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At least 163 records · Page 9Linked to original sources
PubMed2005

Who's buying lunch: are gifts to surgeons from industry bad for patients?

Why does gifting exist in the medical marketplace? It provides a sales advantage in a competitive marketplace by establishing crucial relationships with the patients' fiduciary: the physician and surgeon. Do gifts to physicians from industry harm patients? One can cite mountains of indirect evidence that they do, and maybe in the case of recalled devices and drugs there are actual corpses, but these examples are retrospective and it is impossible to prove that removing detailing eliminates the harm. Banning gifts to surgeons would not completely fix the ethical problem of pharmaceutical and device marketing. Gifts are important because they buy access and foster relationships, but inherent bias in research and the medical literature makes it very difficult to remain objective. It is a race, and education has not kept pace with advertising; only 10% of 575 internal medicine physicians thought they had had sufficient training during medical school and residency regarding professional interaction with sales representatives. Would banning gifts help at all? Would enforcing an unpopular ethical code protect patients? There might be a small improvement, but not as significant as eliminating representatives and product samples altogether. This is not likely to happen without an enormous fight against the wealthiest industry in America. The solution is education. To borrow industry's argument, physicians and surgeons are ethical creatures with capacity for judgment and integrity. They need to understand and believe the magnitude of the problem. Detailing exists because there is a market for it, empowering surgeons with ethical training reduces the demand for goodies, and at some point the popular choice will be to buy their own lunch. Business ethics are not medical ethics. Industry is behaving exactly as it must to maximize profits. Although it is painful for some surgeons, surgical residencies, and professional organizations to envision a future with diminished corporate gifts, it is every surgeon's responsibility to consider whether their dealings with the pharmaceutical and medical equipment industries withstand the harsh light of realities presented herein.

Drug Industry↗
PubMed2005

[Is the pharmaceutical industry really as bad as its reputation?].

The pharmaceutical industry has a bad image. Recently it has often also been criticised in internationally well-known medical journals. An exact examination in the context of the peculiarities of the pharmaceutical products' market has shown that there are at present five areas where ethical problems in the pharmaceutical industry exist: poor information flow, the relationship between the pharmaceutical industry and public health authorities, security standards and the scientific quality of research, provisioning, and priorities in research. It is difficult for the pharmaceutical industry to cope with conflicts of interest and their implications in these areas. There are surely individual ethical deficiencies and shortcomings but this is no reason for the whole branch to be castigated. In comparison to other branches, the pharmaceutical industry is much better than its image. People have to consume pharmaceutical products even though they do not like doing so, and therefore cannot be expected to champion the cause of the branch. It needs to adopt another strategy in order to improve its image.

Attitude of Health Personnel↗
PubMed2001

Medical malpractice, murder and the academic community: trouble ahead.

The morale of the medical professional is at an historic low in many countries. The recent case of a UK general practitioner being convicted of being a mass murderer, combined with increasing criticism of medical negligence and malpractice and an excessive influence of the large pharmaceutical companies has lead to the perception that the profession is under siege. Our professional leadership have not had sufficient public awareness to allay these concerns, and the resulting dip in morale is fast turning into a dangerous rout. We must review what has lead to this situation and what we should be doing now to put it right.Clinical research is under attack and the motives and ethics of large pharmaceutical company sponsorships of clinical trials is under increasing question. At this time there is a risk that medicine, and academic medicine in particular, will lose its attractiveness and the pace of achievements we have seen and benefited from in the last 2 decades may slow. The public debate should move on, it should move on to evaluate how much it would cost to reduce medical error rates to an acceptable level (to stop them altogether is impossible). It should move on to how we can get clinical trials designed and paid for by the public purse rather than merely grumbling that pharmaceutical companies take too much control of trials that they almost alone now appear to be sponsoring. And we should move on to debate about the role and status of the medical profession in the modern era. We can no longer do our best in secret and expect the public to trust us unquestioningly. The public wants and needs to be involved in our decision-making problems and errors. Only through informed debate will we improve health for the while population, now and in the future.

Ethics, Medical↗
PubMedDate not supplied

Product names, proper claims? More ethical issues in the marketing of drugs.

OBJECTIVES: To analyse the explicit or implicit claims embodied in the proprietary names of pharmaceutical products. DESIGN: Linguistic and ethical analysis of proprietary names of pharmaceutical products marketed in the UK and in Denmark. RESULTS AND CONCLUSIONS: A number of drugs have names that allude to their indication or actions. Such names may be problematic, however, because they often promise more than the drug can deliver. Taking into account, firstly, the type of allusion and its degree of sophistication, and, secondly, the seriousness of the indication may help in identifying the most problematic drug names.

Denmark↗
PubMed2007

Assessment by human research ethics committees of potential conflicts of interest arising from pharmaceutical sponsorship of clinical research.

BACKGROUND: Conflicts of interest arising from pharmaceutical industry sponsorship of clinical research have the potential to bias research outcomes and ultimately prejudice patient care. It is unknown how Australian Human Research Ethics Committees (HREC) assess and manage such conflicts of interest. We aimed to gain an understanding of how HREC approach the problem of potential conflicts of interest arising from pharmaceutical sponsorship of clinical research. METHOD: We conducted a survey of HREC chairpersons in New South Wales. RESULTS: HREC vary widely in their approaches to conflicts of interest, including in their use of National Health and Medical Research Council guidelines, which were often misinterpreted or overlooked. Many committees rely primarily on researchers disclosing potential conflicts of interest, whereas a majority of HREC use disclosure to research participants as the primary tool for preventing and managing conflicts of interest. Almost no HREC place limitations on researcher relationships with pharmaceutical companies. CONCLUSION: These findings suggest reluctance on the part of HREC to regulate many potential conflicts of interest between researchers and pharmaceutical sponsors, which may arise from uncertainty regarding the meaning or significance of conflicts of interest in research, from ambiguity surrounding the role of HREC in assessing and managing conflicts of interest in research or from misinterpretation or ignorance of current National Health and Medical Research Council guidelines. Further review of policies and practices in this important area may prove beneficial in safeguarding clinical research and patient care while promoting continuing constructive engagement with the pharmaceutical industry.

Clinical Trials as Topic↗
PubMed2005

Intellectual property rights, moral imagination, and access to life-enhancing drugs.

Although the idea of intellectual property (IP) rights--proprietary rights to what one invents, writes, paints, composes or creates--is firmly embedded in Western thinking, these rights are now being challenged across the globe in a number of areas. This paper will focus on one of those challenges: government-sanctioned copying of patented drugs without permission or license of the patent owner in the name of national security, in health emergencies, or life-threatening epidemics. After discussing standard rights-based and utilitarian arguments defending intellectual property we will present another model. IP is almost always a result of a long history of of scientific or technological development and numbers of networks of creativity, not the act of a single person or a group of people at one moment in time. Thus thinking about and evaluating IP requires a traditional model of IP. It follows that the owner of those rights has some obligations to share that information or its outcomes. If that conclusion is applied to the distribution of antiretroviral drugs, what pharmaceutical companies are ethically required to do to increase access to these medicines in the developing world will have to be reanalyzed from a more systemic perspective.

Anti-HIV Agents↗
PubMed1993

Essential and non-essential drugs marketed by the 20 largest European pharmaceutical companies in developing countries.

This study estimates the proportion of essential drugs out of all drugs offered for sale in six regions of the developing world by the 20 largest European pharmaceutical companies. The total number of drugs offered for sale by the 20 companies is estimated from citations in the most important drug compendia in each region for 1988 and 1989. Essential drugs are defined as drugs listed on the 1988 version of the World Health Organization's (WHO) essential drugs list or equivalent to WHO essential drugs. Only 482, or 16% of a total of 3021 cited drugs were essential drugs or equivalent to an essential drug. The proportion for each company ranged from a low of 5.4% to a maximum of 39.0%. A high proportion, 41.7%, of the 2539 non-essential drugs cited in the compendia contained two or more active ingredients, compared to only 9.5% of the essential drugs. The results indicate that European pharmaceutical companies have yet to focus their drug marketing efforts in developing countries on the essential drugs recommended by the WHO. The ethical responsibility of the pharmaceutical companies is discussed, particularly in respect to their sales on the private market.

Africa↗
PubMed1992

Pharmacy computer prescription databases: methodologic issues of access and confidentiality.

OBJECTIVE: To examine methodologic issues of access and confidentiality regarding the use of pharmacy computer prescription databases (PCPDs) for participant selection to receive mailed, self-administered, hypertensive quality-of-life survey outside a primary-care setting. DESIGN: Two separate PCPD searches by pharmacist owners for patients prescribed at least one of 130 potential antihypertensive medications. The first PCPD used a nonrandom sample of all patients (n = 635); the second PCPD used a random sample (n = 100) of three specific antihypertensive drug groups. Research protocol was approved by the investigators' institutional review board. SETTING: Two independent, privately owned PCPDs. PATIENTS OR OTHER PARTICIPANTS: Individuals prescribed at least 1 of 130 PCPD medications potentially used in antihypertensive treatment. INTERVENTIONS: Individually addressed cover letter on pharmacy letterhead signed by a pharmacist requesting voluntary completion of the enclosed, self-administered, opinion survey on quality of life. MAIN OUTCOME MEASURE: Anonymous survey return to off-site post office box in envelope provided. RESULTS: Favorable or no opposition to PCPD methodology from pharmacist or participants. Ethical opposition was encountered when incorporating PCPD sampling technique into grant proposal. CONCLUSIONS: The American Pharmaceutical Association Code of Ethics is used as a basis to provide recommendations to examine and justify PCPD investigative use. Increasing availability of PCPD technology encourages more efficient and easier methods of research strategy. PCPD use, however, demands identical stringent guidelines used in traditional research and raises potential issues regarding pharmacist-patient confidentiality as well as the right of PCPD use by others.

Clinical Pharmacy Information Systems↗
PubMed2002

Ethical considerations in the relationship between physicians and the pharmaceutical industry.

Persuasion, influence, and change are familiar domains in psychiatry. Frequently, therapists attempt to identify and understand the cognitions, affects, and perceptions their patients have developed or acquired and then, by a number of means, trigger therapeutic changes. Whereas they spend much work in the therapeutic setting attempting to delineate the mechanisms that produce such transformations and to influence change, physicians are often in a similar relationship with the pharmaceutical industry. However, in this relationship, they are the recipients of persuasion and influence.

Conflict of Interest↗