Conflicts of Interest for Doctors (Fall 2008 Trust Magazine briefing)

Source Organization: The Prescription Project

10/01/2008 - The pharmaceutical industry is generous to doctors. It spends an estimated $28 billion to $46 billion each year marketing its wares, equating conservatively to $35,000 annually for each physician (not counting the promotion done by the medical-device industry).

More than 100,000 pharmaceutical sales representatives visit U.S. physicians regularly, providing free lunches, gifts, medication samples and carefullyselected medical literature to promote their products. They want doctors to prescribe more, and more expensive, drugs, and the practice has often become a substitute for objective medical evidence.

The Pew-initiated Prescription Project, led by Community Catalyst in partnership with the Institute on Medicine as a Profession, is concerned that aggressive marketing to physicians creates real and perceived conflicts of interest for doctors and raises questions about the appropriateness of treatment choices. It promotes evidence-based prescribing and strives to eliminate the conflicts of interest that the marketing generates.

A report issued in June by the American Medical Student Association, in collaboration with the Prescription Project, gives an update: Most U.S. medical schools are failing to address conflicts of interest caused by such marketing. Only 21 of 150 medical schools surveyed have strong policies (those graded A or B), according to the AMSA PharmFree Scorecard 2008.

The scorecard evaluates restrictions on gifts, paid speaking for products, acceptance of drug-promotion samples, interaction with sales representatives, industry-funded education and other criteria.

In the spring, the Association of American Medical Colleges proposed sweeping recommendations to medical schools to adopt strong conflict-ofinterest policies to address industry interactions. The association’s proposals affirm reforms that the Prescription Project and AMSA have actively promoted.

The Prescription Project offers tool kits to help medical schools create strong conflict-of-interest policies in many of the areas identified in the scorecard. These aids are available at, the project’s Web site.

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