Legislative, educational, policy and other interventions targeting physicians’ interaction with pharmaceutical companies: a systematic review

Abstract

BackgroundPharmaceutical company representatives likely influence the prescribing habits and professional behaviour of physicians.ObjectiveThe objective of this study was to systematically review the effects of interventions targeting practising physicians’ interactions with pharmaceutical companies.Eligibility criteriaWe included observational studies, non-randomised controlled trials (non-RCTs) and RCTs evaluating legislative, educational, policy or other interventions targeting the interactions between physicians and pharmaceutical companies.Data sourcesThe search strategy included an electronic search of MEDLINE and EMBASE. Two reviewers performed duplicate and independent study selection, data abstraction and assessment of risk of bias.Appraisal and synthesis methodsWe assessed the risk of bias in each included study. We summarised the findings narratively because the nature of the data did not allow a meta-analysis to be conducted. We assessed the quality of evidence by outcome using the GRADE methodology.ResultsOf 11 189 identified citations, one RCT and three observational studies met the eligibility criteria. All four studies specifically targeted one type of interaction with pharmaceutical companies, that is, interactions with drug representatives. The RCT provided moderate quality evidence of no effect of a ‘collaborative approach’ between the pharmaceutical industry and a health authority. The three observational studies provided low quality evidence suggesting a positive effect of policies aiming to reduce interaction between physicians and pharmaceutical companies (by restricting free samples, promotional material, and meetings with pharmaceutical company representatives) on prescription behaviour.LimitationsWe identified too few studies to allow strong conclusions.ConclusionsAvailable evidence suggests a potential impact of policies aiming to reduce interaction between physicians and drug representatives on physicians’ prescription behaviour. We found no evidence concerning interventions affecting other types of interaction with pharmaceutical companies.

Awareness and attitudes of the Lebanese population with regard to physician–pharmaceutical company interaction: a survey study

“…On a broader level, there is a need for system-level interventions to regulate physician–industry interactions 15. These may include self-regulation (eg, voluntary codes of practice) and governmental regulations.…”

Ethical drug marketing criteria for the 21st century

“…Each listed value should be annotated with notes on how to interpret and act on the abstract concepts (table 1). The concrete guidance about specific promotional strategies and tools should also be extended to reflect new evidence and ideas—for example, restricting interactions between industry and prescribers or surrogate marketers, including prohibiting industry gifts to individuals or groups as well as meals, travel costs, and political donations47; banning free samples of prescription medicines; reducing or banning industry sponsorship of specific educational events or scientific studies48; restricting industry links with journal editors34; and encouraging the creation of independent detailing, education, and research.…”

Evidencia sobre conflictos de intereses en medicina

“…Nine reviews were based on research articles (Table 1), of which 4 clearly presented the association between sponsorship and outcomes; 3 did not assess the impact of having a conflict of interest; 1, which included Latin American and Caribbean publications, warns that funding for experimental studies is often ambiguous or unreported; and 1, which is a meta-analysis that analyzes preclinical trials in animals, did not find any difference between disclosing or not the financial conflict of interest. [14][15][16][17][18][19][20][21][22]…”

“…Alkhaled et al 20 Support for a specific drug is more common when the authors have financial conflicts of interest with the company marketing that drug. However, there is not enough evidence supporting an association between the funding of CPGs or consensus by the industry and said support.…”