Latest / U.S. Right to Know articles / Drug company gifts, meals, and payments to doctors lead to worse prescribing, review of 93 studies finds

Transcript

Drug company gifts, meals, and payments to doctors lead to worse prescribing, review of 93 studies finds · U.S. Right to Know articles

• 0:03
  Drug company gifts, meals and payments, to doctors lead to worse prescribing.
• 0:07
  Review of ninety-three studies finds. Key
• 0:14
  findings. Pharmaceutical marketing aimed at doctors, from gifts to meals,
• 0:19
  and payments, may increase inappropriate prescribing and the quantity and cost of
• 0:23
  prescriptions. Conflict of interest policies that restrict or manage interactions between
• 0:30
  pharmaceutical companies and doctors can limit prescribing of inappropriate drugs and over-prescribing.
• 0:37
  Gifts, patients free meals, and other marketing, ploys by pharmaceutical companies heavily
• 0:42
  influence doctors to prescribe more drugs, choose less appropriate treatments, and drive
• 0:48
  up prescription costs, according to a Systematic review of ninety three studies.
• 0:53
  These prescribing choices, can expose patients to drugs that offer fewer benefits,
• 0:57
  cause more side effects, or are unnecessary, while increasing health system costs.
• 1:03
  The review, published today, October 9th in the Cochrane Database of Systematic
• 1:08
  Reviews, found that policies restricting interactions between drug companies and doctors were
• 1:13
  associated with better prescribing choices, lower costs, and possibly fewer prescriptions.
• 1:20
  Overall, when doctors have more contact with drug company promotion, prescribing tends
• 1:24
  to become less appropriate, more frequent, and more expensive, said co-author Dr.
• 1:30
  Lisa Barrow from the University of Colorado Anschutz. This is problematic for
• 1:35
  a number of reasons, and it matters because it directly affects patient
• 1:38
  care. Doctor Quinn Grundy, director of the World Health Organization, Collaborating Centre
• 1:45
  for Governance, Accountability and Tran Transparency in the Pharmaceutical Sector, agreed. It
• 1:50
  shows what we have long suspected: that when doctors accept free meals,
• 1:55
  payments for consulting or sitting on an advisory board, and visits from
• 1:59
  sales representatives, they tend to prescribe more of the promoted drug, that
• 2:03
  their prescribing costs go up, and that they are prescribing drugs that
• 2:07
  are less appropriate or unnecessary, said Grundy, co-author and associate professor at
• 2:13
  the University of Toronto. Earlier this year, another systematic review found doctors
• 2:18
  with more contact with pharmaceutical companies prescribed more painkillers and spent more
• 2:23
  on opioid prescriptions. The findings?
• 2:26
  also come at a time of increased pharmaceutical promotional activity, especially for
• 2:31
  GLP-1 weight loss drugs. One recent follow-up study found that the proportion
• 2:36
  of doctors reporting they received free drug samples rose from 11.4 in
• 2:42
  2011 to 21.6 in 2024. Reports of discussions with pharmaceutical
• 2:48
  representatives increased from 30.4 to 45.6. What
• 2:55
  are the key findings? An international team of researchers examined real-world prescribing
• 3:01
  patterns among millions of doctors exposed to pharmaceutical advertising education, such as
• 3:06
  sales representative visits, gifts, payments, or free samples. Most studies examined
• 3:12
  prescribing at a single point in time, making it difficult to determine
• 3:16
  whether industry interactions caused the differences observed. However, researchers found Gifts
• 3:22
  or payments. Doctors who received gifts or payments tended to prescribe less
• 3:27
  appropriately and write more prescriptions. These marketing tactics by pharmaceutical companies
• 3:33
  probably also increased prescribing costs. We found high certainty evidence that gifts
• 3:38
  and payments have a harmful effect on prescribing appropriateness and are associated
• 3:43
  with higher volumes of prescribing. The authors wrote. Advertising or education. Doctors
• 3:49
  exposed to pharmaceutical company, advertising, and educational activities tended to prescribe less
• 3:55
  appropriately and at higher costs. These activities probably increased prescriptions. Conflict
• 4:01
  of interest policies, rules that restrict or manage industry interactions likely improved
• 4:07
  prescribing choices and may have reduced prescription numbers. Their effect on costs
• 4:12
  was unclear. Hospital drug lists. Promotional interactions may increase doctors requests
• 4:18
  to add drugs to approved hospital lists, but the evidence was uncertain.
• 4:22
  Evidence about the effects of free samples was also unclear. What does
• 4:27
  pharmaceutical marketing involve? Pharmaceutical companies promote medicines through one-on-one visits by sales
• 4:33
  representatives, sponsored education, advertisements into medical journals, direct mail and conferences.
• 4:40
  They also provide meals, travel expenses, and free drug samples, and pay
• 4:45
  doctors to serve on advisory boards or speak at events. Other promotional
• 4:50
  activities include sponsored clinical trials without a scientific justification, sometimes called market
• 4:56
  seating trials, patient education services, and ghostwriting. In 2025, drug
• 5:02
  and medical device companies reported 2.6 billion in non-research payments to US
• 5:07
  physicians, including fees for consulting and speaking, meals, travel, and gifts. Although
• 5:14
  these activities have not always been considered pharmaceutical promotion, internal industry documents
• 5:19
  released through litigation show that companies use the to promote products, the
• 5:24
  researchers note. Promotional information tends to emphasize medicines benefits while minimizing
• 5:30
  their harms, putting patients health at risk. A prescriber who relies on
• 5:36
  information that exaggerates benefits or minimizes harms may prescribe featured medicines more
• 5:41
  often and to a broader set of patients than those who are
• 5:45
  likely to benefit, and may be less conscious of the need to
• 5:48
  avoid prescribing to specific at-risk patient groups than a prescriber who relies
• 5:53
  on more balanced, accurate information, they wrote. Advertising gifts and payments linked
• 5:59
  to more prescriptions, The review included 82 studies from the US, where
• 6:04
  the Physician Payments Sunshine Act requires pharmaceutical companies to disclose payments to
• 6:10
  doctors through a publicly searchable database. Eleven studies came from the UK
• 6:15
  and Europe. The studies, published largely over the past two decades, covered
• 6:20
  a wide range of clinical settings, drug treatments, and medical conditions. These
• 6:24
  include cancer, diabetes, asthma, osteoporosis, depression, and pain. Most research
• 6:30
  on advertising and education examined visits from pharmaceutical sales representatives. All found
• 6:36
  that greater exposure was associated with more prescriptions, higher costs, or less
• 6:41
  appropriate prescribing. The largest and most consistent body of evidence covered gifts
• 6:47
  and payments. One study, for instance, found that patients were more likely
• 6:51
  to
• 6:51
  receive dinosimab, described as a low value, non recommended treatment for prostate
• 6:57
  cancer, when their oncologists received payments from the manufacturer. Notably, doctors receive
• 7:03
  food and drink gifts from pharmaceutical companies far more often than the
• 7:07
  receive consulting, advisory, or speaking fees. These gifts typically have little monetary
• 7:12
  value. But The review shows a clear-dose-response relationship between paid-for-meals and inappropriate
• 7:19
  prescriptions. It's very common for doctors to receive free meals from companies,
• 7:24
  said lead author Dr. Barbara Minzes from the University of Sydney in
• 7:28
  Australia. Doctors often think that this is trivial and doesn't influence them,
• 7:33
  that they can't be bought for the price of a sandwich. But
• 7:36
  the data shows this is an effective marketing strategy. The more free
• 7:41
  meals a doctor receives, the more likely they are to prescribe less
• 7:45
  appropriate or more expensive drugs. One study linked more meals to higher
• 7:50
  quantities and costs of long acting insulin prescriptions. Another found that doctors
• 7:55
  prescribed 9.3 more opioids for each additional meal they received from drug
• 8:01
  companies in the previous year. The over prescription of opioids is the
• 8:05
  most infamous example of pharmaceutical companies promotion, exaggerating benefits and minimizing harms,
• 8:12
  Barrow says. This review found that even inexpensive meals increased opioid prescribing,
• 8:18
  and that the more payments a doctor received from opioid manufacturers, the
• 8:22
  more likely they were to prescribing dangerously high opioid doses. One study
• 8:27
  found that each 1 increase in payments was associated with an average
• 8:31
  of 50 additional daily doses. The widespread inappropriate over prescribing of opioids
• 8:37
  has led to an epidemic of addiction and deaths from overdoses. But
• 8:41
  it is not an isolated incident, Barrow said. Patients should be offered
• 8:46
  the most appropriate treatment for their condition, based on clinical evidence, not
• 8:50
  industry marketing, she said. The opioid crisis was high profile due to
• 8:55
  the significant harms involved, but the systems that enabled it are unfortunately
• 9:00
  considered business as usual within the industry. Interactions between pharmaceutical companies
• 9:06
  and prescribing physicians are widespread, and the harms they cause are rarely
• 9:11
  so visible. Which medicines were linked to industry payments? The authors also
• 9:17
  examined studies that looked at what happened to prescribing outcomes when hospitals
• 9:21
  or medical schools introduced policies that limited doctors interactions with sales representatives,
• 9:28
  banned free samples, or restricted doctors from accepting gifts. Prescribers working under
• 9:34
  these policies prescribed fewer and more appropriate drugs, they found. For example,
• 9:39
  psychiatrists working under stricter policies limiting contact with sales representatives were less
• 9:45
  likely to prescribe antipsychotics and antidepressants to children, including for uses not
• 9:51
  officially approved for them. The research team called for stronger conflict of
• 9:55
  interest policies to protect public health, including rules prohibiting gifts, payments, and
• 10:01
  sales visits. They also recommended limiting doctors exposure to industry promotion during
• 10:07
  medical education and throughout their careers. Addressing pharmaceutical promotion isn't about
• 10:13
  undermining trust in doctors, it's about strengthening and protecting health systems so
• 10:17
  that patients always receive the most appropriate care, Barrow said. Reference. Minces
• 10:23
  B. Lection J, Sutherland JM et al. Pharmaceutical Industry Promotional Interactions and
• 10:28
  Prescribing Outcomes. A Cochrane Systematic Review. Cochrane Database Sist Reverend 2026. Doyen.10002
• 10:36
  slash slash one four six five one eight five fate. Cd zero
• 10:40
  one three four two three dot Pub3.