Pharmaceutical Company Gifts: From Voluntary Standards to Legal Demands

The Role of Business Entertainment in Economic Exchanges: A Governance Perspective and Propositions

While entertainment activities in private business settings (i.e., business entertainment) are widely seen all over the world, issues about their prevalence have remained unresolved in the literature. This study takes an institutional approach to elucidate (1) the governance role of business entertainment in economic exchanges, (2) the mechanism through which business entertainment plays this role, and (3) the conditions under which business entertainment plays a greater role to facilitate economic exchanges. Our starting point is that economic transactions are governed through a combination of market rules, legal restraints, and social norms. We argue that business entertainment plays a governance role by boosting the power of social norms to regulate the behaviors of economic actors. As such, business entertainment should be more prevalent under the conditions where social fabrics are dense but market and legal infrastructures are underdeveloped. This governance approach provides a common ground to accommodate the positive versus negative views on business entertainment advocated by two camps of researchers in management, economics, and sociology. It also offers useful guidelines for policymakers to regulate, and for executives to manage, this prevalent but often misunderstood business practice.

A Study of Attitude and Knowledge of the Psychiatry Resident Doctors toward Clinician-Pharmaceutical Industry Interaction

BACKGROUND

Pharmaceutical industry and clinicians are the two important stakeholders in the modern-day health care. However, concerns have been expressed about the lack of congruence between the goals of these two.

AIMS

The current study aimed at exploring the knowledge and attitude of the psychiatry resident doctors toward the clinician-pharmaceutical industry interaction and also at exploring the knowledge of the residents about the new Medical Council of India guidelines on this issue.

MATERIALS AND METHODS

The survey was conducted among psychiatry residents. Descriptive statistics with frequency distribution was carried out by using SPSS version 17.0.

RESULTS

It had a good response rate of around 90%. The survey reveals the knowledge and attitude of the psychiatry residents toward the psychiatrist-pharmaceutical industry interaction.

CONCLUSIONS

The survey provides understanding in knowledge and attitude of the psychiatry residents towards the psychiatrist-pharmaceutical industry interaction.

Pharmaceutical speakers' bureaus, academic freedom, and the management of promotional speaking at academic medical centers

Pharmaceutical companies routinely engage physicians, particularly those with prestigious academic credentials, to deliver "educational" talks to groups of physicians in the community to help market the company's brand-name drugs. Although presented as educational, and even though they provide educational content, these events are intended to influence decisions about drug selection in ways that are not based on the suitability and effectiveness of the product, but on the prestige and persuasiveness of the speaker. A number of state legislatures and most academic medical centers have attempted to restrict physician participation in pharmaceutical marketing activities, though most restrictions are not absolute and have proven difficult to enforce. This article reviews the literature on why Speakers' Bureaus have become a lightning rod for academic/industry conflicts of interest and examines the arguments of those who defend physician participation. It considers whether the restrictions on Speakers' Bureaus are consistent with principles of academic freedom and concludes with the legal and institutional efforts to manage industry speaking.

Debunking myths in physician-industry conflicts of interest

PURPOSE

To call attention to the myths that surround physician-industry conflicts of interest, to refute their validity, and to propose ways to address them so as to insure that physicians make medical practice decisions in the best interest of their patients.

DESIGN

Perspective.

METHODS

Review, analysis, and discussion of the implications of selected pertinent literature.

RESULTS

Physicians often have voluntary financial relationships with industry based on behaviors and motivations that include entitlement, recognition, belonging, and money. The pharmaceutical and device industry spends billions of dollars annually in marketing to physicians. The sophisticated marketing plan seeks access to physicians through gifting mechanisms to ingratiate them and to influence them to prescribe industry's drugs and to purchase its products. Despite widely accepted studies that demonstrate that industry's marketing activities influence physicians' medical practice behavior to the detriment of patients and the public, physicians persist in voicing myths to justify their partaking of industry's largesse. Many physicians believe that their voluntary financial conflicts of interest with industry can be managed by simply disclosing them and by "being honest." Yet there is no support from well-conducted studies to support the effectiveness of this approach.

CONCLUSIONS

Medical organizations and academic institutions are the ones to take the lead in recognizing that these voluntary financial conflicts of interest are unacceptable and should be stopped. Such conflicts mainly relate to the acceptance of gifts and money that are designed to influence behavior and are a form of financial coercion.

Conflicts of interest between physicians and the pharmaceutical industry and special interest groups

Health care in the United States is a tangled web of competing interest groups beneath which ethical conflicts of interest flourish. Physicians, professional organizations, and academic medical centers must continually evaluate their relationships with the pharmaceutical industry as they relate to personal, professional, and institutional ethical values. This article explores the relevant pressing ethical issues and proposals for changing course and managing these potentially troublesome relationships.

Biomedical research and corporate interests: a question of academic freedom

The current situation in medicine has been described as a crisis of credibility, as the profit motive of industry has taken control of clinical trials and the dissemination of data. Pharmaceutical companies maintain a stranglehold over the content of medical journals in three ways: (1) by ghostwriting articles that bias the results of clinical trials, (2) by the sheer economic power they exert on journals due to the purchase of drug advertisements and journal reprints, and (3) by the threat of legal action against those researchers who seek to correct the misrepresentation of study results. This paper argues that Karl Popper's critical rationalism provides a corrective to the failure of academic freedom in biomedical research.