The Influence of Big Pharma on Medical Practices
The influence of the pharmaceutical industry on the medical field has become a topic of increasing concern and scrutiny. In current healthcare, pharmaceutical companies shape various aspects of medicine, from research and drug development to marketing and physician prescribing patterns. However, questions are starting to arise regarding the extent to which this influence impacts patient care and the ethical considerations surrounding it.
First, the pharmaceutical industry invests a large portion of its resources and money in R&D to bring innovative drugs to market. Although this investment is crucial for advancing medical treatments and improving patient outcomes, concerns have been raised about the potential for bias and conflicts of interest that may arise when industry funding becomes intertwined with medical research. Studies have shown that research funded by pharmaceutical companies may have a higher likelihood of producing results favorable to their products, leading to potential overestimation of drug benefits and underreporting of adverse effects. For example, a paper by Lexchin et al. found that “research funded by drug companies was less likely to be published than research funded by other sources. Studies sponsored by pharmaceutical companies were more likely to have outcomes favoring the sponsor than were studies with other sponsors.”
Beyond research, the pharmaceutical industry heavily engages in marketing practices targeted at healthcare professionals. “Big pharma” reps often visit medical practices to promote their products and provide information to physicians. While this information can be valuable for staying updated on new treatments, there is a concern that marketing efforts may influence prescribing habits. Kaiser Permanente further explains this issue, writing that “aggressive pharmaceutical marketing contributes significantly to the overall high spending on prescription drugs in the United States. Reasonably well-insured patients and their physicians are not significantly affected by high drug costs and have little to no knowledge of a drug’s price.” Lastly, physicians may be more likely to prescribe medications that have been heavily marketed to them, potentially compromising their objectivity and the best interests of their patients.
Another area of concern is the influence of pharmaceutical industry-sponsored continuing medical education (CME) programs. These programs are designed to educate healthcare professionals and keep them informed about the latest advancements in medical practice, but the funding and involvement of pharmaceutical companies in CME can raise questions about the potential bias in the educational content and whether it aligns with the best interests of patients. Striking a balance between industry involvement and maintaining unbiased, evidence-based education is crucial to upholding the integrity of medical practice. Furthermore, there are many arguing that CME programs are ineffective. A research study done by Berry et al. supports this, indicating that “Considering the widespread prevalence, societal cost, and disproportionately low percentage of CME hours addressing the leading contributors to premature death and years of living with a disability, change is needed in physician education.”
The relationships between physicians and the pharmaceutical industry extend beyond education and marketing but are manifested through industry-sponsored gifts, meals, and financial incentives to healthcare professionals. While accepting small tokens of appreciation may seem harmless, there is a concern that such practices may subtly influence physicians' decision-making processes, leading to potential overprescribing or favoritism towards certain medications. The doctor-patient relationship must be preserved to ensure that medical decisions are based solely on patient needs, supported by the AAFP, which writes that “Gifts, even small ones such as pens and notepads, influence behavior. Direct payments from a pharmaceutical company increase the likelihood that physicians will prescribe that company's medications.”
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Lexchin, Joel, et al. Pharmaceutical Industry Sponsorship and Research Outcome and Quality: Systematic Review. Vol. 326, no. 7400, 29 May 2003, pp. 1167–1170, www.ncbi.nlm.nih.gov/pmc/articles/PMC156458/#:~:text=Research%20funded%20by%20drug%20companies,to%205.51%3B%2018%20comparisons)., https://doi.org/10.1136/bmj.326.7400.1167. Accessed 16 July 2023.
Barrueta, Anthony A. “Pharmaceutical Marketing Hurts Patients’ Care.” Kaiserpermanente.org, Kaiser Permanente, 5 Apr. 2022, about.kaiserpermanente.org/news/pharmaceutical-marketing-hurts-patients-care. Accessed 17 July 2023.
Jelinek GA;Neate SL. “The Influence of the Pharmaceutical Industry in Medicine.” Journal of Law and Medicine, vol. 17, no. 2, 2019, pubmed.ncbi.nlm.nih.gov/19998591/#:~:text=The%20influence%20of%20drug%20companies%20extends%20further%20to%20sponsorship%20of,industry%20and%20medicine%20is%20required. Accessed 17 July 2023.
Keller, Frieder, et al. The Relationship between the Physician and Pharmaceutical Industry: Background Ethics and Regulation Proposals. Vol. 57, no. 4, 1 Aug. 2016, pp. 398–401, www.ncbi.nlm.nih.gov/pmc/articles/PMC5048228/, https://doi.org/10.3325/cmj.2016.57.398. Accessed 17 July 2023.
Brown, Steven R. “Physicians Should Refuse Pharmaceutical Industry Gifts.” American Family Physician, vol. 104, no. 4, 15 Oct. 2021, pp. 348–350, www.aafp.org/pubs/afp/issues/2021/1000/p348.html. Accessed 4 Sept. 2024.
