done on the subject and the blames for bribery have monopolized the media. This work intended to review what has been said in medical literature about these interactions. How do physicians see themselves when interacting with pharmaceutical companies and their representatives? Do these companies in fact change their prescriptive behaviour, and, if so, how do they change it? How can physicians interact with detailers and still keep their best practice? A Medline research, from 1966 till 2002, was performed using the key-words as follows. A database similar to Medline but concerning medical journals published in Portugal, Índex das Revistas Médicas Portuguesas, was also researched from 1992 to 2002.

Pharmaceutical companies are profit bound and they allot promoting activities, and detailing in particular, huge amounts of money. Most physicians hold firmly to the belief that they are able to resist and not be influenced by drug companies promotion activities. Nevertheless, all previous works on literature tell us the opposite. Market research also indicates that detailers effectively promote drug sales.

Various works also suggest that the information detailers provide to physicians may be largely incorrect, even comparing it to the written information provided by the pharmaceutical companies they work for. The frequency at which portuguese physicians (especially family physicians) contact with pharmaceutical sales representatives is higher than the frequency reported in countries where the available studies come from (namely, Canada and the United States of America). This may put portuguese physicians at a higher risk, making it imperative that work and wide debate are initiated among the class.

Keywords:
delegados de informação médica, indústria farmacêutica, pharmaceutical companies, pharmaceutical sales representatives, detailers, marketing of health services

Notes:

Free full Portuguese text