Interaction between physicians and the pharmaceutical industry: A scoping review for developing a policy brief

Abstract

BackgroundPayments to physicians by the pharmaceutical industry are common, but recent evidence shows that these payments influence physician prescribing behavior in the form of increased prescription of brand-name drugs, expensive and low-cost drugs, increased prescription of payer company drugs, etc. Considering that these payments increase drug costs for patients and health systems, there is a public interest in controlling them. Therefore, this study aimed to identify and propose policy options for managing physician-pharmaceutical industry interactions in the context of Iran's health system.MethodsIn the first phase, a systematic search was conducted to identify relevant policies and interventions in Web of Science, PubMed, and ProQuest databases from 2000 to 2022. Then, the opinions of the research team and an expert group (physicians, health policy and transparency experts, and industry representatives) were used to categorize the interventions and propose policy options along with their advantages, disadvantages, and implementation considerations.ResultsIn the search, 579 articles were retrieved, and 44 articles were found suitable for the final analysis. Twenty-nine interventions and strategies were identified, and based on these; Five policy options were identified: prohibition, restriction, physician self-regulation, voluntary industry disclosure, and mandatory industry disclosure.ConclusionThe proposed policies in our study include advantages, challenges, and implementation considerations based on up-to-date evidence that can help policymakers use them to manage COI in physician-pharmaceutical industry interactions in Iran's health system. A combination of measures seems to help manage COI: firstly, using self-regulating physicians and industry to institutionalize transparency, and in the next step, implementing mandatory industry disclosure policies and establishing restrictions on some financial interactions.

Drug Promotions Between Ethics, Regulations, and Financial Interests

“…The relationship between the medical world and the pharmaceutical industry is a universal reality, and the link between the pharmaceutical industry and the health care ecosystem is very complex, especially in the current context of developing new paradigms regarding the therapeutic space. 112,[148][149][150][151][152][153] Harmonization of these relationships is difficult to achieve given that the main duty of industry is to shareholders (to bring profit) while that of doctors is to patients and society. The harmonization of these interests has been attempted through legislative regulations and self-regulations that impose transparency, financial limits, monitoring, in the context of the development of increasingly stringent regulations at European level, including on data protection and obtaining informed consent.…”

“…The relationship between the medical world and the pharmaceutical industry is a universal reality, and the link between the pharmaceutical industry and the health care ecosystem is very complex, especially in the current context of developing new paradigms regarding the therapeutic space. 112,148–153…”

The Primacy of Ethics in Aesthetic Medicine: A Review

“…Medical aesthetics is rife with potential financial conflicts of interest. 48 Its growing integration into the wellness and beauty industries attracts multiple industry stakeholders. Industry sponsorship of trials, gifts to physicians, and speaking fees are common, 49 , 50 yet physicians often hesitate to disclose these relationships publicly, despite considering such gifts acceptable.…”

Overcoming Ethical Issues Surrounding the Relationships Between Physicians and Pharmaceutical Companies in Rural Hospitals

“…The relationship between physicians and pharmaceutical company representatives is an example of a non-clinical ethical dilemma regularly encountered in medicine and may be related to COIs in clinical practice [ 1 ]. Using specific medications manufactured by pharmaceutical companies with which physicians have relationships can breach ethics [ 2 ]. When the relationship between a company and a physician is based on the company’s provision of products to the physician, the physician may develop an unprofessional tendency to prescribe medications from the company as opposed to their competitors.…”