Cardiologists 'main recipient of pharmaceutical industry disbursements'

Cardiovascular News

Cardiologists 'main recipient of pharmaceutical industry disbursements'

26 April 2007

MedWire News: Cardiologists are more likely than other hospital physicians, and twice as likely as family practitioners, to be remunerated by the pharmaceutical industry for consulting, giving lectures, or enrolling patients on trials, and have the costs of attending meetings reimbursed, a survey of US clinicians suggests.

There has been substantial interest in the relationships between physicians and the pharmaceutical, medical device, and other medically related industries in recent years. However, data on the extent and predictors of such relationships are uncommon, despite the availability of the relevant information.

To investigate further, Eric Campbell, from Harvard Medical School in Boston, Massachusetts, USA, and colleagues surveyed 3167 physicians from across the USA working in anesthesiology, cardiology, family practice, general surgery, internal medicine, and pediatrics between 2003 and 2004. The weighted response rate was 58%.

The results, published in the New England Journal of Medicine, show that 94% of physicians had a relationship with the pharmaceutical industry in one form or another, with 83% receiving food in the workplace and 78% being given drug samples. Reimbursements for costs linked to professional meetings or continuing medical education were paid to 35% of respondents, while 28% had payments for consulting, giving lectures, or enrolling patients in clinical trials.

Analysis showed that, on multivariate analysis, cardiologists were more than twice as likely as family practice physicians to have received payments, and were more likely to have received samples, gifts, or reimbursements than family practitioners, at odds ratios of 1.64, 1.14, and 1.04, respectively.

Interestingly, pediatricians were less likely than family practitioners to have benefited in these ways, at odds ratios of 0.46, 0.67, 0.59, and 0.51 for samples, gifts, reimbursements, and payments, respectively. Anesthetists were, overall, even less likely to have a relationship with the pharmaceutical industry than family physicians, at respective odds ratios of 0.05, 0.89, 0.31, and 0.21.

The findings also showed that family practitioners more frequently met with representatives of the pharmaceutical industry than other physicians, and physicians working in solo, two-person, and group practices more often met with representatives than did those working in hospitals.

The researchers conclude: "Our data show that physician–industry relationships are common in medicine, as are relationships between professionals and industrial organizations in the health sciences and many other sectors of the US economy. Furthermore, our data suggest that physicians' relationships with industry vary according to physicians' personal and professional characteristics and according to the practice setting."

They add: "We can only speculate about the reasons for these variations by specialty. Further research should consider factors such as the number and costs of drugs prescribed by physicians in the specialties in question, the accessibility of physicians in each specialty to company representatives, and the influence of physicians on the prescribing practices of their peers."

Link: http://www.nofreelunch.org/

Abstract:
http://content.nejm.org/cgi/content/abstract/356/17/1742
Full text:
N Engl J Med 2007; 356: 1742–1750