Exposure to the drug company marketing in Greece: Interactions and attitudes in a non-regulated environment for medical students

Attitude towards pharmaceutical promotional tools and its influence on physicians’ prescribing behaviour in Sudan

Purpose

Due to the proliferation of generic medicines, pharmaceutical marketing has become increasingly competitive, and marketing executives are now focusing their attention on understanding the prescribing behaviour of physicians to enable them to devise marketing strategies that would put them at a superior business position relative to their competitors. Previous studies carried out either lack a sound theoretical foundation, or report contrasting results, making generalizations sketchy. Thus, a better understanding of attitude-prescribing axiom is needed. Underpinned by the theory of reasoned action (TRA), this study aims to empirically examine the factors that predict the prescribing behaviour of physicians.

Design/methodology/approach

A conceptual model was developed and tested on a sample of 355 respondents drawn from 76 private and 50 public hospitals in Sudan. The data set from the questionnaire survey included both general practitioners (N = 200) and specialists (N = 155). Primary data gathered were analysed using partial least squares structural equation modelling (PLS-SEM).

Findings

The findings reveal that the prescribing behaviour of physicians is positively influenced by the physician’s attitude towards direct marketing, personal selling, educational travel and public relations, but negatively influenced by gifts. Besides, the moderating effect of subjective norms showed no significant influence on the relationship between attitude and prescribing behaviour. However, gender seems to moderate the attitude towards health sector-related charity on prescribing behaviour and the attitude towards scientific conferences on prescribing behaviour.

Research limitations/implications

The findings gathered from this study offers a significant contribution to the ongoing debate on the essential factors that influence the prescribing behaviour of physicians in the hospital setting.

Originality/value

By examining the essential factors that predict physicians’ prescribing behaviour, pharmaceutical companies can improve their understanding of physicians’ attitudes towards the pharmaceutical promotional tools. This is an aspect that is ill reflected in the literature.

How Polish medical students are socialised to cooperate with the pharmaceutical industry: a focus group study of the importance of informal, hidden and null curricula

This study analysed how Polish medical students are socialised to cooperate with the pharmaceutical industry via informal, hidden, and null curricula. Nine focus groups were run with medical students in their second year and upwards at three Polish medical universities. Initially, most students had difficulty in discerning pharmaceutical companies' presence in their education, but on reflection they all recognised this presence. Students said that they were surrounded by small medical gifts provided by companies, met pharmaceutical representatives, and took part in events for physicians organised and/or sponsored by the pharmaceutical industry. Nevertheless, they did not think they were the main target of the industry's marketing activities, saying that these were largely aimed at practicing doctors, and that they were only targeted as opportunities arose. Students' statements make it clear that their socialisation takes place within a culture which consents to medical professionals' cooperation with the industry. Medical students come to perceive cooperation with the industry as natural, and benefits from the industry as a privilege of doctors. Medical schools can prevent this by introducing guidelines, conflict of interest polices, and changing the formal curriculum, but the need for such measures is not currently recognised in Poland.

Quantity and quality of conflict of interest policies at German medical schools: a cross-sectional study and survey

OBJECTIVES

To assess the quantity and evaluate the quality of policies and curricula focusing on conflicts of interests (COI) at medical schools across Germany.

DESIGN

Cross-sectional study, survey of medical schools, standardised web search.

SETTING

Medical schools, Germany.

PARTICIPANTS

38 German medical schools.

INTERVENTIONS

We collected relevant COI policies, including teaching activities, by conducting a search of the websites of all 38 German medical schools using standardised keywords for COI policies and teaching. Further, we surveyed all medical schools' dean's offices. Finally, we adapted a scoring system for results we obtained with 13 categories based on prior similar studies.

MAIN OUTCOMES AND MEASURES

Presence or absence of COI-related policies, including teaching activities at medical school. The secondary outcome was the achieved score on a scale from 0 to 26, with high scores representing restrictive policies and sufficient teaching activities.

RESULTS

We identified relevant policies for one medical school via the web search. The response rate of the deans' survey was 16 of 38 (42.1%). In total, we identified COI-related policies for 2 of 38 (5.3%) German medical schools, yet no policy was sufficient to address all COI-related categories that were assessed in this study. The maximum score achieved was 12 of 26. 36 (94.7%) schools scored 0. No medical school reported curricular teaching on COI.

CONCLUSIONS

Our results indicate a low level of action by medical schools to protect students from undue commercial influence. No participating dean was aware of any curriculum or instruction on COI at the respective school and only two schools had policies in place. The German Medical Students Association and international counterparts have called for a stronger focus on COI in the classroom. We conclude that for German medical schools, there is still a long way to go.

Conflicts of interest in infection prevention and control research: no smoke without fire. A narrative review

Conflicts of interest (COIs) do occur in healthcare research, yet their impact on research in the field of infection prevention and control (IPC) is unknown. We conducted a narrative review aiming to identify examples of COIs in IPC research. In addition to well-known instances, we conducted PubMed and Google searches to identify and report case studies of COIs in IPC and antimicrobial resistance (AMR), which were chosen arbitrarily following consensus meetings, to illustrate different types of COIs. We also searched the Retraction Watch database and blog to systematically identify retracted IPC and/or infectious disease-related papers. Our review highlights COIs in academic research linked to ties between industry and physicians, journal editors, peer-reviewed journals' choice for publication, and guideline committees participants and authors. It explores how COIs can affect research and could be managed. We also present several selected case studies that involve (1) the chlorhexidine industry and how it has used marketing trials and key opinion leaders to promote off-label use of its products; (2) the copper industry and how reporting of its trials in IPC have furthered their agenda; (3) the influence of a company developing "closed infusion systems" for catheters and how this affects networks in low- and middle-income countries and guideline development; (4) potential perverse incentives hospitals may have in reporting healthcare-associated infection or AMR rates and how government intervention may restrict AMR research for fear of bad publicity and subsequent negative economic consequences. Finally, the analysis of reasons for the retraction of previously published papers highlights the fact that misconduct in research may have other motivations than financial gain, the most visible form of COIs. COIs occur in the field of research in general, and IPC and AMR are no exceptions. Their effects pervade all aspects of the research and publication processes. We believe that, in addition to improvements in management strategies of COIs, increased public funding should be available to decrease researchers' dependency on industry ties. Further research is needed on COIs and their management.