Numbers Are Down, But Drug Company Ties Continue

Fewer physicians say they have relationships with pharmaceutical manufacturers and other medical companies, but the majority still have some ties, particularly in areas with high healthcare costs, a new study finds.

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A new survey finds that although the number of physicians who report having relationships with pharmaceutical manufacturers or other industrial companies has dropped in recent years, the vast majority of them still maintain such relationships. The study, which is published in the Archives of Internal Medicine, documents changes in the frequency of particular types of relationships.

“While physician-industry relationships have decreased significantly since 2004, they are still found among more than three-quarters of those responding to our survey,” said Eric G. Campbell, PhD, of the Mongan Institute for Health Policy (IHP) at Massachusetts General Hospital, who led the study. “The persistence of industry's substantial financial interaction with U.S. physicians supports the need for a nationwide system to publicly report these relationships.”

In 2004, a survey of physician-industry relationships conducted by the same time found that 94% of respondents reported at least one type of drug industry relationship. Receiving prescription samples or food in the workplace were reported most frequently, and reimbursement for the costs of medical meetings or continuing education were also common, as well as speaking and consulting fees.

Since then, considerable attention by the media, government, and academic institutions to conflict-of-interest concerns has led to new regulations and policy changes designed to improve disclosure of -- and in some cases, prevent -- such relationships. To investigate whether these measures have changed the prevalence of physician-industry relationships, the investigators surveyed 1,900 U.S. physicians in seven specialties: internal medicine, family practice, pediatrics, anesthesiology, cardiology, general surgery and psychiatry.

Campbell and colleagues found that the overall rate of physician-industry relationships dropped from 94% to 84%. Receiving drug samples or gifts such as food and beverages was most frequently reported, with rates of 64% and 71%, respectively. The percentages receiving reimbursements or payment for services to companies were about half what they were in 2004, while the number of meetings respondents reported having with pharmaceutical company representatives dropped from an average of three per month to two, a change the authors believe could reflect greater pressures on physicians' time as well as institutional policy changes.

The survey also included a question asking how often physicians had prescribed a brand name drug when an equivalent generic was available. Overall, respondents with industry relationships were more likely to self-report prescribing the more-expensive drugs. It was also found that physician-industry relationships were reported more frequently in regions with higher health costs.

“Our finding of a significant association between physician-industry relationships and the use of more expensive drugs suggests that future investigations of factors underlying high-cost medicine should explore the possible driving role of these relationships," Campbell said in a statement. "While the reduced number of meetings with industry representatives and the decreased frequency of some relationships may signal the slow death of the traditional marketing model based on gifts to physicians, the influence of industry continues to be prevalent and powerful.”

To read the Archives of Internal Medicine study, click here.

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