Articles/Links: Industry Marketing to Physicians

• Health Industry Practices That Create Conflicts of Interest Author: T.A. Brennan, D.J. Rothman, L. Blank, D. Blumenthal, S.C. Chimonas, J.J. Cohen, J. Goldman, J.P. Kassirer, H. Kimball, J. Naughton and N. Smelser - Jan 25, 2006
  A major challenge to medical professionalism is the conflict of interest between physicians' commitment to patient interests and pharmaceutical company product promotion. Research in the social sciences and psychology on gifting suggests that current self-regulation controls will not satisfactorily protect patients. This paper calls for more stringent regulation and proposes a policy for academic medical centers to take the lead in eliminating physicians' conflicts of interest.READ MORE »
• New Federal Guidelines For Physician-Pharmaceutical Industry Relations: The Politics of Policy Formation Author: S. Chimonas and D.J. Rothman - Jul 2005
  In October 2002, the federal government issued a draft "Compliance Program Guidance for Pharmaceutical Manufacturers." The draft questioned the legality of many arrangements left to the discretion of physicians and drug companies, including industry-funded educational and research grants, consultancies, and gifts. The authors compared the draft, the changes requested by industry and organized medicine, and the final document, issued in April 2003.
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• A Social Science Perspective on Gifts to Physicians From Industry Author: J. Dana and G. Loewenstein - Jul 9, 2003
  Gift giving by the pharmaceutical industry may not only subconsciously bias the prescribing practice of doctors; it also serves to increase the costs of prescription drugs, and may lead to irrational prescribing. The courting of doctors causes biases resulting in a conflict of interests between financial self interest and professional or ethical interest. The article provides social science research that investigates a "self interested bias" related to conceptions of fairness and demonstrates that: 1. individuals are unable to remain objective, 2. bias is denied, and 3.self interest indirectly affects decisions. The article also cites data that reflects the unconscious bias of doctors after various gifts were given by pharmaceutical companies. The article concludes with policy suggestions, most pointedly, that all gifts should be prohibited.READ MORE »
• Defending Professional Independence: ACCME's Proposed New Guidelines for Commercial Support of CME Author: A.S. Relman - May 14, 2003
  This article discusses the Accreditation Council on Continuing Medical Education's (ACCME) new guidelines for support of continuing medical education programs by commercial industries, such as pharmaceutical companies.READ MORE »
• OIG Compliance Program Guidance for Pharmaceutical Manufacturers Author: Office of Inspector General, Department of Health and Human Services - May 5, 2003
  "This Federal Register notice sets forth the recently issued Compliance Program Guidance for Pharmaceutical Manufacturers developed by the Office of Inspector General (OIG). Through this notice, the OIG is setting forth its general views on the value and fundamental principles of compliance programs for pharmaceutical manufacturers and the specific elements that pharmaceutical manufacturers should consider when developing and implementing an effective compliance program."READ MORE »
• Draft OIG Compliance Program Guidance for Pharmaceutical Manufacturers Author: Office of Inspector General, Department of Health and Human Services - Oct 3, 2002
  "This Federal Register notice seeks the comments of interested parties on draft compliance guidance developed by the Office of Inspector General (OIG) for the pharmaceutical industry. Through this notice, the OIG is setting forth its general views on the value and fundamental principles of compliance programs for pharmaceutical manufacturers and the specific elements that pharmaceutical manufacturers should consider when developing and implementing an effective compliance program."READ MORE »
• The Invisible Hand of the Marketing Department Author: Canadian Medical Association Journal - Jul 9, 2002
  In this editoral, the writers warn that pharmaceutical company marketing to physicians has become more sublte, and physicians should be aware of how marketing tactics influence industry sponsorship on clinical practice guidelines, consensus conferences, narrative and systematic reviews and continuing professional development. Furthermore, the authors argue that conflicts of interest should be disclosed when they are witnessed.READ MORE »
• Physician-Industry Relations. Part I: Individual Physicians Author: S.L. Coyle for the Ethics and Human Rights Committee, ACP-ASIM - Mar 5, 2002
  Part one of this two-part paper gives advice to physicians, professional societies, and medical education providers when dealing with industries. This article argues that gift giving and receiving can cloud decisions about patient care and create difficult and unethical conflicts of interest.READ MORE »
• Relationships between Authors of Clinical Practice Guidelines and the Pharmaceutical Industry Author: N.K. Choudhry, H.T. Stelfox and A.S. Detsky - Feb 6, 2002
  This study's aim was to examine the extent of the interaction between authors of clinical practice guidelines (CPGs) and the drug industry. Authors of CPGs have the potential to influence a large proportion of health care professionals, which bring to light the question of possible conflicts of interest between these authors and pharmaceutical companies.READ MORE »
• Sponsorship, Authorship, and Accountability Author: F. Davidoff, C.D. DeAngelis, J.M. Drazen, J. Hoey, L. Hojgaard, R. Horton, S. Kotzin, M.G. Nicholls, M. Nylenna, A.J. Overbeke, H.C. Sox, et al - Sep 12, 2001
  This editorial argues for authorship in peer reviewed medical journals maintaining independence from sponsors to ensure autonomy and accountability.READ MORE »
• Separating Continuing Medical Education From Pharmaceutical Marketing Author: A.S. Relman - Apr 18, 2001
  The author argues that pharmaceutical industry involvement in continuing medical education (CME) is inappropriate and promotes conflicts of interests. Furthermore medical educational institutions seem to welcome pharmaceutical company involvement in programs which should be the sole responsibility of the prodession. CME's link to the marketing of drugs is now reducing its credibility and integrity.READ MORE »
• Conflict of Interest and The Public Trust Author: Catherine DeAngelis - Nov 2000
  A financial relationship of any sort with drug and medical device manufacturers constitutes a conflict of interests. The scope of conflicts run from small gifts such as a medical bag received in the first year of medical schooling to funding of clinical investigations by private companies and investment relationships with companies who's drugs or devices that a Dr. has a hand in approving. The article outlines a series of policies and procedures that will curb the deterioration of public trust brought on by such conflicts.READ MORE »
• Physicians' Conflicts of Interest in Japan and the United States: Lessons for the United States Author: M.A. Rodwin and A. Okamoto - Apr 2000
  This article examines Japanese health policy, specifically in regards to physicians' conflicts of interest. The author then compares the US system in this light to the Japanese system, highlighting differences.READ MORE »
• Clinical Loyalties and the Social Purposes of Medicine Author: M.G. Bloche - Jan 20, 1999
  There lies a tension between loyalty to patients' needs and social expectations of medicine. The way law handles this tension is not adequate; ethics and law need to mediate this tension that satisfies both paradigms.READ MORE »
• The Doctor as Double Agent Author: M. Angell - Sep 1993
  In the 1990s, American doctors served metaphorically as "double agents," by balancing their committment to patients' interests to society's monetary obligations. The author argues that doctors cannot be asked to withhold beneficial care to save money for third party payers, especially in the enormous resource-spending environment of our current inefficient and inflationary system. To do this would be to serve a political agenda and place the essential patient-centered ethic in peril.READ MORE »
• Understanding Financial Conflicts of Interest Author: D.F. Thompson - Aug 19, 1993
  Publication: New England Journal of Medicine, 329(8): 573-576
  A conflict of interest occurs when a primary interest tends to be unduly influenced by a secondary interest. A primary interest is determined by the professional duties of a physician, scholar, or teacher. A secondary interest is usually only problemetatic when it is weighted more heavily than the primary professional interests. The author outlines the elements of, reasoning for regulating, standards for assessing, and remedies for conflicts of interest.
• Physicians and the Pharmaceutical Industry: Is a gift ever just a gift? Author: A. Wazana
  Publication: JAMA, 283(3): 373-380 This study examines the effect on prescribing of interaction between physicians and the pharmaceutical industry. The study looks at gifts, samples, industry-funded meals, funding for travel or lodging, speakers, CME sponsorship, honoraria, research funding and employment. It concludes that physician-industry interactions affects professional and prescribing behavior.
• Vermont Pharmaceutical Marketing Gift Disclosure Law Author: State of Vermont –2002 The statute (33 V.S.A. §2005) requires disclosure of expenses for marketing to doctors, hospitals, nursing homes, pharmacists and health benefit plan administrators. Exemptions include drug samples, expenses for clinical trials, gifts valued under $25, scholarships for conferences, unrestricted grants for CME, and drug rebates and discounts. The Attorney General oversees compliance and publishes an annual report that now includes names of recipients. The Vermont AG website about the Law, including links to the text of the law and reports 2004-2006.READ MORE »
• Other state statutes on gifts, disclosure and related issues. Gifts/disclosure:
  Minnesota, 1993 (Minn.Stat.Ann. Sec. 151.461)
  Maine, 2003 (Me.Rev.Stat.Title 22, Sec. 2698-A)
  West Virginia, 2004 (W.Va. Code Sec.5A-3C-1 et seq.)
  Related action:
  California, 2004 (Ca Health & Safety Codes Sections 119400-119402)
  District of Columbia, 2004 (D.C. Code Secs. 48-831.01 et seq.)
  Florida, 2006 (See SB 1408 2nd engrossed, Section 3). READ MORE »