Based on four different papers, published in The New England Journal of Medicine, the PLoS Medicine, and the Journal of General Internal Medicine, the efforts to curb drug companies’ courting of your doctors is still ineffective.
In fact, the industry is working harder than ever to influence which medicines you are prescribed, by sending out sales representatives with greater frequency, bringing gifts, meals and offering consulting fees to high prescribers.
According to the study published in The New England Journal of Medicine,
94 percent of doctors have some type of relationship with the drug industry
80 percent of doctors commonly accept free food and drug samples
One-third of doctors were reimbursed by the drug industry for going to professional meetings or continuing education classes
28 percent of doctors have been paid for consulting, giving lectures, or signing their patients up for clinical trials
Contacts between doctors and sales reps have jumped from an average of 4.4 visits per month in 2000, to an average of:
16 times per month with cardiologists
9-10 times per month with internists
8 times per month with pediatricians
4 times per month with surgeons
The only group appearing to be meeting drug company representatives less often than before is anesthesiologists, who now see reps twice a month.
These sales tactics are working. In the second PLoS Medicine study, visits by drug detailers (sales reps) prompted nearly half of 97 doctors to increase their prescriptions for Gabapentin, an anti-seizure drug. In many cases the reps were advocating the use of Gabapentin for non-approved, so-called “off-label” uses.
The Journal of General Internal Medicine study found that physicians do understand the potential conflicts of interest, but that they still view their meetings with drug reps as both valuable and appropriate. According to the authors of that study, this proves that the voluntary guidelines currently in place are inadequate.
The New England Journal of Medicine April 26, 2007; 356:1742-1750 (Free Full Text Report)
PLoS Medicine April, 2007; 4(4):e150 (Free Full Text Report)
PLoS Medicine April, 2007; 4(4):e134 (Free Full Text Report)
Journal of General Internal Medicine February, 2007; 22(2): 184–190 (Free Full Text Report)
Washington Post April 28, 2007