Med School Gift Bans Affect Docs' Prescribing Later

Physicians are beginning to face more scrutiny about conflicts of interest, but medical schools could contribute to putting a stop to physicians accepting gifts. According to a new study, physicians who went to a medical school that limited pharmaceutical company gifts to students are less susceptible to drug marketing.

The authors of the research appearing in BMJ looked at the prescribing patterns in 2008 and 2009 of physicians who attended one of 14 schools with an active gift restriction policy in place compared to physicians who graduated from those same schools before the policies were implemented. In particular, they studied the likelihood a physician would prescribe a newly marketed medication of the existing alternatives of three psychotropic classes: desvenlafaxine, lisdexamfetamine and paliperidone.

“Our study provides some early preliminary evidence that exposure to a gift restriction policy during medical school may reduce the likelihood that a physician will prescribe newly introduced medications over older alternatives within the same drug class,” wrote authors Marissa King, Connor Essick, Peter Bearman and Joseph S. Ross.

Studies before 2002 reveal that most medical students were exposed to marketing efforts by pharmaceutical companies: on average, students either received a gift or attended an industry-sponsored event on a weekly basis.

Decreasing a physician’s likelihood to prescribe new medications over older alternatives could mean slowing the escalation of health care costs if the new medication offers no additional benefits to patients.

However, there is another, more negative, effect. Typically, successful marketing efforts usually reduce the time it takes for new drug adoption and increase the probability a physician will adopt a new drug. If the new drug is an improvement over the older alternatives, this change in behavior could slow the diffusion of medical advances.

“Future research examining the effect of these policies on medications with varying levels of innovativeness is necessary to establish whether medical school gift restriction policies reduce prescribing of all newly marketed medications or affect prescribing selectively,” the authors wrote.

Read more:

Potential Financial Conflicts of Interest in Medicine

Medical School Gift Restriction Policies and Physician Prescribing of Newly Marketed Psychotropic Medications - BMJ