These two articles were just published online [subscription required]:
Vaithianathan R. Better the devil you know than the doctor you don’t: Is advertising drugs to doctors more harmful than advertising to patients? J Health Serv Res Policy 2006; 11(4):235-239.
Abstract: Most countries ban the advertising of prescription medication directly to consumers, yet allow drug companies to promote drugs to doctors intensively. Such a differential treatment of promotion cannot be justified on economic grounds, but is a result of paternalism in health care regulation, which portrays patients as gullible and doctors as perfect agents. Instead, there should be a complete deregulation of direct-to-consumer (DTC) advertising and doctors ought to be required to reveal their relationships with drug companies. This is particularly apt, given the calls for similar transparency rules to address the potential conflict of interest between drug companies and researchers.
PubMed Record DOI Link
Morgan MA, Dana J, Loewenstein G, Zinberg S, Schulkin J. Interactions of doctors with the pharmaceutical industry. J Med Ethics 2006; 32(10):559-563.
OBJECTIVE: To assess the opinions and practice patterns of obstetrician-gynaecologists on acceptance and use of free drug samples and other incentive items from pharmaceutical representatives.
METHODS: A questionnaire was mailed in March 2003 to 397 members of the American College of Obstetricians and Gynecologists who participate in the Collaborative Ambulatory Research Network.
RESULTS: The response rate was 55%. Most respondents thought it proper to accept drug samples (92%), an informational lunch (77%), an anatomical model (75%) or a well-paid consultantship (53%) from pharmaceutical representatives. A third (33%) of the respondents thought that their own decision to prescribe a drug would probably be influenced by accepting drug samples. Respondents were more likely to think the average doctor’s prescribing would be influenced by acceptance of the items than theirs would be (p<0.002). Respondents who distributed drug samples to patients indicated doing so because of patients’ financial need (94%) and for their convenience (76%) and less so as a result of knowledge of the efficacy of the sample product (63%). A third (34%) of respondents agreed that interactions with industry should be more strictly regulated.
CONCLUSION: Obstetrician-gynaecologists largely indicated that they would act in accordance with what they think is proper regarding accepting incentive items from pharmaceutical representatives. Although accepting free drug samples was considered to be appropriate more often than any other item, samples were most commonly judged to be influential on prescribing practices. The widely accepted practice of receiving and distributing free drug samples needs to be examined more carefully. PubMed Record DOI Link