Doctors and pharmaceutical companies — do gifts and training influence prescriptions?

Aim of the study: The objective of this review is to explore interactions between physicians and the pharmaceutical industry including sales representatives and their impact on physicians' attitude and prescribing habits.

Results: Physician-pharmaceutical industry and its sales representative's interactions and acceptance of gifts from the company's PSRs have been found to affect physicians' prescribing behaviour and are likely to contribute to irrational prescribing of the company's drug. Therefore, intervention in the form of policy implementation and education about the implications of these interactions is needed.

Aim of the study: Physicians' relationships with the pharmaceutical industry have recently come under public scrutiny, particularly in the context of opioid drug prescribing. This study examines the effect of doctor-industry marketing interactions on subsequent prescribing patterns of opioids using linked Medicare Part D and Open Payments data for the years 2014-2017.

Results: This study examines the effect of doctor-industry marketing interactions on subsequent prescribing patterns of opioids using linked Medicare Part D and Open Payments data for the years 2014-2017. Results indicate that both the number and the dollar-value of marketing visits increase physicians' patented opioid claims. Furthermore, direct-to-physician marketing of safer abuse-deterrent formulations of opioids is the primary driver of positive and persistent spillovers on the prescribing of less safe generic opioids - a result that we show appears to be driven by insurance coverage policies. These findings suggest that pharmaceutical marketing efforts may have unintended public health implications.

Aim of the study: To evaluate the association between pharmaceutical industry payments to rheumatologists and their prescribing behaviors.

Results: Of 4822 rheumatologists in the Medicare prescribing databases, 3729 received any payment from a pharmaceutical company during this time frame. Food/beverage payments were associated with an increased proportion of prescriptions for the related drugs (range, 1.5% to 4.5%) and an increased proportion of annual Medicare spending for the related drugs (range, 3% to 23%). For every $100 in food/beverage payments, the probability of prescribing increased (range, 1.5% to 14% for most drugs) and Medicare reimbursements increased (range, 6% to 44% for most drugs). Consulting/compensation payments were associated with an increased proportion of prescriptions (range, 1.2% to 1.6%) and an increased proportion of annual Medicare spending (range, 1% to 2%). For every $1000 in consulting/compensation payments, both the probability of prescribing increased (5% or less for most drugs) and Medicare reimbursements increased (less than 10% for most drugs).

Aim of the study: Controversy exists over the fact that physicians have regular contact with the pharmaceutical industry and its sales representatives, who spend a large sum of money each year promoting to them by way of gifts, free meals, travel subsidies, sponsored teachings, and symposia.

Results: The present extent of physician-industry interactions appears to affect prescribing and professional behavior and should be further addressed at the level of policy and education.

Aim of the study: The interaction between physicians and pharmaceutical industry highlighted many issues lately concerning their influence on physician's attitude and their prescribing behavior. To evaluate the attitudes of Tunisian ophthalmologist towards pharmaceutical promotion.

Results: One hundred and two valid responses were received. Twenty-nine respondents (28.43%) estimated the number of visits by pharmaceutical representatives (PR) at 11 to 20 times during the last year. Most physicians considered guides (94%), drug samples (88%), articles (86%), stationery (81%), sponsorship of overseas conferences (72%) and international trips to symposia organized by pharmaceutical industries (58%), as appropriate gifts. Over 80% of doctors agreed that promotional activities by drug companies were appropriate. Accepting sponsorship from a pharmaceutical company for a partner to attend a meeting was considered inappropriate by 79% of ophthalmologists. Eighty-eight percent of the respondents agreed that receiving gifts will increase their prescription of the company's drug. However, they perceived themselves to be less influenced than their colleagues (p=0.011). Eighty-six percent of ophthalmologists reported training about how to interact with PR to be insufficient.

Aim of the study: The pharmaceutical bill is increasing at an alarming rate. The physician practice variation has a pronounced effect on healthcare spending. A number of factors can influence the prescribing behavior of physicians. The aim of this review was to identify the factors affecting the prescribing decision of physicians.

Results: Thirty-three studies met the inclusion criteria from 1122 search results. A total of 33 factors were identified. The most frequent factors were patients' clinical condition, pharmaceutical industries, physician attributes, patient preference and cost of medicine. Physicians' personal attributes, cost of the medicine and pharmaceutical industries' marketing and promotion strategies were mostly mentioned to influence prescribing decision. The identified factors showed that prescribing is not only geared for patient benefit, but also towards personal interest. The use of valid and reliable practice guidelines could reduce the negative impact of wide ranges of factors and promote the rational prescribing effectively.

Aim of the study: Chronic nonmalignant pain (CNMP) is commonly treated with opioids and other analgesics, yet prescribing carries risks and substantial costs. Promotional and financial interactions between clinicians and the pharmaceutical industry may influence analgesic prescribing, but CNMP-relevant evidence has not been systematically synthesized.

Aim of the study: Payments from pharmaceutical companies to oncologists can influence prescribing practices. However, some physicians believe that receiving payments from multiple competing manufacturers might balance these biasing effects, effectively "canceling out" any conflict of interest. This study examines how often physicians receive industry payments for multiple, competing drugs.

Results: Among 2460 eligible oncologists, a minority received payments related to all 3 competing drugs within the drug class they prescribed: 1.6% of oncologists prescribing epidermal growth factor receptor inhibitors, 25.3% for BCR-ABL tyrosine kinase inhibitors, and 34.3% for CDK4/6 inhibitors. Oncologists who received payments for all 3 drugs were more likely to prescribe ribociclib versus palbociclib, and less likely to prescribe dasatinib, compared to unpaid oncologists. Those who received payments for 2 drugs were more likely to prescribe afatinib versus osimertinib. Receipt of payments from all competing companies occurs among a minority of oncologists, but a substantial minority for some drug classes. Oncologists who receive payments from multiple companies have different prescribing patterns than unpaid oncologists, suggesting that competing payments may not result in "balanced" influence.