A report published Sept. 9 in the British Medical Journal (BMJ) disclosed the extent of this corruption by Big Pharma. The said piece was written by Alice Fabbri of the University of Bath in the United Kingdom and Quinn Grundy of the University of Toronto in Canada.
"Drug and medical device industries globally continue to target clinicians early in their careers – including during periods of training – to cultivate long-term, reciprocal relationships through payments, free meals and sponsored education," they wrote. "Industry influence still threatens the integrity of healthcare and harms patients."
One study cited by Fabbri and Grundy examined payments to more than 5,000 cardiology fellows in the United States. The said paper published Sept. 1 in JAMA Internal Medicine looked at these fellows before and after graduating from medical school.
The study found that of the more than 5,000 cardiology fellows examined, 73 percent received "industry marketing payments" (IMPs) in the year before graduating. Meanwhile, 88 percent received IMPs in the first few years after they graduated. (Related: 65% of doctors are getting cash "kickbacks" from big pharma.)
"IMPs to physicians may compromise the objectivity and integrity of clinical decision-making, playing a role in non-recommended care, higher health costs and reduced patient trust," the JAMA Internal Medicine study stated. "Payments to trainees merit scrutiny because these payments may be formative on future practice."
Fabbri and Grundy also referenced an internal company document from the late 1990s, which outlined a plan "to influence physicians from the bottom up." The said memo published by drugmaker Parke-Davis sought to solidify the company's "role in the resident's mind as [they evolve] into a practicing physician."
According to the BMJ piece, the Parke-Davis memo reportedly became public "through litigation around off-label drug promotion." Drug company Warner-Lambert acquired Parke-Davis in the 1970s, and Pfizer later acquired Warner-Lambert in 2000 – with Parke-Davis included in the deal.
Meanwhile, a study published December 2018 in the Journal of Osteopathic Medicine (JOM) scrutinized data from the Centers for Medicare & Medicaid Services Open Payments database for calendar year 2015. The study authors found that almost 82,000 payments were made to approximately 12,000 cardiologists. These IMPs for 2015 amounted to a total of $13.9 million.
The authors of the December 2018 study also found that upon closer scrutiny, IMPs to cardiologists fell into one of 12 categories. The categories are as follows:
The JOM study also noted that a total of 45 companies submitted payments to a cardiologist for the year 2015. Anglo-Swedish drug company AstraZeneca made the highest overall payments, which were valued at $7.2 million. Its IMPs accounted for 51.85 percent of total payments to cardiologists for that year.
Fabbri and Grundy noted, citing other papers on the matter, that IMPs influence doctors' decision making.
"Even the receipt of low value industry-sponsored meals is associated with increased prescribing of the promoted brand name medication," they wrote. The two ultimately warned in their BMJ report that increased drug promotion as a result of IMPs to doctors can negatively affect patients' health "by contributing to over-, under- and mistreatment."
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Medical journal reveals over 6,500 Australian doctors received payments from Big Pharma companies.
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