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Pharma marketing sways Canadian doctors

Posted by Colin Rose on October 15, 2008

Unlike their American colleagues, many Canadian doctors admit they are influenced by drug propaganda. But they don’t think those free sample compromise their judgement. Really? Let’s say a patient has a routine blood lipid test and the “bad” cholesterol is high and the patient is obese and smoking. What is a busy doctor going to do? Grab a box of Lipitor off his or her cabinet full of free samples or spend half an hour explaining the necessity of lifestyle choices in preventing atherosclerosis or diabetes?

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Medical Post
September 26, 2008 Matthew Sylvain

But just because it influences decisions, doesn’t mean physician judgment is compromised

TORONTO | Almost half of respondents to our Medical Post-mdPassport online eithics survey said their prescribing habits have been influenced by drug company advertising and other acts of persuasion. Depending on your perspective, that shows a remarkable honesty.

Then again, if you count yourself among the 54% who answered no, that you are unswayed by the arguments of detailers and the like, you might think that nearly half your colleagues are too easily influenced.

“I think physicians are influenced by it,” said Dr. Gerry Rosenquist, a gynecologist at the Winchester, Ont. District Memorial Hospital, who was asked to share his opinions on the survey findings. He added, however, “that doesn’t mean they (doctors) are influenced negatively.”

Few physicians would compromise their practice of medicine by intentionally prescribing products that were improper for their patients, he said.

Dr. Heidi Carlson, a Moncton, N.B., pediatrician, agreed the marketing isn’t inherently and entirely negative. The ads, rep visits and drug samples allow a busy doctor to quickly learn of a medication’s advantages and disadvantages, she told the Medical Post.

“I would be lying if I said I hadn’t given out free samples before, and I hadn’t taken the free samples before,” she said “because certainly, if there are new things on the market that are supposed to be better, I’d rather have patients trying them first—and seeing if they are of any use to them—before asking them to go out and buy them. So I can’t say I haven’t been influenced by it.”

Dr. Barbara Mintzes (PhD), an assistant professor in the University of British Columbia department of anesthesiology, pharmacology and therapeutics, was surprised by the admission by 46% of respondents that their prescribing had been influenced by marketing.

She said that seemed refreshingly sincere in light of a recent U.S. study of hospital-based physicians that found only 1% of them believed their own behaviour was influenced by pressure from pharmaceutical and equipment makers. Meanwhile, they thought more than 50% of their physician colleagues were swayed. That variance in opinion is so great it’s suggestive in itself, she said.

“I don’t think you would call anyone a dunce for actually saying that yes, they do believe there is some influence on their prescribing from marketing exercises,” said Dr. Mintzes, who is also a part of the Therapeutics Initiative, an independent, non-profit organization that assesses drug therapies.

The president of Canada’s Research-Based Pharmaceutical Companies (Rx&D), an industry lobby group, noted its members follow a marketing code of conduct. According to the code, “Information provided to health-care professionals by our members must be accurate, fair and balanced,” said Russell Williams in an e-mailed statement.

Williams added that information packages on clinical evaluations also meet standards set out in the Food and Drugs Act, and regulations.

Said one doctor, commenting on the survey, “Script ‘buying’ by big pharma, thinly disguised as a phase four clinical trial, is a problem.”

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