Conflict of Interests Between Doctors and Drug Companies - The entanglement between doctors and drug companies is creating controversy in both the public and academic worlds as it becomes clear that the integrity of medical research and the prescription habits of doctors are being influenced.

The close relationship between doctors and drug companies is attracting increasing public and academic scrutiny, as drug costs grow ever higher.

Despite evidence that information from drug company representatives is often overly positive, 80 percent to 95 percent of doctors see drug reps regularly. Many doctors also receive gifts from drug companies each year.

In the United States an estimated 80,000 drug company representatives, backed by more than $19 billion of industry's combined annual promotional budgets, are visiting doctors every day.

Evidence has shown that gifts from drug companies influence doctor’s prescribing habits and have been associated with an increase in prescriptions of the promoted drug. Nonetheless, meals

Forms of Drug Company Conflicts of Interest Face-to-face visits from drug company representatives Acceptance of direct gifts of equipment, travel, or accommodation Acceptance of indirect gifts, through sponsorship of software or travel Attendance at sponsored dinners and social or recreational events Attendance at sponsored educational events, continuing medical education, workshops, or seminars Attendance at sponsored scientific conferences Ownership of stock or equity holdings Conducting sponsored research Company funding for medical schools, academic chairs, or lecture halls Membership of sponsored professional societies and associations Advising a sponsored disease foundation or patients' group Involvement with or use of sponsored clinical guidelines Undertaking paid consultancy work for companies Membership of company advisory boards of "thought leaders" or "speakers' bureau" Authoring "ghostwritten" scientific articles Medical journals' reliance on drug company advertising, company purchased reprints, and sponsored supplements

and expenses for travel or accommodation for industry-sponsored educational meetings, which often highlight the sponsor’s drug, are commonly accepted by doctors.

The industry has recently implemented a voluntary code to address relationships with health care professionals. However, many question the effectiveness of such codes considering that if a company flies 300 doctors to a golf resort, reimburses their costs, pays them to attend, and educates them about the company's latest drug, in order to train them to become members of the company's stable of paid speakers, the entire activity would be in compliance.

Further, many professional societies rely on industry sponsorship and their medical journals often rely on industry-funded research trials, advertisements and industry-sponsored supplements.

Currently, an estimated 60 percent of biomedical research and development in the United States is privately funded.

However, there is an abundance of strong evidence that industry-sponsored research tends to yield results that are favorable to sponsor much more often than non-industry studies.

The many conflicts of interest have led one expert to say that the medical profession is being bought by the pharmaceutical industry.

Moreover, many experts agree that the entanglement between drug companies and doctors is part of the reason for ever-increasing drug costs and part of the reason why attempts to control costs are undermined.

British Medical Journal May 31, 2003;326:1189-192 (Part 1, Full Text Article)

British Medical Journal May 312003;326:1193-1196 (Part 2, Full Text Article)