Association Between Academic Medical Center Pharmaceutical Detailing Policies and Physician Prescribing

Larkin, Ian; Ang, Desmond; Steinhart, Jonathan; Chao, Matthew; Patterson, Mark T; Sah, Sunita; Wu, Tao; Schoenbaum, Michael; Hutchins, David; Brennan, Troyen A.; Loewenstein, George

doi:10.1001/jama.2017.4039

Cited by 95 publications

(74 citation statements)

References 14 publications

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“…Across all drugs in their data, they find that 5 We measure these policies using the American Medical Students Association (AMSA) Conflict of Interest Report Card scores. In related work using these data, Larkin et al (2017) examine the direct effects of conflict-of-interest policies, finding that they have a modest, but significant negative effect on prescribing.…”

Section: Introductionmentioning

confidence: 99%

Physician-Industry Interactions: Persuasion and Welfare

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Physician-Industry Interactions: Persuasion and Welfare

et al. 2018

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“…A growing literature documents the importance of these relationships on physician prescribing: specifically, more total prescribing and more prescribing of expensive medications in particular. [1][2][3][4][5][6][7][8][9] To be sure, grants and contractually defined consulting relationships can have beneficial effects on patient care by fostering innovations in drug discovery and technology. However, other common relationships, including speakers' bureaus and token consulting arrangements, may promote activities of questionable medical benefit by favoring industry's interests over those of patients, such as by promoting brand-name drug prescriptions and use of new devices and tests with uncertain value to patients.…”

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confidence: 99%

Association of Mandatory Disclosure Policies and Laws With Physician-Industry Financial Relationships

et al. 2019

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Beside the goal of increasing transparency to the public, disclosure policies and laws have been established with a goal to also reduce ethically questionable financial relationships between physicians and the medical industry. Data on these relationships should be reviewed to understand the association between these policies and laws and the attainment of reduced relationships. OBJECTIVE To assess whether disclosure policies and laws have been associated with a decrease in financial disclosure reporting by physicians. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study uses yearly data from 2008 through 2015 from the participants in the American Academy of Ophthalmology's Annual Meeting. Trends in financial disclosures over time were investigated for the association of disclosure policies and laws with potentially beneficial, as well as ethically questionable physician-industry ties. Linear regression models were used to estimate the annual change in financial disclosures and are reported with 95% CIs. EXPOSURES Disclosure policies and laws. MAIN OUTCOMES AND MEASURES The annual aggregate financial disclosures by type (ie, consultant, lecturer, employee, grant support, equity owner, patent holder). RESULTS Financial disclosures increased from 3966 in 2008 to 5266 in 2015 (P < .001). The number of disclosures reported in the categories consultant, equity owner, patents, and grant support all increased from 2008 to 2015 (consultant disclosures, 121 [95% CI, 88-155] per year; P < .001; equity owner disclosures, 32 [95% CI, 22-42] per year; P < .001; patent disclosures, 19 [95% CI, 13-26] per year; P < .001; grant support disclosures, 78 [95% CI, 48-107] per year; P < .001), while the employee and lecturer categories did not change significantly. The percentage of financial disclosures in the lecturer category decreased relative to the total (estimate, −1.1% [95% CI, −1.3% to −0.8%] per year; P < .001), owing to the number of financial disclosures for this category remaining stable while most other types increased. CONCLUSIONS AND RELEVANCE Disclosure was not associated with a chilling effect (decrease in financial disclosures associated with potentially beneficial physician-industry ties). Disclosure was associated with a possible disinfecting effect, whereby the percentage of ethically questionable disclosures (ie, lecturers) decreased, although the frequency remained stable. A permissive effect (physicians becoming more inclined to having industry relationships) was also observed. Thus, disclosure rules should be enhanced or alternative approaches to disclosure reconsidered to promote a decrease in ethically questionable relationships.

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“…Exposición temprana: La RMI existe desde las escuelas de medicina; una revisión sistemática encontró que los estudiantes de universidades que restringían a los RV eran más escépticos y críticos con la información que aquellos estudiantes sin restricciones (17) . Larkin reportó una reducción modesta pero significativa en prescripción de medicamentos de marca cuando restringían el contacto de los estudiantes con la IF (41) . La exposición temprana puede ser un factor que explique la percepción de la RMI como algo natural.…”

Section: Tabla 2 Actuaciones De La Industria Farmacéutica En La Visiunclassified

Relación médico-industria y los conflictos de interés: aspectos históricos y normativos, impactos negativos y propuestas

Genta-Mesa

Flórez

2019

Iatreia

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El presente artículo revisa de manera narrativa y general la relación entre los médicos y la industria (RMI); se incluye a la industria farmacéutica, de dispositivos, de suplementos y los conflictos de intereses que surgen de dicha relación. Se aborda el tema mediante algunas definiciones y un breve recuento histórico de cómo la RMI se ha convertido en un problema importante en el ejercicio médico y los sistemas de salud.El artículo expone los diversos roles dentro de los escenarios más comunes en los que ocurre la RMI: en la investigación biomédica, las guías de práctica clínica, la educación médica continua, la visita médica, los líderes de opinión, así como en la interacción directa, la exposición indirecta y la que denominamos exposición temprana. Se mencionan, posteriormente, algunas técnicas que utiliza la industria para modificar los hábitos de prescripción basadas en elementos de psicología social, así como el papel que ejercen los obsequios y otras estrategias de mercadeo.Se revisó la literatura que muestra el impacto y el efecto que estas técnicas tienen en el ejercicio médico. Finalmente, se plantean algunas propuestas que se han desarrollado desde la normatividad y recomendaciones para afrontar el problema que podrían contribuir a mitigar los efectos negativos de una RMI muy estrecha. Estas propuestas son prohibir el contacto de los estudiantes con la industria, la inclusión del tema de conflictos de intereses (CI) en los currículos de medicina, financiación alternativa de la educación continua, declaración de conflictos como norma, campañas de concientización, uso de evidencia sintetizada y analizada transparente e independientemente, entre otras.

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Association Between Academic Medical Center Pharmaceutical Detailing Policies and Physician Prescribing

Cited by 95 publications

References 14 publications

Physician-Industry Interactions: Persuasion and Welfare

Physician-Industry Interactions: Persuasion and Welfare

Association of Mandatory Disclosure Policies and Laws With Physician-Industry Financial Relationships

Relación médico-industria y los conflictos de interés: aspectos históricos y normativos, impactos negativos y propuestas

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