Perception on ethical considerations from physicians of department of risaralda (colombia) about receiving benefits from the pharmaceutical industry

Jorge Enrique Machado-Alba1, Santiago García-Betancurt1 

Abstract

Objective: To learn physicians’ perspectives regarding the ethical considerations of receiving benefi ts from the pharmaceutical industry through its sales representatives. Methods: Observational study, using phone interviews with general practitioners and specialists in Colombia, conducted between June 1 and July 15, 2014. The variables considered were age, sex, specialty, time as a practicing professional, place of work, level of care, city, and ethical perceptions of visits by representatives of the pharmaceutical industry and perceptions of gifts, restaurant invitations, conferences, trips, and money offered by the representatives. A multivariate analysis was per- formed. Results: A total of 172 physicians were interviewed; of these. 68.0% were male with a mean age of 41±5.3 years, and they received a mean of 2.7 visits per week. A total of 90.1% of interviewees considered ethical to receive desktop items, 91.3% to receive drug samples, 87.2% to receive invitations to conferences, 60.5% to accept money for research projects, and 55.8% to receive money to hold conferences. A total of 69.2% of the physicians believed that there tends to be a conflict of interest in the medical-pharmaceutical relationship, with statistically significant differences in physicians who work in public vs. private institutions (85.5% vs. 50.0%; p=0.002) and in general physicians vs. specialists (79.2% vs. 62.0%; p=0.04). Discussion: The relationship between the pharmaceutical industry and physicians is composed of everyday interactions that can vary. The offer of different types of benefi ts is identifi ed as a source of potential confl icts of interest that may lead to ethical dilemmas in the practice of medicine.

Keywords: Ethics; Doctor Offi ce Visits; Confl ict of Interest; Pharmaceutical Industry; Pharma- coepidemiology; Colombia (source: MeSH)

Percepción respecto a consideraciones éticas de los médicos del departamento de risaralda (colombia) derivadas de recibir beneficios de la industria farmacéutica

Resumen

Introducción: los médicos son visitados continuamente por representantes de los laboratorios farmacéuticos con fi nes promocionales. Objetivo: conocer la percepción de los médicos res- pecto a las consideraciones éticas derivadas de recibir benefi cios o prebendas de la industria farmacéutica a través de sus representantes comerciales. Métodos: estudio observacional, mediante entrevistas telefónicas a médicos generales y especialistas en Colombia, entre 1 de junio y 15 de julio de 2014. Se consideraron las variables edad, sexo, especialidad, tiempo de ejercicio profesional, lugar de trabajo, nivel de atención, ciudad, percepciones éticas sobre la visita de representantes de la industria farmacéutica, regalos, invitaciones a restaurantes, congresos, viajes, dinero. Se hizo análisis multivariado. Resultados: se entrevistaron 172 médicos, el 68,0% eran hombres, edad promedio 41+5,3 años, recibían una media de 2,7 visitas semanales. El 90,1% de encuestados consideró ético recibir elementos de escritorio, 91,3% recibir muestras médicas, 87,2% recibir invitaciones a congresos, 60,5% aceptar dinero para proyectos de investigación, y 55,8% recibir dinero para realizar conferencias. El 69,2% de los médicos cree que en la relación médico-industria farmacéutica suele existir un conflicto de intereses, observándose diferencias estadísticamente significativas entre los médicos que trabajan en instituciones públicas vs privadas (85,5% vs 50,0%; p=0,002) y entre médicos generales versus especialistas (79,2% vs 62,0%; p=0,04). Discusión: la relación de la industria farmacéutica con los médicos representa una actividad cotidiana en la cual las interacciones pueden ser variadas, y el ofrecimiento de diferentes tipos de beneficios fue identificado dejando en evidencia la posibilidad de creación de potenciales conflictos de intereses y que dan pie a la generación de dilemas éticos al ejercer la profesión médica.

Palabras clave: Ética; Visita a Consultorio Médico; Conflicto de Intereses; Industria Farmacéutica; Farmacoepidemiología; Colombia (fuente: DeCS)

Introduction

Physicians are the target of promotional activities by pharmaceutical companies, investing a huge amount of money to promote their products using various sales techniques, including visits by sales representatives (1).

These visits can have a signifi cant impact on physicians’ preferences for certain drugs (2) and may generate potentially inappropriate prescrip- tions that contribute to increasing health costs and the lack of adherence to drugs’ approved guidelines due to the use of second-line drugs over recommended drugs (3). Pharmaceutical companies are also blamed for the increase in the prescription of new medicines, including those that do not demonstrate any advantage when compared to traditional medicines with proven efficacy (4).

The marketing targeted at physicians includes verbal presentations that are typically accompanied by promotional brochures based on studies that occa­sionally are of poor methodological quality, and it has been found that up to 11% are inaccurate (3). In the United States, approximately $11 billion are invested annually in strategies to increase pharmaceutical companies’ product sales, spending globally in 2012, $89.5 billion in sales and marketing expenses (5, 6). In addition, it has been reported that some physicians do not recognize the influence that these activities may have on their own decisions and the effect they may have on their clinical judgment, whereas they do recognize the influence they have on the prescriptions of other prescribers (1, 5, 7, 8, 9).

It has been shown that 50.8% of physicians think that there are no ethical problems in the relationship between the medical and the pharmaceutical indus­tries; however, a conflict of interest is considered to exist when prescriptions are influenced by factors other than scientific information or when professional opinion on a patient’s care may be unduly influenced by an ulterior motive (10-12).


1 Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A. Pereira, Colombia.

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