IT HAPPENS EVERYWHERE

An analysis of 58 studies in several countries found that information from drug companies influenced the decisions doctors made, and not necessarily in a positive way.

"You couldn't say that information from pharmaceutical companies benefited doctor's prescribing, which is what pharmaceutical companies claim," said Dr. Geoffrey Spurling of the University of Queensland in Brisbane, Australia, who led the study.

"Many doctors claim they are not influenced and having done the review, that is not supported. You have to say that at least some of the time, doctors are influenced," he said in a telephone interview.

Several of the researchers in the study are members of Healthy Skepticism, an international nonprofit research, education, and advocacy association set up to "reduce harm from misleading health information."

The report found that doctors who accepted briefings or other information from drug companies were more likely to prescribe those products.

Thirty-eight studies showed that exposure to drug company information resulted in more frequent prescriptions, while 13 did not have such an association, Dr. Spurling and his colleagues wrote in their report published in the open-access journal PLoS Medicine.

None of the studies found that doctors prescribed a drug less often because of promotional or informational materials. More than half the studies were conducted in the United States. Other countries included the United Kingdom, Canada, Denmark, France, Estonia, Turkey and Australia.

"The companies don't spend this money with drug detail people if it doesn't work," said Dr. Sid Wolfe of the U.S. advocacy group Public Citizen, which has campaigned against such drug company activity.

Dr. Spurling singled out a study in Britain of more than 1,000 general practitioners that found that those who met drug salespeople more often tended to prescribe more costly drugs.

But that did not guarantee that patients got the most suitable drugs.

Dr. Spurling also cited studies that found that doctors' prescriptions were of a lower quality when compared against standard guidelines and those recommended by expert panels.

For example, official U.S. guidelines in the United States advise doctors to use the oldest, cheapest generic drugs to treat high blood pressure and diabetes before turning to newer, patented and often more dangerous prescription drugs.

The researchers called for regulation on the amounts of money that pharmaceutical companies may spend on promoting their products. In 2004 alone, drug companies spent $57.5 billion on promotion in the United States, they said.

"We need more regulation on promotional information. We couldn't find any benefit," Dr. Spurling said.

Doctors also need more information from a variety of sources such as universities or accrediting organizations, he said.

"A good doctor keeps up with practicing medicine by reading the literature, peer-reviewed journals," Dr. Wolfe agreed.

"If they don't have time to do that, and rely on drug company detailers, they are not practicing good medicine."

On Tuesday, the investigative journalism group ProPublica, along with several news organizations, reported that seven big drug companies had paid more than 17,000 U.S. doctors many thousands of dollars to talk to other doctors about the companies' products (see Reuters Health story of Oct 19, 2010).

PLoS Medicine. Abstract