Interactions between Non-Physician Clinicians and Industry: A Systematic Review

Grundy, Quinn; Bero, Lisa; Malone, Ruth E.

doi:10.1371/journal.pmed.1001561

Cited by 42 publications

(52 citation statements)

References 44 publications

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“…Registered nurses described financial relationships with industry that took place outside their workplace that were similar to those reported by colleagues who were physicians or prescribing nurses (12,(21)(22)(23)). Yet, nurses reported that the most significant interactions with industry occurred in day-today practice, both because these interactions were frequently necessary to their practice and because they found them practically and ethically challenging.…”

Section: Discussionsupporting

confidence: 53%

“…Both actual and perceived COIs may threaten nurses' status as the most trusted professionals in the eyes of the public and may jeopardize their relationships with patients (10). Yet, almost nothing is known about the ways that RNs interact with industry, though research suggests they may have become an important "soft target" for industry and a back door to prescribers in light of increasing restrictions on physician-industry interactions (11,12). This has been accompanied by a shift within the medical industry away from traditional marketing channels targeted at physicians, including a reduction in face-to-face marketing and an increase in marketing directed at nonphysician clinicians, payers, and patients (13).…”

mentioning

confidence: 99%

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Marketing and the Most Trusted Profession: The Invisible Interactions Between Registered Nurses and Industry

Grundy¹,

Bero²,

Malone³

2016

Ann Intern Med

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Section: Discussionsupporting

confidence: 53%

mentioning

confidence: 99%

Marketing and the Most Trusted Profession: The Invisible Interactions Between Registered Nurses and Industry

Grundy¹,

Bero²,

Malone³

2016

Ann Intern Med

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“…Donohue and Berndt (Donohue & Berndt, 2004) found that drug choice probability positively increases with an increase in detailing expenses. Physician detailing has a significant and lasting influence on a physician's drug choice (Iizuka & Jin, 2007, Søndergaard, Vach, Kragstrup, & Andersen, 2009, Grundy, Bero, & Malone, 2013. Manchanda and Chintagunta (2004) reported that physicians who were over-detailed prescribed 50% more than the average physician, while physicians who were optimally detailed prescribed 60-104% more.…”

Section: Literature Reviewmentioning

confidence: 99%

Pricing and Promotional Decisions of a Drug Manufacturer with the Presence of a Price-Volume Agreement

Zhang¹,

Gregorio²

2016

IJBA

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Physicians prescribe not only based on the health outcome and costs of a drug, but also based on their personal experience and preference for certain drugs. Thus, drug manufacturers invest a significant amount of promotional efforts to influence physicians, efforts including detailing, invited conferences, and sponsored research, etc. Since a third-party payer must pay for all claims for a drug that is covered by an insurance plan, the expense for the drug may be very high and uncertain. To control increasing drug costs and sales uncertainty, price-volume agreements have been proposed as a way to reduce the risk of higher-than-expected drug expenses. In such agreements, a drug manufacturer has to return a portion to the payer of sales exceeding a pre-specified volume threshold. In this paper, we investigated the drug pricing and promotional decisions of a drug manufacturer in the presence of a price-volume agreement under three different pricing scenarios. We found it not necessarily true that a high drug price or a high quality drug (with a high health benefit) reduces the manufacturer's motivation to promote. We also found that the existence of a price-volume agreement may not increase the drug price, but it does help control the promotional effort. Although a negotiated price may be lower than the price set by the manufacturer, a negotiation may not always be preferred because the manufacturer's profit is reduced by the negotiation and thus an agreement may not be reached under certain circumstances.

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“…Una revisión sistemática publicada en 2013 en Plos Medicine puso de relieve que las interacciones entre industria y profesional afectan también a profesionales sanitarios no médicos 15 . En dicha revisión sistemática se citan de forma específica a los/las dietistas, los cuales mantienen, a pesar de ser conscientes de los problemas relacionados con los sesgos en las investigaciones, actitudes positivas hacia la interacción con la industria, denominándola a veces de forma cariñosa como "el diablo necesario" 15 . A pesar de que la interacción industria-profesional no es sinónimo de mala praxis en investigación o en la práctica clínica, los datos sobre su influencia en las conclusiones de los estudios son claros y contribuyen a la percepción de que "la ciencia de la nutrición humana y dietética está en venta" 6 .…”

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Conflictos de interés en nutrición humana y dietética

Baladía¹,

Martínez-Rodríguez²

2016

Rev Esp Nutr Hum Diet

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Sea como fuere, es un hecho constatado que los conflictos de interés (financieros o de otro tipo) tienen el potencial de producir sesgos importantes en la literatura científica 2 . Una revisión sistemática publicada en la revista JAMA en 2003 concluyó, tras revisar 8 artículos de revisión que evaluaban un total de 1.140 investigaciones, que existe una asociación positiva y estadísticamente significativa entre la financiación por parte de la industria y las conclusiones que favorecen a la misma (odds ratio 3,60; intervalo de confianza 95%: 2, 91) 3 . En la misma línea, una revisión Cochrane publicada en 2012 4 concluyó, tras evaluar 48 artículos, que los estudios financiados por la industria obtienen más a menudo resultados favorables en términos de eficacia (riesgo relativo 1,24; intervalo de confianza 95%: 1,14-1,35), de efectos adversos (riesgo relativo 1,87; intervalo de confianza 95%: 1,54-2,27), y en sus conclusiones (riesgo relativo 1,31; intervalo de confianza 95%: 1,20-1,44).Por si algún lector se ve tentado a pensar que este tipo de sesgos solamente ocurren por influencia de la industria del "Big Pharma", Michel Lucas y Elizabeth Loder lo expusieron A menudo los científicos tienden a pensar que existen conflictos de interés cuando hay intereses financieros en una investigación, sin embargo lo cierto es que la definición o el concepto de conflicto de interés es mucho más amplia.Quizás el origen de esta interpretación pueda explicarse por la definición que Dennis F. Thomson ofreció del concepto en 1993 en The New England Journal of Medicine 1 : "Un conflicto de intereses es un conjunto de condiciones en la que el juicio profesional en relación a un interés primario (como por ejemplo el bienestar de un paciente o la validez e integridad de una investigación), tiende a ser indebidamente influenciado por un interés secundario (como por ejemplo el beneficio económico)". A pesar de la expresa mención de los conflictos de interés financieros en el título de la publicación y en la ejemplificación, la lectura completa del artículo identifica claramente otros intereses secundarios que pueden representar un conflicto de interés, tales como el reconocimiento científico, el avance en la carrera académica, o el éxito en la publicación de artículos 1 .

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Interactions between Non-Physician Clinicians and Industry: A Systematic Review

Cited by 42 publications

References 44 publications

Marketing and the Most Trusted Profession: The Invisible Interactions Between Registered Nurses and Industry

Marketing and the Most Trusted Profession: The Invisible Interactions Between Registered Nurses and Industry

Pricing and Promotional Decisions of a Drug Manufacturer with the Presence of a Price-Volume Agreement

Conflictos de interés en nutrición humana y dietética

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