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Most doctors get money, gifts from industry

Research questions sellers' influence

By Rita Rubin

April 26, 2007

Virtually all doctors in a national survey of six specialties reported some sort of relationship — from free lunches to payments for consulting and lecturing — with medically related industries such as those for drugs or medical devices, a report says today.

Researchers mailed surveys and a $20 check to a random sample of 3,167 practicing anesthesiologists, cardiologists, family practitioners, general surgeons, internists and pediatricians in late 2003 and early 2004. Slightly more than half responded. Among the findings, reported in The New England Journal of Medicine:

•Cardiologists were more than twice as likely as family practitioners to receive payments from industry.

•On average, family practitioners reported meeting 16 times a month with industry reps — the most of any specialty surveyed.

•Factors significantly linked to higher odds of receiving payments from industry included being male, having a patient population with fewer than a quarter on Medicaid or uninsured, and playing a role in training doctors or developing practice guidelines.

More than a quarter of respondents said they were paid by industry. "That to me is a pretty high percentage," says lead author Eric Campbell, assistant professor of health policy at Harvard Medical School. He says he wasn't surprised that family doctors met most often with industry reps: "They're treating an incredibly wide spectrum of diseases."

Doctors tell him they can't be bought with a free pizza, Campbell says, but social science research shows that even inexpensive gifts can influence behavior.

The Pharmaceutical Research and Manufacturers of America (PhRMA), the main trade group for prescription drug makers, adopted a voluntary Code on Interactions with Healthcare Professionals in April 2002. The guidelines say that only modest meals and gifts (and only those useful in medical practice) should be allowed.

"Marketing is one of several important ways for health care providers to receive the information they need to make sure medicines are used properly and patients are safely and effectively treated," PhRMA senior vice president Ken Johnson said in a statement issued in response to Campbell's paper.

If their goal is to inform, why do sales reps target only high-prescribers? asks Georgetown doctor Adriane Fugh-Berman, director of the publicly funded PharmedOut, which educates doctors about drug companies' influence on prescribing. Fugh-Berman co-authored an article about drug reps' tactics that was posted this week by PloS Medicine, an open-access online journal.

Co-author Shahram Ahari says he worked as a drug rep for nearly two years after earning a bachelor's degree in molecular biology and Asian studies. "I was the only person who had a science education in my (company) training class. The science is really irrelevant to the actual sales. We're there to befriend you and influence you."

Article link: http://www.usatoday.com/printedition/life/20070426/bl_bottomstrip26.art.htm