Drug companies court M.D.s with gifts and events

As entanglement between doctors and the drug industry grows, a two-part article by journalist Ray Moynihan in a recent issue of BMJ (formerly, British Medical Journal) explored the brewing conflicts at one of the world's leading medical institutions over how to redefine relations with big pharmaceutical companies.

Across the United States, drug companies sponsor close to 300,000 events for doctors every year as part of their promotional efforts.

Against this background, the University of California San Francisco (UCSF) is considering plans to end free lunches sponsored by drug companies and remove drug representatives. Elsewhere, medical reform groups and student associations are also calling for disentanglement from drug companies and independent education and sources of information.

“Relationships with industry are critical, but they need redefining,” says Professor Haile Debas, Dean of Medicine at UCSF. “We have to make sure our relationships are more appropriate.”

“In some ways we are all addicts to big pharma's money,” argues Chief Executive Officer of UCSF Medical Center, Mark Laret, “but we are going to have to wean ourselves off a dependency that is generally inappropriate. This relationship is one of those things we need to clean up. The sooner the better.”

Many individual doctors, and their professional associations, are facing difficult choices about whether they remain part of the industry's extended promotional machinery or seek real distance in their relationships, to give prescribing, teaching, and advice that is truly independent, wrote Moynihan. Growing moves toward genuine separation may well make previously acceptable conflicts of interest untenable, he concluded.

SOURCE: “Who pays for the pizza? Redefining the relationships between doctors and drug companies” by Ray Moynihan, BMJ  2003;326:1189-1192, May 31, 2003.