- Industry spends $35 billion annually marketing pharmaceuticals, much of it directly to physicians.
- In this longitudinal study, a majority of doctors surveyed in 2011 and again in 2024 agreed that marketing interactions threaten trust in medicine.
- Yet most agreed that physicians receive some useful information from pharmaceutical marketing and that gifts under $50 from industry are acceptable.
Most doctors said it's appropriate to accept gifts valued at under $50 from the pharmaceutical industry, according to one of the many findings from a longitudinal study that surveyed physicians at the start of their careers in 2011 and then again last year.
Yet a majority of the participants agreed at both points that marketing interactions threaten trust in medicine, with the share who strongly agreed with that idea growing from 5.6% in 2011 to 14.5% in 2024 (P=0.004), reported Aaron Kesselheim, MD, JD, MPH, of Brigham and Women's Hospital in Boston, and colleagues.
More than 90% of those surveyed last year said that doctors might prescribe pricier drugs without extra benefits or become unconsciously biased toward a certain product as a result of interactions with pharma reps, according to the findings in JAMA Health Forum
"Physicians expressed greater concern about pharmaceutical marketing in some spaces, but then also greater recognition that pharmaceutical representative materials are important resources to learn about drugs," co-author Helen Mooney, MPH, also of Brigham and Women's Hospital, told MedPage Today.
The majority of doctors surveyed said they receive useful information from pharmaceutical marketing, growing from 66.3% in 2011 to 76.9% in 2024 (P=0.005). The pharmaceutical industry spends $35 billion annually on drug marketing, much of it directly to physicians, the authors noted.
"It's an interesting contrast, that these materials are recognized to be useful, but then at the same time there was high agreement that trust that patients and the public can have in physicians can be threatened by these marketing interactions, that bias can come from advertising, as it has been demonstrated in the literature," Mooney added.
Bryan Carmody, MD, of Eastern Virginia Medical School in Norfolk, who was not involved with the study, said that "although the authors played up the differences, what's remarkable is how much stayed the same" and that "the directionality of the sentiment was the same for every item, and many are virtually identical from 2011 to 2024."
In the follow-up survey, a majority of respondents agreed to the following statements:
- It's appropriate for doctors who receive pharma speaking fees about a given drug to then lecture medical students on that same topic
- Schools should not permit industry sales reps to have access to preclinical students on campus
- Most free drug samples are given to needy patients as a result of interactions with pharma reps
- Forcing doctors to disclose financial relationships with drug companies does not impede useful collaborations that would lead to the development of new drugs
Meanwhile, over 75% said that direct-to-consumer pharma advertising is not useful for patients.
The view that limits on pharmaceutical consulting may hamper drug development was slightly higher in the follow-up survey (28.5% vs 23.1% in 2011, P=0.01).
More respondents in 2024 also thought that medical schools shouldn't allow interactions between pharmaceutical companies and students in training facilities (72.2% vs 59.6% in 2011, P=0.004). And there was also greater agreement that schools should require faculty to disclose their conflicts of interest before lectures (99.7% vs 88.9%, P<0.001).
Mooney said there are opportunities to increase policies about conflict-of-interest disclosures in medical school settings and to limit marketing to students.
Carmody noted that what's less clear is whether the shifts the researchers observed are due to changes in individuals' thinking over time -- perhaps with experience, some physicians see more danger in industry-physician interactions, for example -- or changes in the profession or society at large.
Shifting attitudes "may be attributable to respondents' leaving training and assuming professional roles or may represent secular changes over time," Kesselheim and co-authors suggested.
For the study, randomly selected medical students and residents were surveyed about their thoughts and interactions towards the pharmaceutical industry in 2011. The same group was resurveyed in 2024.
In total, 1,610 medical students (of 3,495) and 739 residents (of 1,815) responded to the 2011 survey. Most of the medical students were not attending a top 20 NIH-funded medical school.
Researchers found contact information for 1,130 of the original cohort, though 229 turned out to be invalid, leaving 901 potential respondents. Of those, 294 responded -- a 33% response rate -- and 291 were matched to their 2011 responses.
Among the latest survey respondents, mean age was 41 years and 49.5% were women. Most (71.8%) identified as white, with 20.6% Asian, 5.5% Black, and 4.8% Hispanic or Latino.
Three-quarters of respondents in 2024 worked in hospitals or clinics (74.2%); 30% were at academic research institutions, 27.2% at medical schools, and 24.4% in private practice. Four out of five spent at least half of their time directly caring for patients.
The study was limited by its 13-year timeline, which affected the response rate and led to an oversampling of academic researchers. The survey's self-reporting nature also risked social desirability bias.
Disclosures
This research was supported in part by Arnold Ventures.
Mooney reported prior equity in Johnson & Johnson, AbbVie, Merck, Organon, and Bristol Myers Squibb. Kesselheim reported serving as an expert witness in cases against Gilead and Johnson & Johnson.
Carmody did not report any disclosures.
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.