Healthy Skepticism Library item: 6645

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: book

Schimm DS, Spece RG, Digregorio M.
Conflicts of interest in relationships between physicians and the pharmaceutical industry
New York: Oxford University Press 1996

Abstract:

Manufacturers can try to influence physicians to use or prescribe their products by offering gifts, payment for consulting, honoraria for presentations and subsidies or hospitality for physicians attending conferences; sponsoring continuing medical education; making direct payments to clinician-investigators for performing research; marketing products via advertisements and personal detailing; and lobyying regulators and legislators. This chapter surveys the major practices used by manufacturers to influence physician behaviour and discusses how this introduces conflicts of interest into relationships among patients, physicians, the biomedical industry and the public. The chapter uses the manufacture of coagulation factor concentrates for hemophiliacs as a case study that illustrates the pervasive influence of pharmaceutical companies. Finally, the chapter suggests reforms to the be considered in response to theese conflicts of interest.

Keywords:
*analysis/United States/United Kingdom/ conflict of interest/ reimbursement to doctors/ agency role/ doctor-patient relationship/ drug company sponsored research/ relationship between researchers, academic institutions and industry/ corporate funding/CME/continuing medical education/quality of information/gift giving/regulation of promotion/FDA/Food and Drug Administration/quality of prescribing//journal advertisements/sales representatives/profit motive/ad revenue/scientific publications/coagulation factor concentrates/safety & risk information/doctors/ industrial physicians/ETHICAL ISSUES IN PROMOTION: GIFT GIVING/ETHICAL ISSUES IN PROMOTION: PAYMENTS IN STUDIES/EVALUATION OF PROMOTION: DETAILING/EVALUATION OF PROMOTION: JOURNAL ADVERTISEMENTS/INFLUENCE OF PROMOTION: DOCTOR-PATIENT RELATIONSHIP/INFLUENCE OF PROMOTION: PRESCRIBING, DRUG USE/PROMOTION DISGUISED: SUPPORT FOR CME/REGULATION, CODES, GUIDELINES: DIRECT GOVERNMENT REGULATION/REGULATION, CODES, GUIDELINES: HEALTH PROFESSIONAL ORGANIZATIONS/SPONSORSHIP: RESEARCH

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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