Are Financial Payments From the Pharmaceutical Industry Associated With Physician Prescribing? : A Systematic Review.

BACKGROUND: Financial payments from the drug industry to U.S. physicians are common. Payments may influence physicians' clinical decision making and drug prescribing. PURPOSE: To evaluate whether receipt of payments from the drug industry is associated with physician prescribing practices. DATA SOURCES: MEDLINE (Ovid), Embase, the Cochrane Library, Web of Science, and EconLit were searched without language restrictions. The search had no limiting start date and concluded on 16 September 2020. STUDY SELECTION: Studies that estimated the association between receipt of industry payments (exposure) and prescribing (outcome). DATA EXTRACTION: Pairs of reviewers extracted the primary analysis or analyses from each study and evaluated risk of bias (ROB). DATA SYNTHESIS: Thirty-six studies comprising 101 analyses were included. Most studies (n = 30) identified a positive association between payments and prescribing in all analyses; the remainder (n = 6) had a mix of positive and null findings. No study had only null findings. Of 101 individual analyses, 89 identified a positive association. Payments were associated with increased prescribing of the paying company's drug, increased prescribing costs, and increased prescribing of branded drugs. Nine studies assessed and found evidence of a temporal association; 25 assessed and found evidence of a dose-response relationship. LIMITATION: The design was observational, 21 of 36 studies had serious ROB, and publication bias was possible. CONCLUSION: The association between industry payments and physician prescribing was consistent across all studies that have evaluated this association. Findings regarding a temporal association and dose-response suggest a causal relationship. PRIMARY FUNDING SOURCE: National Cancer Institute.

The challenge of institutionalised complicity: Researching the pharmaceutical industry in the era of impact and engagement.

The pharmaceutical industry plays a central role in the production of the drugs we use to treat most illnesses. It is immensely powerful and has received sustained attention from sociologists of health and illness, who have provided a critique of its influence and sometimes unethical behaviour. However, in recent years, funders are increasingly expecting researchers to engage and collaborate with stakeholders, including industry. This raises important questions about the institutionalisation of complicity and the different forms this might take. This article asks: How can sociologists engage with the pharmaceutical industry in a positive and constructive manner, whilst remaining independent, principled and critical? It will draw on my experience of establishing a major project on high-priced drugs for rare diseases and the literature on collaboration, stakeholder engagement and responsible research to propose a methodological framework to address this challenge. This is based on six PRIMES: (normative) Principles, Reflection and Independence, (field) Mapping, (careful) Engagement and Strategic intervention that have broad applications to many other areas of contemporary social science research.

Industry payments to hospitalist physicians: a 5-year analysis of the Open Payments programme from 2014 to 2018.

We analysed Open Payments programme data (https://openpaymentsdata.cms.gov) on industry-to-physician payments to hospitalists for the years 2014 to 2018. Payments to hospitalists increased by 106.5% from 2014 to 2018 with food and beverage (38.5%) and compensation for services other than consulting (24.3%) being the highest-paid categories. Industry payment to hospitalists was highly skewed with top 10 hospitalists receiving more than 30% of the total payments during the study period. The most common drugs associated with payments were anticoagulant medications (apixaban and rivaroxaban). Industry seems to be spending a significant amount of money to increase awareness of medications among hospitalists. Identification of these trends and potential motives of industry spending is critical to address any potential physician bias.

Cannabis and work: Need for more research.

Cannabis sativa is one of the oldest and most widely used plants in the world with a variety of industrial, medical, and nonmedical applications. Despite its long history, cannabis-derived products remain a source of controversy across the fields of medicine, law, and occupational safety and health. More favorable public attitudes about cannabis in the US have resulted in greater access to cannabis through legalization by states, leading to more consumption by workers. As more states adopt cannabis access laws, and as more workers choose to consume cannabis products, the implications for existing workplace policies, programs, and practices become more salient. Past workplace practices were grounded in a time when cannabis consumption was always viewed as problematic, considered a moral failing, and was universally illegal. Shifting cultural views and the changing legal status of cannabis indicate a need for research into the implications and challenges relating to cannabis and work. This commentary suggests research needs in the following areas: (a) data about industries and occupations where cannabis consumption among workers is most prevalent; (b) adverse health consequences of cannabis consumption among workers; (c) workplace supported recovery programs; (d) hazards to workers in the emerging cannabis industry; (e) relationship between cannabis consumption and occupational injuries; (f) ways to assess performance deficits and impairment from cannabis consumption; (g) consumption of synthetic cannabinoids to evade detection by drug testing; (h) cannabis consumption and its effect on occupational driving; and (i) ways to craft workplace policies and practices that take into consideration conflicting state and federal laws pertaining to cannabis.

A Brief Recent History of Women in Computational Chemistry at Vertex Pharmaceuticals.

Countless reports cite the importance of diversity in the academic, industrial, and government workplace. This article shares the different perspective on gender diversity from five women who have recently joined Vertex's computational chemistry group. It is written with the hope that other scientists will take the themes which resonant and adopt them to their own institutions to inspire the fostering of an inclusive environment while in pursuit of scientific discoveries.

Industry Payments to US Physicians by Specialty and Product Type.

This study examines the distribution of payments within and across specialties and the medical products associated with the largest total payments.

The status of licensed pharmacy workforce in Saudi Arabia: a 2030 economic vision perspective.

BACKGROUND: The economy of Saudi Arabia is currently undergoing a major transformation which will have an impact on employment in the pharmacy sector. However, quantitative data characterizing the pharmacy workforce in the Kingdom are currently not available. Therefore, the aim of this study was to determine the current status of the licensed pharmacy workforce in the pharmacy field in Saudi Arabia. METHODS: Descriptive statistics were performed on data from the Saudi Commission for Health Specialties (SCFHS) as of March 2017. RESULTS: The labor market for pharmacists in Saudi Arabia is dominated by expatriates. Saudi nationals constitute less than 20% of the pharmacists employed in the Kingdom. The underemployment of Saudis is most evident in the largest sectors of the pharmacy field, namely, private health care establishments, community pharmacies, and pharmaceutical companies. CONCLUSION: There is an unmet need to train Saudi citizens as pharmacists and retain them in the workforce. Addressing this issue should become an important objective in Saudi Arabia's Vision for 2030.

Marketing and the Most Trusted Profession: The Invisible Interactions Between Registered Nurses and Industry.

BACKGROUND: The mainstay for addressing conflicts of interest in health care is disclosure of personal financial ties to industry. However, this approach fails to capture the complexity of industry interactions that are built into clinical practice. Further, the policy climate focuses on physicians and traditional pharmaceutical marketing. OBJECTIVE: To describe industry activities targeted at registered nurses. DESIGN: Qualitative, ethnographic study conducted from January 2012 to October 2014. SETTING: Four acute care hospitals in a western U.S. city. PARTICIPANTS: A purposive sample of 72 participants with direct experience with industry, including staff nurses, administrators, and industry and supply chain professionals. MEASUREMENTS: Fieldwork, including observations (102 hours), semistructured in-depth interviews (n = 51), focus groups (n = 4), and documents analysis. RESULTS: Nurses' reported financial relationships with industry were similar to those reported by prescribers. However, nurses reported that their most significant interactions with industry occurred in daily practice. The current policy environment rendered these interactions invisible, leaving nurses with little guidance to ensure that the boundary between service and sales remained intact. LIMITATIONS: This study could not determine the frequency or prevalence of nurse-industry interactions. The sample is not representative. CONCLUSION: Nurse-industry interactions may be common and influential, but they remain invisible in the current policy climate. Although some aspects of these interactions may be beneficial, others may pose financial risks to hospitals or safety risks to patients. Disclosure strategies alone do not provide health professionals with adequate support to manage day-to-day interactions. Management of industry interactions must include guidance for nurses. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality; Canadian Institutes of Health Research; and University of California, San Francisco.

Comparison of Industry Payments to Physicians and Advanced Practice Clinicians.

This study uses Open Payments data to characterize and compare payments to physicians and advanced practice clinicians.

[Pharmacoeconomics - Challenges for Health Professionals].

Over the last 30 years, medical expenditure has increased throughout the world. The main reasons estimated to lay behind it include aging, ever more chronic diseases and new emerging diseases, new drugs, expanded indications of current drugs, and development of pharmaceutical industry. A challenge for healthcare professionals is to sustain current quality of care and enable medical innovations while attempting to contain costs. The overall goal is to demonstrate the pharmacoeconomic value, i.e. a balance of economic, humanistic and clinical outcomes.

[Ethics and transparency committee of physicians in their relationship with the pharmaceutics: Industry recommendations for physician support]. / Comité de Ética y Transparencia en la Relación Médico-Industria (CETREMI); recomendaciones a la industria para el apoyo de los médicos.

Las siguientes recomendaciones a la industria farmacéutica se fundamentan en los principios éticos del CETREMI: - El paciente es lo primero: • Que la atención sea óptima para todos los pacientes. Que las compañías farmacéuticas apoyen las decisiones del médico que garanticen el tratamiento más eficaz, seguro, accesible y adecuado. • Que las compañías farmacéuticas colaboren para que los pacientes tengan acceso fácil y oportuno a los medicamentos. • Que las compañías farmacéuticas colaboren para que la información sobre los tratamientos beneficie a los pacientes en todos los rubros, incluyendo el económico.

[How to Use Presentations and Leaflets from Pharmaceutical Companies].

Presentations and leaflets from pharmaceutical companies are still a major source of information for physicians in Japan. Most physicians trust them and base their clinical practice on them. Such products from pharmaceutical companies are just advertising, because they are profit-making enterprises. Gifts from pharmaceutical companies to health care providers introduce bias when prescribing medicine. Thus, it is important that health care providers who receive this information from pharmaceutical companies, interpret it correctly. There are several methods for information supplements used by pharmaceutical companies. The range of the vertical axis on a survival curve may not be the full range, and differences between treatment groups are expanded in graphs. Sometimes the shape of the survival curve is artificial. The treatment effects should be interpreted based on various indicators such as raw incidence, relative risk or the number needed to treat. A composite endpoint is often used in mega-studies because each individual outcome which comprises the composite endpoint has a small event rate that is not enough to reach statistical significance, whether outcomes are important for patients or not. Evidence-based medicine is a formulated method of clinical reasoning from evidence used to make decisions. We should consider not only the evidence, but also a patient's clinical state and circumstances, a patient's preferences and actions, and the clinical expertise of the health care providers. Although pharmaceutical companies seduce health care providers, they have to recognize the true magnitude of the effects of their products and recommend their use for patients carefully.

Trends in Botulinum Toxin-Related Industry Payments to Physicians.

Objectives: To evaluate trends in botulinum toxin (BTX) industry payments to physicians. Methods: Cross-sectional analysis of nonroyalty, BTX-specific payments made by Allergan (Botox), Ipsen (Dysport), and Merz (Xeomin) to physicians using the 2016-2020 Open Payments Database. Results: Between 2016 and 2020, >$27 million in payments was made for BTX-related activities to dermatologists, neurologists, ophthalmologists, otolaryngologists, and plastic surgeons, with payments ranging from $3.9 million in 2016 to $8.7 million in 2019. 21.7% was paid to dermatologists, 57.5% to neurologists, 5.9% to ophthalmologists, 5.7% to otolaryngologists, and 9.1% to plastic surgeons. Conclusions: Growing amounts are being paid to physicians for BTX-related activities-both medical and aesthetic. Despite the variety of indications for BTX within otolaryngology, otolaryngology payments were overshadowed by other specialties, which may reflect greater BTX utilization in those specialties.