http://www.healthsentinel.com/org_news.php?event=org_news_print_list_item&id=056

Roman Bystrianyk, "Pharmaceutical Companies Influence Medical
Students", Health Sentinel, September 16, 2005,

The pharmaceutical industry spends between $12 and $18 billion each
year marketing to physicians and residents. This amount of money
includes approximately 60 million annual visits by pharmaceutical
representatives as well as most of the $1.5 billion spent annually on
continuing medical education.

The September 2005 issue of the Journal of the American Medical
Association (JAMA) examines medical students' exposure to
pharmaceutical company interaction. The study authors, composed of 11
medical doctors and PhDs, studied 8 medical schools to measure the
frequency of medical student exposure to drug company gifts and the
students' attitudes about those gifts.

Pharmaceutical representatives present information favoring their
products and this increases the likelihood of prescribing that product.
These prescriptions may be "inconsistent with evidence-based
guidelines" and may be a sign of the presence of drug samples or
demand by patients due to direct advertising to consumers. Because of
these forces, prescriptions may occur even if a drug was not the
doctor's first choice.

These pharmaceutical-doctor interactions increase the likelihood for
physicians making requests for drugs with "no clear advantage over
existing ones, prescribing nonrationally, prescribing costlier drugs,
and prescribing fewer generic drugs", even though physicians often
deny being influenced by pharmaceutical company marketing.

The study authors found that the students received a variety of gifts.
Some of the gifts were as follows: 96% of students received free
lunches, 89% received some form of snack (e.g. donut, candy, coffee),
50% received a paid dinner, 42% received drug samples, and 2% had their
travel expenses for a conference paid for by a drug company. Also, 93%
of students had been asked or required by a physician to attend a
sponsored lunch and this "may have represented a subtle coercion."

The authors found that most students believe they are entitled to gifts
because of financial hardships. Simultaneously, students believe that
sponsored educational events are likely to be biased and although they
feel they personally will not be influenced they believe their fellow
students are more likely to be influenced. This perception combined
with a high amount of pharmaceutical company interactions suggests
"as a group they are at risk for unrecognized influence by marketing
efforts."

While most would assume that schools have policies regarding drug
companies interacting with students 7 of the 8 schools had none. At the
1 school that had a policy 95% of the students were not aware their
school had a policy.

The authors conclude "research should focus on evaluating methods to
limit these experiences and affect the development of these attitudes,
with a goal of ensuring that physicians' decisions are based solely
on helping the individual patient achieve the greatest possible
benefit."

SOURCE: Journal of the American Medical Association, September 2005