Educate Yourself!

Below we have included the most recent studies published in the medical literature concerning interactions between the pharmaceutical industry and the medical community. The studies are organized into topic sections with links to the abstracts in PubMed.

Overview Articles

Physician-Industry Interactions

Influence on Prescription Practices

Influence on Medical Research

Bias in Pharm Rep Information and Promotional Materials

"Free" Samples

Direct-to-Consumer (DTC) Advertising

Patient Beliefs

Influence on Continuing Medical Education (CME)

Off-Label Medication Use

Interventions

Medical Students, Residents, and Pharma

The Case of Gabapentin

Other

Overview Articles

Rothman DJ, Chimonas S. New developments in managing physician-industry relationships. JAMA. 2008 Sep 3;300(9):1067-9.

Brennan TA, Rothman DJ, Blank L, Blumenthal D, Chimonas SC, Cohen JJ, Goldman J, Kassirer JP, Kimball H, Naughton J, Smelser N.  Health Industry Practices That Create Conflicts of Interest: A Policy Proposal for Academic Medical Centers.  JAMA. 2006;295(4):429-433.

Blumenthal D.  Doctors and Drug Companies.  NEJM 2004; 83 (4): 407-8.

Moynihan R. Who pays for the pizza? Redefining the relationships between doctors and drug companies. 1: Entanglement.  BMJ 2003;326:1189-1192.

Moynihan R. Who pays for the pizza? Redefining the relationships between doctors and drug companies. 2: Disentanglement. BMJ 2003;326:1193-1196.

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Physician-Industry Interactions

Campbell EG, Gruen RL, Mountford J, Miller LG,Cleary PD, Blumenthal D. A national survey of physician-industry relationships. NEJM 2007; 356(17):1742-50.

Chimonas S, Brennan TA, Rothman DJ. Physicians and drug representatives: exploring the dynamics of the relationship. J Gen Intern Med 2007; 22(2):184-90.

Morgan MA, Dana J, Loewenstein G, Zinberg S, Schulkin J. Interactions of doctors with the pharmaceutical industry. J Med Ethics 2006; 32(10):559-63.

Sierles FS, Brodkey AC, Cleary LM, McCurdy FA, Mintz M, Frank J, et al. Medical students' exposure to and attitudes about drug company interactions: a national survey.  JAMA 2005; 294(9):1034-42.

Keim SM, Mays MZ, Grant D. Interactions between emergency medicine programs and the pharmaceutical industry. Acad Emerg Med 2004; 11:19-26.

Wazana A. Physicians and the pharmaceutical industry: is a gift ever just a gift? JAMA 2000; 283:373-380.

Chren M. Interactions between physicians and drug company representatives. Am J Med 1999; 107:182-183.

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Influence on Prescribing Practices

Sox HC, Rennie D. Seeding trials: just say "no". Ann Intern Med. 2008 Aug 19;149(4):279-80.

Hill KP, Ross JS, Egilman DS, Krumholz HM. The ADVANTAGE seeding trial: a review of internal documents.
Ann Intern Med. 2008 Aug 19;149(4):251-8.

Abramson J, Wright JM. Are lipid-lowering guidelines evidence-based? Lancet 2007; 369(9557):168-9.

Iserson KV, Cerfolio RJ, Sade RM.  Politely refuse the pen and note pad: gifts from industry to physicians harm patients.  Ann Thorac Surg 2007; 84(4):1077-84.

Greving JP, Denig P, van der Veen WJ, Beltman FW, Sturkenboom MC, Haaijer-Ruskamp FM. Determinants for the adoption of angiotensin II receptor blockers by general practitioners. Soc Sci Med 2006; 63(11):2890-8.

Adair RF, Holmgren LR. Do drug samples influence resident prescribing behavior? A randomized trial. Am J Med 2005; 118(8):881-4.

Dana J, Loewenstein G. A social science perspective on gifts to physicians from industry. JAMA 2003; 290:252-255.

Katz D, Caplan AL, Merz JF. All gifts large and small: toward an understanding of the ethics of pharmaceutical industry gift-giving. Am J Bioeth 2003; 3:39-46.

Steinman MA.  Of principles and pens: attitudes and practices of medicine housestaff toward pharmaceutical industry promotions. Am J Med 2001; 110(7):551-7.

Wazana A. Physicians and the pharmaceutical industry: is a gift ever just a gift? JAMA 2000; 283:373-380.

Sandberg WS, Carlos R, Sandberg EH, Roizen MF. The effect of educational gifts from pharmaceutical firms on medical students’ recall of company names of products. Acad Med 1997; 72:916-18.

Chren MM, Landefeld CS. Physicians’ behavior and their interactions with drug companies: a controlled study of physicians who requested additions to a hospital drug formulary.  JAMA 1994; 271:684-689.

Orlowski JP, Wateska L. The effects of pharmaceutical firm enticements on physician prescribing patterns: there's no such thing as a free lunch. Chest 1992; 102:270-273.

Cleary JD. Impact of pharmaceutical sales representatives on physician antibiotic prescribing. J Pharm Technol 1992; 8:27-29.

Lurie N, Rich EC, Simpson DE, et al. Pharmaceutical representatives in academic medical centers. J Gen Intern Med 1990; 5:240-243.

 Peay MY, Peay ER. The role of commercial sources in the adoption of a new drug. Soc Sci Med 1988; 26:1183-1189.

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Influence on Medical Research

Angell M. Industry-sponsored clinical research: a broken system. JAMA. 2008 Sep 3;300(9):1069-71.

Hill KP, Ross JS, Egilman DS, Krumholz HM. The ADVANTAGE seeding trial: a review of internal documents. Ann Intern Med. 2008 Aug 19;149(4):251-8.

Ross JS, Hill KP, Egilman DS, Krumholz HM. Guest authorship and ghostwriting in publications related to rofecoxib: a case study of industry documents from rofecoxib litigation. JAMA. 2008 Apr 16; 299(15):1800-12.

Psaty BM, Kronmal RA. Reporting mortality findings in trials of rofecoxib for Alzheimer disease or cognitive impairment: a case study based on documents from rofecoxib litigation. JAMA. 2008 Apr 16; 299(15):1813-7.

DeAngelis CD, Fontanarosa PB. Impugning the integrity of medical science: the adverse effects of industry influence. JAMA. 2008 Apr 16; 299(15):1833-5.

Greenland P, Lloyd-Jones D. Critical lessons from the ENHANCE trial. JAMA 2008; 299(8):953-5.

Kirsch I, Deacon BJ, Huedo-Medina TB, et al. Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration. PLoS Med 2008; 5(2):e45.

Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R. Selective publication of antidepressant trials and its influence on apparent efficacy. NEJM 2008; 358(3):252-60.

Pearce N. Corporate influences on epidemiology. Int J Epidemiol 2008; 37:46–53.

Parascandola M. A turning point for conflicts of interest: The controversy over the National Academy of Sciences' first conflict of interest disclosure policy. J Clin Oncol 2007; 25:3609-3614.

Epstein RA.  Influence of pharmaceutical funding on the conclusions of meta-analyses. BMJ 2007; 335:1167-1167.
           
Yank V, Rennie D, Bero LA. Financial ties and concordance between results and conclusions in meta-analyses: retrospective cohort study.  BMJ 2007; 335:1202-1205.

Mello MM, Joffe S. Compact versus Contract -- Industry Sponsors' Obligations to Their Research Subjects. NEJM 2007; 356:2737-2743.

DeAngelis CD. The influence of money on medical science. JAMA 2006; 296:996-998.

Curfman GD, Morrisey S, Drazen JM. Expression of concern reaffirmed. NEJM 2006; 354:1193.

Campbell EG et al. Financial relationships between institutional review board members and industry. NEJM 2006; 355(22):2321-9.

Steinbrook R. Wall Street and clinical trials. NEJM 2005; 353(11):1091-3.

Steinbrook R. Gag clauses in clinical-trial agreements. NEJM 2005; 352(21):2202-10.

Gibson L. GlaxoSmithKline to publish clinical trials after US lawsuit. BMJ 2004;328-1513.

Melander H, Ahlqvist-Rastad J, Meijer G, Beermann B. Evidence b(i)ased medicine--selective reporting from studies sponsored by pharmaceutical industry: review of studies in new drug applications. BMJ 2003; 326:1171–1173.

Lexchin J, Bero LA, Djulbegovic B, Clark O. Pharmaceutical industry sponsorship and research outcome and quality: systematic review.  BMJ 2003; 326:1167-1170.

Bekelman JE, Li Y, Gross CP. Scope and Impact of Financial Conflicts of Interest in Biomedical Research: A Systematic Review. JAMA 2003; 289:454-465.

Djulbegovic B, Lacevic M, Cantor A, Fields KK, Bennett CL, Adams JR. The uncertainty principle and industry-sponsored research. Lancet. 2000 Aug 19;356(9230):635-8.

Bombardier C, Laine L, Reicin A, et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. NEJM 2000; 343:1520-1528.

Kahn JO, Cherng DW, Mayer K, et al. Evaluation of HIV-1 immunogen, an immunologic modifier, administered to patients infected with HIV having 300 to 549 x 106/L CD4 cell counts: a randomized controlled trial. JAMA 2000; 284:2193-2197

Silverstein FE, Faich G, Goldstein JL, et al. Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: a randomized controlled trial. JAMA 2000; 284:1247-1255.

Angell M. Is academic medicine for sale? NEJM 2000; 342:1516-1518.

Bodenheimer T. Uneasy alliance -- clinical investigators and the pharmaceutical industry. NEJM 2000; 342:1539-1544.

Friedberg M, Saffran B, Stinson TJ, Nelson W, Bennett CL. Evaluation of conflict of interest in economic analyses of new drugs used in oncology. JAMA 1999;282:1453-1457.

Stelfox HT, Chua G, O'Rourke K, Detsky AS. Conflict of interest in the debate over calcium-channel antagonists. NEJM 1998; 338:101-106.

Cho MK, Bero LA. The quality of drug studies published in symposium proceedings. Ann Intern Med 1996; 124:485-489.

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Bias in Pharm Rep Information and Promotional Materials

Cooper RJ, Schriger DL.  The availability of references and the sponsorship of original research cited in pharmaceutical advertisements.  CMAJ 2005; 172(4):487-91.

Lohiya S. Pharmaceutical advertisements in medical journals received in a medical clinic: are we having "too much of a good thing"?. J Natl Med Ass 2005; 97(5):718-20.

Villanueva P, et al. Accuracy of pharmaceutical advertisements in medical journals. Lancet 2003; 361: 27-32.

Cooper RJ, et al. The quantity and quality of scientific graphs in pharmaceutical advertisements. J Gen Intern Med 2003; 18(4):294-7.

Gutknecht DR. Evidence-based advertising? A survey of four major journals. J Am Board Fam Pract 2001; 14:197–200.

Mindell J, Kemp T. Evidence based advertising? Only two fifths of advertisements cited published, peer reviewed references. BMJ 1997; 315:1622.

Stryer D, Bero LA.  Characteristics of materials distributed by drug companies. An evaluation of appropriateness. J Gen Int Med 1996; 11:575-583.

Cho MK, Bero LA. The quality of drug studies published in symposium proceedings. Ann Intern Med 1996; 124(5):485-9.

Ziegler MG, Lew P, Singer BC. The accuracy of drug information from pharmaceutical sales representatives. JAMA 1995; 273:1296-1298.

Shaughnessy AF, Slawson DC, Bennett JH. Separating the wheat from the chaff: identifying fallacies in pharmaceutical promotion. J Gen Int Med 1994; 10:563-8.

Keng A, Coley RM. Evaluating the accuracy of citations in drug promotional brochures. Ann Pharmacother 1994; 28(11):1231-5.

Wilkes MS, Doblin BH, Shapiro MF. Pharmaceutical advertisements in leading medical journals: experts’ assessments. Ann Intern Med 1992; 116:912-9.

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"Free" Samples

Miller DP, Mansfield RJ, Woods JB, Wofford JL. The impact of drug samples on prescribing to the uninsured. South Med J. 2008 Sep;101(9):888-93.

Alexander GC, Zhang J, Basu A. Characteristics of Patients Receiving Pharmaceutical Samples and Association Between Sample Receipt and Out-of-Pocket Prescription Costs. Med Care 2008; 46(4):394-402.

Cutrona SL, Woolhandler S, Lasser KE, Bor DH, McCormick D, Himmelstein DU. Characteristics of Recipients of Free Prescription Drug Samples: A Nationally Representative Analysis.  Am J Public Health 2008; 98:284-289.

Adair RF, Holmgren LR. Do drug samples influence resident prescribing behavior? A randomized trial. Am J Med 2005; 118(8):881-4.

Taylor M. Drug samples bring scrutiny. Mod Healthc 2005; 35(18):22, 2005.

MacKinnon NJ. Use of drug samples as a threat to seamless health care. Am J Health Syst Pharm 2004; 61(14):1497-500.

Groves KE, Sketris I, Tett SE. Prescription drug samples-does this marketing strategy counteract policies for quality use of medicines? J Clin Pharm Ther 2003; 28:259-71.

Zweifler J, Hughes S, Schafer S, Garcia B. Are sample medicines hurting the uninsured? J Am Board Fam Pract. 2002 Sep-Oct;15(5):361-6.

Chew LD, O’Young TS, Hazlet TK. A physician survey of the effect of drug sample availability on physicians’ behavior. J Gen Intern Med 2000; 15:478–483.

Westfall JM, McCabe J, Nicholas RA. Personal use of drug samples by physicians and office staff. JAMA 1997; 278:141-3.

Tong KL, Lien CY. Do pharmaceutical representatives misuse their drug samples? Can Fam Physician 1993; 41:1363-6.

Morelli D, Koenigsberg MR. Sample medication dispensing in a residency practice. J Fam Pract 1992; 34:42-8.

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Direct-to-Consumer (DTC) Advertising

Boden WE, Diamond GA. DTCA for PTCA -- Crossing the Line in Consumer Health Education? NEJM 2008 May 14.

Donohue JM. Cevasco M. Rosenthal MB. A decade of direct-to-consumer advertising of prescription drugs. NEJM 2007; 357(7):673-81.

Frosch DL, Krueger PM, Hornik RC, Cronholm PF, Barg RK. Creating Demand for Prescription Drugs: A Content Analysis of Television Direct-to-Consumer Advertising. Ann Fam Med 2007; 5:6-13.

Kravitz RL. Epstein RM. Feldman MD. Franz CE. Azari R. Wilkes MS. Hinton L. Franks P. Influence of patients' requests for direct-to-consumer advertised antidepressants: a randomized controlled trial. JAMA 2005; 293(16):1995-2002.

Gilbody S, Wilson P, Watt I. Benefits and harms of direct to consumer advertising: a systematic review. Qual Saf Health Care 2005; 14:246-250.

Donohue JM, Berndt ER, Rosenthal M, Epstein AM, Frank RG. Effects of pharmaceutical promotion on adherence to the treatment guidelines for depression. Med Care 2004; 42:1176-1185.

Mintzes B, Barer ML, Kravitz RL, Bassett K, et al. How does direct-to-consumer advertising (DTCA) affect prescribing? A survey in primary care environments with and without legal DTCA. CMAJ 2003; 169(5):405-12.

Rosenthal MB, Berndt ER, Donohue JM, Frank RG, Epstein AM. Promotion of prescription drugs to consumers. NEJM 2002; 346:498-505.

Wolfe SM.  Direct-to-Consumer Advertising -- Education or Emotion Promotion?. NEJM 2002; 346:524-526.

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Patient Beliefs

Hampson LA, Agrawal M, Joffe S, Gross CP, Verter J, Emanuel EJ.  Patients' Views on Financial Conflicts of Interest in Cancer Research Trials. NEJM 2006; 355:2330-2337.

Gibbons RV, Landry FJ, Blouch DL, Jones DL, Williams FK, Lucey CR, Kroenke K. A comparison of physicians' and patients' attitudes toward pharmaceutical industry gifts. J Gen Inter Med 1998; 13(3):151-4.

Mainous AG 3rd, Hueston WJ, Rich EC. Patient perceptions of physician acceptance of gifts from the pharmaceutical industry. Arch Fam Med 1995; 4(4):335-9.

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Influence on Continuing Medical Education (CME)

Relman AS. Industry support of medical education. JAMA. 2008 Sep 3;300(9):1071-3.

Podolsky SH, Greene JA. A historical perspective of pharmaceutical promotion and physician education. JAMA. 2008 Aug 20;300(7):831-3.

Steinbrook R. Financial support of continuing medical education. JAMA 2008; 299(9):1060-2.   

Moynihan R. Doctors' education: the invisible influence of drug company sponsorship. BMJ 2008; 336(7641):416-7.

Steinman MA, Baron RB. Is continuing medical education a drug-promotion tool?: YES. Can Fam Physician 2007; 53(10):1650-7.

Steinbrook R. Commercial support and continuing medical education. NEJM 2005; 352:534-5.

Davis DA. CME and the pharmaceutical industry: two worlds, three views, four steps CMAJ 2004; 171(2):149-50.

Relman AS. Separating continuing medical education from pharmaceutical marketing. JAMA 2001; 285(15):2009-12.

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Off-Label Medication Use

Stafford RS. Regulating off-label drug use--rethinking the role of the FDA. NEJM 2008 Apr 3; 358(14):1427-9.

Radley DC, Finkelstein SN, Stafford RS, Off-label prescribing among office-based physicians.  Arch Intern Med 2006; 166(9):1021-6.

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Interventions

Ehringhaus SH, Weissman JS, Sears JL, Goold SD, Feibelmann S, Campbell EG. Responses of medical schools to institutional conflicts of interest. JAMA 2008; 299(6):665-71.
   
Rothman DJ. Academic medical centers and financial conflicts of interest. JAMA 2008; 299(6):695-7.

Brennan TA, Mello MM.  Sunshine Laws and the Pharmaceutical Industry. JAMA 2007; 297:1255-1257.

Ross JS, Lackner JE, Lurie P, Gross CP, Wolfe S, Krumholz HM. Pharmaceutical company payments to physicians: early experiences with disclosure laws in Vermont and Minnesota. JAMA 2007; 297:1216-1223.

Campbell EG.  Doctors and Drug Companies - Scrutinizing Influential Relationships.  NEJM 2007; 357:1796-1797.

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Medical Students, Residents, and Pharma

Fitz MM, Homan D, Reddy S, Griffith CH 3rd, Baker E, Simpson KP. The hidden curriculum: medical students' changing opinions toward the pharmaceutical industry. Acad Med. 2007 Oct;82(10 Suppl):S1-3.

Hyman PL, Hochman ME, Shaw JG, Steinman MA. Attitudes of preclinical and clinical medical students toward interactions with the pharmaceutical industry. Acad Med. 2007 Jan;82(1):94-9.

Sierles FS, Brodkey AC, Cleary LM, McCurdy FA, Mintz M, Frank J, et al. Medical students' exposure to and attitudes about drug company interactions: a national survey.  JAMA. 2005; 294(9):1034-42.

Zipkin DA, Steinman MA. Interactions between pharmaceutical representatives and doctors in training. A thematic review. J Gen Intern Med. 2005; 20(8):777-86.

Rogers WA, Mansfield PR, Braunack-Mayer AJ, Jureidini JN. The ethics of pharmaceutical industry relationships with medical students. Med J Aust. 2004; 180(8):411-4.

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The Case of Gabapentin

Steinman MA, Harper GM, Chren MM, Landefeld CS, Bero LA. Characteristics and impact of drug detailing for gabapentin. PLoS Med 2007; 4(4):e134.

Steinman MA, Bero LA, Chren MM, Landefeld CS. Narrative review: the promotion of gabapentin: an analysis of internal industry documents. Ann Intern Med 2006; 145(4):284-93.

Mack A. Examination of the evidence for off-label use of gabapentin. J Manag Care Pharm 2003; 9(6):559-68.

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Other

Lenzer J, Brownlee S. Naming names: is there an (unbiased) doctor in the house? BMJ. 2008 Jul 23; 337:a930.

Burton B. Drug industry weakens US bill about disclosure of gifts. BMJ. 2008 Jun 7; 336(7656):1268.

Kesselheim AS, Avorn J. Pharmaceutical promotion to physicians and first amendment rights. NEJM. 2008 Apr 17; 358(16):1727-32

Lee K. Has the hunt for conflicts of interest gone too far? No. BMJ 2008; 336(7642):477.

Lenzer J, Brownlee S. An untold story? BMJ 2008 Mar 8;336(7643):532-4.

Jutel A, Menkes DB. Soft targets: nurses and the pharmaceutical industry. PLoS Med 2008; 5(2):e5.

Fugh-Berman A, Ahari S. Following the script: how drug reps make friends and influence doctors. PLoS Med 2007; 4(4):e150

Tonelli MR.  Conflict of Interest in Clinical Practice. Chest 2007; 132: 664-670.

Pinto SL, Lipowski E, Segal R, Kimberlin C, Algina J. Physicians' intent to comply with the American Medical Association's guidelines on gifts from the pharmaceutical industry. J Med Ethics 2007; 33(6):313-9.

Marco CA. Moskop JC. Solomon RC. Geiderman JM. Larkin GL. Gifts to physicians from the pharmaceutical industry: an ethical analysis. Ann Emerg Med 2006; 48(5):513-21.

Shrank WH, Hoang T, Ettner SL, et al. The implications of choice: prescribing generic or preferred pharmaceuticals improves medication adherence for chronic conditions. Arch Intern Med 2006; 166:332-7.

Steinbrook R. For sale: physicians' prescribing data. NEJM 2006; 354(26):2745-7.

Komesaroff PA, Kerridge IH. Ethical issues concerning the relationships between medical practitioners and the pharmaceutical industry. Med J Aust 2002; 176:118-121.

McKinney W, Schiedermayer D, Lurie N, Simpson D, Goodman J, Rich E. Attitudes of internal medicine faculty and residents toward professional interaction with pharmaceutical sales representatives. JAMA 1990; 264:1693-1697.

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