Does information provided by drugmakers to doctors result in higher prescribing frequency, higher costs and lower prescribing quality? This is not a new issue, of course, but a new study that attempted to quantify patterns says the answer is yes. And the researchers came to this conclusion by scouring 58 studies in several countires that examined a variety of company contact.
This included visits by sales reps, journal advertisements, attendance at pharmaceutical sponsored meetings, information that was mailed to docs, prescribing software, and participation in sponsored clinical trials. The outcomes measured were quality, quantity, and cost of physician prescribing, according to the new study published in PLoS Medicine.
The bottom line: the researchers found that docs who accepted meetings, briefings or other info from drugmakers were more likely to prescribe those products. In all, 38 studies showed that exposure to drug company info resulted in more frequent prescriptions, while there was no association in 13 other studies, more than half of which were originally conducted in the US. None of the studies, by the way, found that a drug was prescribed less often due to promotional materials or some other info.
“We found no benefit for doctors from pharmaceutical promotion. So doctors need to recognize these tactics and should instead use information sources that are independent of pharmaceutical companies,” lead author Geoffrey Spurling says in a statement. "If companies want to contribute to medical education then they should put their money into a common pool that would be administered by an independent organization.”
As examples, he cited one study in which docs with low prescribing costs were more likely to have rarely or never read promo mail or journal ads than docs with high prescribing costs. Another study of docs in the UK of more than 1,000 general practitioners found that docs who reps more often prescribed costlier drugs, although that did not mean patients received the most appropriate meds.
But he did acknowledge a caveat: Most of the studies included in the review were observational studies - the docs in the studies were not randomly selected to receive or not receive company info - so it is not possible to conclude that exposure actually causes a change in physician behavior. Some of the authors, by the way, are members of Healthy Skepticism, a non-profit that seeks to improve health by "reducing harm from inappropriate, misleading or unethical marketing of health products or services, especially misleading pharmaceutical promotion," investigate and communicate about marketing practices, and promote healthy skepticism about marketing practices, among other things.