E-drug: Article of interest
E druggers may want to look at an article in the latest issue of JAMA
entitled ?Physicians and the pharmaceutical industry: is a gift ever
just a gift?? The web site address to view the entire article is:
<jama.ama-assn.org/issues/v283n3/full/jrv90028.html>. Here is the
Controversy exists over the fact that physicians have regular
contact with the pharmaceutical industry and its sales
representatives, who spend a large sum of money each year
promoting to them by way of gifts, free meals, travel subsidies,
sponsored teachings, and symposia.
To identify the extent of and attitudes toward the relationship
between physicians and the pharmaceutical industry and its
representatives and its impact on the knowledge, attitudes, and
behavior of physicians.
A Medline search was conducted for English-language articles
published from 1994 to present, with review of reference lists from
retrieved articles; in addition, an Internet database was searched
and 5 key informants were interviewed.
A total of 538 studies that provided data on any of the study
questions were targeted for retrieval, 29 of which were included in
Data were extracted by 1 author. Articles using an analytic design
were considered to be of higher methodological quality.
Physician interactions with pharmaceutical representatives were
generally endorsed, began in medical school, and continued at a
rate of about 4 times per month. Meetings with pharmaceutical
representatives were associated with requests by physicians for
adding the drugs to the hospital formulary and changes in
prescribing practice. Drug company sponsored continuing medical
education (CME) preferentially highlighted the sponsor's drug(s)
compared with other CME programs. Attending sponsored CME
events and accepting funding for travel or lodging for educational
symposia were associated with increased prescription rates of the
sponsor's medication. Attending presentations given by
pharmaceutical representative speakers was also associated with
The present extent of physician-industry interactions appears to
affect prescribing and professional behavior and should be further
addressed at the level of policy and education.
Joel Lexchin MD
Townhouse #2--40 Cedar Crescent
Glenside, S.A. 5065
Tel: +8 8338 0151
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