TORONTO – Global News recently reported patient advocacy groups are being funded by pharmaceutical companies. However, concerns about physicians’ relationships with the pharma industry persist.
Things have gotten better over the last 5 to 10 years with changes that pharma companies have made to their code of conduct, such as eliminating practices such as paying for things like physicians’ travel to conferences, social events at national scientific meetings, and green fees for golf course consulting meetings.
But the influence of pharmaceutical companies is still pervasive, and it starts right from medical education. Recently it was discovered the University of Toronto medical school was offering an educational program that was financed by a pharmaceutical, with the lecturer working for that drug company, and all students receiving a free reference book developed by that company.
And when we were training as residents, we would get a free meal paid for by a pharmaceutical company as part of our daily educational rounds. Although that is rare now, pharma still plays a strong role in continuing medical education for physicians.
I remember being offered a generous stipend to give a presentation to GPs about lung disease at one such event, and the company actually gave me their own slides, which I refused to use. Then they asked if I would at least use their ad campaign colour as the background for my own slides. I had to refuse to give the talk.
That’s when I realized that for pharma, these events really are about marketing — more so than about education.
Most physicians don’t believe any of this free stuff influences their prescribing behaviour, but multiple studies reviewed in the Canadian Medical Association Journal as long ago as in 1993 have shown that physicians who receive enticements and attend pharmaceutical events do then prescribe those drugs more often.
But like it or not, pharmaceutical companies play a key role in how we manage our patients.
Pharma reps go out and meet with GPs and specialists on a regular basis, and play a role in educating them about new drug developments. That education can be useful but it’s obviously biased, and the conflict is that as physicians, we should be thinking about prevention first, non-drug therapies second, and drug therapies last.
Pharma companies also give out drug samples. This is a tricky area because I deal with an underprivileged population and rely heavily on drug samples for my patients, however I am also well aware that research from the American Journal of Medicine in 2005 suggests that drug samples do also influence prescribing.
At the end of the day, physicians have a responsibility to do what’s best for their patients, and pharmaceutical companies have a responsibility to do what’s best for their shareholders – and those two things are sometimes the same, but usually they’re not. So as doctors, I think we constantly need to remember that.
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