Yes. But definitely not all doctors though.

When I worked for what used to be called the Western Australian Centre for Remote and Rural Medicine as a project officer helping to coordinate monthly broadcasts of continuing medical education programs to doctors and hospitals in remote and rural areas of  Western Australia, I was surprised by the approach the big pharmaceutical companies took to marketing their product to doctors. It seemed very unsophisticated! They produced all these expensive giveaways and beat a continual path to our offices and to doctors’ surgeries. It was all about having their product name in doctors’ homes and surgeries, and we could always count on their sponsorship for conferences and events, with no expense spared on catering. Seems like nothing has changed!

By Ray Moynihan, The Age, July 11, 2017: DON’T let anyone tell you drug companies wining and dining doctors is a thing of the past. Sadly, these hidden flows of influence are at epidemic proportions, with almost 30,000 events every year where pharma picks up the tab.

I’ve been researching this field for more than two decades and while transparency and public scrutiny has grown steadily, unhealthy promotion continues. Today, I’m part of a team at Sydney and Bond Universities who’ve just published an analysis in BMJ Open of 116,000 events that took place over four years to 2015, at a cost of $290 million. To give a flavour, there was the $82-a-head meal at Sydney’s Banjo Patterson restaurant, where lucky GPs learned about the latest evidence on cholesterol – courtesy of Pfizer, the maker of one of the best-selling anti-cholesterol drugs of all time. And then there was the single conference for 300 specialists at a flash hotel for which Roche splashed out around $750,000.

While many of these “educational” events happen in hotels and restaurants, often with lashings of good wine, most of them happen in hospitals and doctor’s surgeries, with sandwiches and sushi.

Drug companies and medical groups argue these events are valuable places for a busy doctor to learn. But the evidence suggests otherwise. This massive dose of marketing maybe be causing harm to patients – at risk of being prescribed a drug they don’t need – and to the public purse – given increasing concerns about sustainability.

A few years ago, Australian researchers reviewed all the evidence about potential impacts of seeing drug reps, viewing advertisements, or attending company-sponsored meetings. Led by Dr Geoff Spurling at the University of Queensland, that review found no good evidence exposure to this promotion improved the quality of prescribing – rather doctors tended to prescribe more, at higher cost, and lower quality.

Just last year a huge study of almost 280,000 doctors in the United States – published in the prestigious JAMA Internal Medicine journal – found doctors “who received a single meal promoting the drug of interest had higher rates of prescribing”. While this finding was an association only, not a cause-and-effect relationship, it’s this kind of evidence making some doctors, hospitals and even health systems say no to free lunches.

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