Pharmaceutical drug promotion: perception and attitude of medical interns towards drug company interactions in a tertiary care teaching hospital
Keywords:Attitude, Drug company gifts, Drug company interactions, Interns, Medical representatives
Background: Interactions of pharmaceutical industry with the physicians which are usually mediated through pharmaceutical representatives have a significant impact on physician decision-making. This interaction can start as early as medical school during their training and this is said to influence their prescribing behavior when they become physicians. Aims and objectives of the study was to evaluate the attitude of interns towards pharmaceutical companies interactions including accepting gifts, ethical issues and influence on clinical decisions and also to study perception of medical interns towards the accuracy of information provided by the medical representatives.
Methods: This was a cross sectional questionnaire based study that was conducted among the medical interns of the teaching hospital attached to Mandya Institute of Medical Sciences, Mandya. The study was carried out between July and August 2016. A preformed structured questionnaire was distributed to the interns consenting to participate in the study. Completed questionnaires were collected, compiled and data was analyzed.
Results: A total of 93 questionnaires were distributed and 90 interns responded (response rate 96.7%). About 44.4% respondents felt that accepting gifts from Drug Company would influence their own decision making. Only 26.6% of them were of the opinion that it is ethical to accept pharmaceutical company gifts. Majority of them felt that Medical Representatives exaggerate the benefits of medicines and downplay the risks and contraindications of medicine. About 32.2% of them were of the opinion that they would prefer to prescribe the drug from the companies offering them with gifts over those without. Majority of the respondents felt that the doctors should be offered with gifts by drug companies whenever their drugs are prescribed.
Conclusions: Attitude of Medical Interns towards Drug Company interactions as observed suggests for training the budding doctors on appropriate drug company interactions to prevent the risks associated with promotional efforts of pharmaceutical companies.
Austad KE, Avorn J, Franklin JM, Campbell EG, Kesselheim AS. Association of marketing interactions with medical trainees' knowledge about evidence-based prescribing: results from a national survey. JAMA Intern Med. 2014;174(8):1283-90.
Moynihan R. Who pays for the pizza? Redefining the relationships between doctors and drug companies. 1: entanglement. BMJ. 2003;326:1189-92.
Lexchin J. Interactions between physicians and the pharmaceutical industry: what does the literature say? CMAJ, 1993;149:1401-07.
Wazana A. Physicians and the pharmaceutical industry: is a gift ever just a gift? JAMA. 2000;283:373-80.
Villanueva P, Peiro´ S, Librero J, Pereiro´ I. Accuracy of pharmaceutical advertisements in medical journals. Lancet. 2003;361:27-32.
Mintzes B, Lexchin J, Sutherland JM, Beaulieu MD, Wilkes MS, Durrieu G et al. Pharmaceutical Sales Representatives and Patient Safety: A Comparative Prospective Study of Information Quality in Canada, France and the United States. J Gen Intern. 2013;28:1368-75.
Prosser H, Almond S, Walley T. Influences on GPs’ decision to prescribe new drugs-the importance of who says what. Fam Pract. 2003;20:61-8.
Halperin EC, Hutchison P, Barrier RC. A population-based study of the prevalence and influence of gifts to radiation oncologists from pharmaceutical companies and medical equipment manufacturers. Int J Radiat Oncol Biol Phys. 2004;59:1477-83.
Caudill TS, Johnson MS, Rich EC, McKinney WP. Physicians, pharmaceutical sales representatives, and the cost of prescribing. Arch Fam Med. 1996;5:201-6.
Rogers WA, Mansfield PR, Braunack AJ, Jureidini JN. The Ethics of pharmaceutical Industry relationships with medical students. Med J Aust. 2004;180(8):411-4.
Monaghan MS, Galt KA, Turner PD, Houghton BL, Rich EC, Markert RJ et al. Student understanding of the Relationships between the Health Professions and the Pharmaceutical Industry. Teach Learn Med. 2003;15:14-20.
Ingole S. Attitudes of Medical Students Towards Relationship With Pharmaceutical Company: Do We Need A Change? International Journal of Pharma Sciences and Research. 2011;2(2):45-57.
Gupta SK, Nayak RP, Sivaranjani R. A study on the interactions of doctors with medical representatives of pharmaceutical companies in a Tertiary Care Teaching Hospital of South India. J Pharm Bioall Sci. 2016;8:47-51.
Alosaimi FD, Al Kaabba A, Qadi M, Albahlal A, Alabdulkarim Y, Alabduljabbar M et al. Physicians' attitudes towards interaction with the pharmaceutical industry. East Mediterr Health J. 2015;20(12):812-9.
Hodges B. Interactions with the pharmaceutical industry: experiences and attitudes of psychiatry residents, interns and clerks. CMAJ. 1995;153(5):553-9.
Sierles FS, Brodkey AC, Cleary LM, McCurdy FA, Mintz M, Frank J et al. Medical students' exposure to and attitudes about drug company interactions: a national survey. JAMA. 2005;294(9):1034-42.
Austad KE, Avorn J, Franklin JM, Kowal MK, Campbell EG, Kesselheim AS. Changing interactions between physician trainees and the pharmaceutical industry: a national survey. J Gen Intern Med. 2013;28(8):1064-71.
Beyhun NE, Kolayli CC, Can G, Topbas M. Turkish Final Year Medical Students' Exposure to and Attitudes Concerning Drug Company Interactions: A Perspective from a Minimally Regulated Environment for Medical Students. PLoS One. 2016;11(12).
Othman N, Vitry AI, Roughead EE, Ismail SB, Omar K. Medicines information provided by pharmaceutical representatives: a comparative study in Australia and Malaysia.BMC Public Health. 2010;10:743.
Lieb K, Scheurich A. Contact between doctors and the pharmaceutical industry, their perceptions, and the effects on prescribing habits. PLoS One. 2014;9(10).
Wofford JL, Ohl CA. Teaching appropriate interactions with pharmaceutical company representatives: the impact of an innovative workshop on student attitudes. BMC Med Educ. 2005;5(1):5.
Sandberg WS, Carlos R, Sandberg EH, Roizen MF. The effect of educational gifts from pharmaceutical firms on medical students’ recall of company names of products. Acad Med. 1997;72:916-18.
Brennan TA, Rothman DJ, Blank L, Blumenthal D, Chimonas SC, Cohen JJ. Health industry practices that create conflicts of interest: a policy proposal for academic medical centers. JAMA. 2006;295(4):429-33.
Grande D, Frosch DL, Perkins AW, Kahn BE. Effect of exposure to small pharmaceutical promotional items on treatment preferences. Archives of Internal Medicine. 2009;169(9):887-93.
Sagarin BJ, Cialdini RB, Rice WE, Serna SB. Dispelling the illusion of invulnerability: the motivations and mechanism of resistance to persuasion. Journal of Personality of Psychology. 2002;83(3):526-41.
McCormick BB, Tomlinson G, Brill-Edwards P, Detsky AS: Effect of restricting contact between pharmaceutical company representatives and internal medicine residents on post training attitudes and behavior. JAMA. 2001;286:1994-99.