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PharmFree Campaign. Revitalizing Professionalism AMSA. PharmFree Concerns. Pharmaceutical Industry influences on physicians are detrimental to the doctor/patient relationship Advertising dollars could be better spent on research and development of new drugs. What is the Issue?.
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PharmFree Campaign Revitalizing Professionalism AMSA
PharmFree Concerns • Pharmaceutical Industry influences on physicians are detrimental to the doctor/patient relationship • Advertising dollars could be better spent on research and development of new drugs
What is the Issue? • What do Medical Students receive? • Pens • ID badge holders • Lunches • Textbooks
What is the Issue? • What do Doctors receive? • Pens, notepads, office supplies • Lunches and dinners • Unrestricted educational grants • Consulting fees
Professionalism • Free pens, notepads and office supplies “commercialize” physicians • Gifts, consulting fees and paid vacations create a conflict of interest
What Do Patients Think? J Gen Int Med 1998, 13:151
Increased Cost of Drugs • Who pays for the pens and lunches given to doctors, residents and medical students? • Who pays for the TV and magazine ads? • Our patients, through the cost of their medications
Advertising • Pharmaceutical companies spend $15 billion to advertise and promote drugs • Approximately $10,000 per doctor • $5.5 billion on detailing alone • Is it necessary? • Peer-reviewed journals • Medical Letter
Do Ads Influence Doctors? • A) Yes • B) No • C) Doesn’t Matter Answer: A … and C
Do Ads Influence Doctors? • A) Yes • Multiple studies in the literature show that prescribing patterns are affected by trips, gifts and advertisements
Do Ads Influence Doctors? Invitations Received Drug Introduced Trip Chest 1992;102:270
Do Ads Influence Doctors? • A) Yes • Information from the drug companies is biased, so relying upon it is not evidence-based medicine • JAMA 1995;273:1296 • JGIM 1996;11:575 • Ann Int Med 1992;116:912
Do Ads Influence Doctors? • C) Doesn’t Matter • If doctors were immune to the ads, then $15 billion was wasted on promotions, paid for by our patients • That’s more than drug companies spend on R&D!
What can medical students do? • Encourage more efficient use of pharmaceutical $$: Don’t partake of the Pharma largesse • Find unbiased sources of information such as doctors of pharmacology and The Medical Letter • Ask practicing physicians about their policies toward drug reps
For More Information: • No Free Lunch: www.nofreelunch.org • AMSA: www.amsa.org/prof/PharmFree.cfm
Questions for Discussion • What policy towards drug reps does your hospitals have? Physicians you’ve worked with? Your private physician?
Questions for Discussion • Vermont recently passed a law requiring pharmaceutical companies to declare all gifts over $25 given to physicians. Similar legislation has been introduced in Congress. Is this an appropriate arena for government oversight?
Questions for Discussion • 48 of the top 50 selling drugs in the 1990s were developed in part by public dollars. Should the government control the prices of drugs that are developed with public money?