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Slightly fewer doctors receiving freebies from drug firms, study finds

Fewer doctors are accepting free drug samples, meals, trips and financial payments from drug companies than six years ago, a new study has found.

But the overall number of doctors who continue to receive drug-industry freebies remains high. More than 8 out of 10 (83.8 percent) of the doctors surveyed for the study reported accepting at least one type of gift from industry in 2009. That compares with more than 9 out of 10 (94.0 percent) in 2004.

These findings are significant, for research has shown that doctors who receive free gifts from a drug company — even such seemingly innocuous items as pens and coffee mugs — are more likely to prescribe (and overprescribe) brand-name drugs marketed by that company.

Indeed, the current study found that among the doctors who reported receiving at least one type of free gift from a drug company in 2009, only 23.2 percent said they had never prescribed a brand-name drug when an equivalent generic was available during the previous 12 months. That compares with 35.5 percent of physicians who reported turning down drug company freebies.

“These findings suggest that [physician-industry relationships] are associated with higher health care costs,” note lead author Eric Campbell of the Mongan Institute for Health Policy in Boston, and his colleagues.

Specific findings
This new study, which was published Monday in the Archives of Internal Medicine, based its findings on eight-page questionnaires filled out last year by 1,891 doctors randomly chosen from the membership files of the American Medical Association. The doctors represented seven specialties (internal medicine, cardiology, general surgery, pediatrics, anesthesiology and psychiatry). The 2004 survey included 1,662 doctors from the same specialties, except for psychiatry. (The responses from psychiatrists, therefore, were not part of any of the comparisons made between the two surveys.)

The study found falloffs in the number of doctors accepting free drug samples (63.8 percent in 2009 versus 78.0 percent in 2004) and general gifts like food and tickets to cultural or sporting events (70.8 percent in 2009 versus 83.0 percent in 2004).

But the biggest drops were in the number of doctors who said they had received industry reimbursement for attending medical meetings and other events (18.3 percent in 2009 versus 35.0 percent in 2004) and payments for serving on advisory boards or for enrolling patients in clinical trials (14.1 percent in 2009 versus 28.0 percent in 2004).

Heart doctors head the list
Cardiologists were the most likely to accept gifts and payments from the drug industry, the study found; psychiatrists, the least likely.

In addition, doctors in small group practices were more likely than those in hospital and medical school settings to receive free samples, reimbursements and gifts. But doctors in medical schools were the most likely to receive payments for speaking, consulting and enrolling patients in clinical trials.

Also, the study found that doctors who practice in areas of the country where medical costs are lower were less likely to have financial ties to industry. “[I]t is possible,” write Campbell and his co-authors, “that companies market less aggressively in regions where many patients are impoverished and covered by Medicaid, which strictly restricts its formulary and use of brand-name products.”

Campbell and his colleagues also point out that because the press, the public and even some professional institutions have developed an increasingly negative view of physician-industry relationships, their study’s results “should be viewed as lower-bound estimates of the actual frequency of relationships with industry.”

‘[I]t is clear,” they conclude, “that industry still has substantial financial links with the nation’s physicians. These findings support the ongoing need for a national sytsem of disclosure.”

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