Historical Archive

Doctors and industries

“Pharmaceutical companies must learn to win friends without having to buy them and doctors must learn to enhance the credibility of their profession without having to sell it”, stated Australian journalist Ray Moynihan a few years ago in the British Medical Journal. A few years have passed and the intertwining between doctors and industry, despite the great attention devoted to the subject, still does not seem to have dissolved. On the contrary. And this without of course neglecting the merits of the two realities and the benefits they have brought to the lives of patients. The umpteenth chapter of this story comes from a study by the New England Journal of Medicine which focuses more specifically on the relationship between doctors and industry, taking into consideration the individual therapeutic areas.
The many studies conducted in the past, from 1982 to 1997, underlines the introduction of the research, have never focused on the single specialties, nor on the geographical areas. In addition, no study has considered possible predictive factors inherent in medical practice. In the meantime, things have changed, at least formally. In 2002, the Pharmaceutical Research and Manufacturers of America (PhRma), i.e. the Overseas Farmindustria, adopted a new specific code of ethics on relations between doctors and industries, establishing the obligation to maintain relations only for the purpose of benefiting patients. And to improve medical practice. This means that pharmaceutical companies should not give doctors tickets to shows, various gifts or reimbursements for travel expenses and so on.
With similar premises, the systematic survey published in New England and conducted on 3167 doctors belonging to six different specialties (cardiology, anesthesiology, general medicine, internal medicine, surgery and pediatrics) between the end of 2003 and the beginning of 2004, should have give very different results. The survey posed three basic questions: what do doctors receive from the industry? How often do meetings with informants take place and what are the consequences? Here's the answers.
Well, almost all of the doctors, no less than 94%, maintain relationships with drug companies. Reports means dinners, galas and refresher courses offered by companies, which are the practice in the United States. One in four also receives fees for consultations of various kinds. More specifically, 35% states that he has received reimbursements for participation in congresses and meetings, while 28% admits that he receives sums for consultations, readings or for the involvement of patients in clinical trials. Specifically, the most "entangled" category is that of cardiologists, involved twice as much as family doctors. But there is also a record for family doctors, who are the most visited by scientific representatives. A similar argument also applies to payments, with the doctors' 18% paid for a scientific consultation and the 26% receiving reimbursements for the expenses incurred to participate in scientific congresses and conferences.
The film is always the same, the novelty of this study lies in having estimated the importance of the medical specialty and the way of working. Already because the doctor of a private practice, even in partnership with other colleagues, meets more frequently with the personnel of the industries than it happens to doctors who work in hospitals and clinics. Perhaps the guidelines issued are not enough or perhaps they should only be applied, because as Marco Bobbio, a cardiologist from Turin who has dealt extensively with the issue, wrote, "the relationship between doctors and industry is vital and must not be undermined by economic interests that misrepresent the scientific information for the purpose of obtaining a personal economic advantage".

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Fedaiisf Federazione delle Associazioni Italiane degli Informatori Scientifici del Farmaco e del Parafarmaco