Institutions play a part in doctor–drug industry relationship
According to a new study published in JAMA, institutions and organisations can play a role in the relationships between doctors and the drug industry and this may affect which drugs are prescribed to patients.
The study creators pointed out in their paper that since the beginning of the 21st century, industry and academic institutions have adopted policies that regulate doctor interactions with drug representatives. Examining data collected between 2006 and 2012 from academic medical centres in five US states, the researchers found that detailed drugs (those promoted by pharma representatives) lost market share after policies were adopted by the centres.
Prescribing patterns for eight types of medications for a variety of disorders, including drugs to lower cholesterol, control diabetes, treat depression and help with sleep, were analysed. All of the drugs included in the study had at least 2,000 assigned pharma company salespeople during the study period. Additionally, they had a market share of more than 25%, but less than 75% and it was found that 87 out of the 262 drugs were detailed during the study period.
Before the policies were adopted — at 10–36 months before — detailed drugs had a market share of about 19%, compared to 14% for non-detailed drugs. At 12–36 months after the policies were implemented, the market share of detailed drugs fell about two percentage points whereas the non-detailed drugs rose one percentage point.
Reduction in market share for the detailed drugs from before and after the policies were adopted represented about 9 % difference. Out of the eight drugs examined, six had significant changes in market share over the study period.
Furthermore, it was found that nine of the medical centres examined had significant changes in prescriptions of detailed drugs. Those most likely to see a change were the centres that regulated gifts to doctors, restricted drug representatives’ access to the facility and enforced the policies.
Lead author, Ian Larkin, University of California, Los Angeles Anderson School of Management, USA, said: “Our findings suggest that the organisational level can and does make an important difference. The million-dollar question is whether drug detailing and restrictions on detailing are affecting patient outcomes.”