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Big pharma, and physicians’ prescribing habits

Does information from pharmaceutical companies help GPs make better prescribers? Professor Ernst thinks not.

An Australian team recently reviewed the evidence regarding pharmaceutical companies influence on doctors' prescribing (see reference below). They included factors like sales representative visits, journal advertisements, attendance at sponsored meetings, mailed information, prescribing software and participation in sponsored trials. The overall findings are sobering.

The authors found that the relationship between exposure to information provided directly by pharmaceutical companies and the quality, frequency, and cost of prescribing varied. However, with only one exception, the included studies reported that exposure to information from pharmaceutical companies was associated with either lower prescribing quality or no association was detected.

Exposure to information from pharmaceutical companies was also associated with either an increase in prescribing frequency or no association was detected. Three studies found that exposure was associated with increased drug sales up to a point of diminishing returns beyond which more promotion was increasingly less effective. Finally, with only one exception, exposure to information from pharmaceutical companies was associated with an increase in prescribing costs or no association was detected.

And what does this have to do with CAM? The answer is VERY LITTLE. Except perhaps that, in CAM, there seems to be a general opinion that big pharma is evil and bent on suppressing CAM. During many years of research, I have found not a shred of evidence that this assumption is true. But, as the Australian team has shown, that does not mean that all the efforts of the pharmaceutical industry are aimed at improving healthcare.

Professor Edzard Ernst is professor of complementary medicine at the Peninsula Medical School, University of Exeter

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