No in my view a clinician decision in not influenced by pharma. And med. Equipment companies. Of course it can influence their brand selection. The research and conferences need huge amount of money. Why a physician should pay for such services which he has to utilize for public service. I am not in favour of ban of such services. They must be banned if and only if govt. Of that country is ready to sponsor to physician. Govt. must fix the profit of any company and the benefits must be provided to the patient. There is no uniformity in pricing of pharmaceutical and medical equipment products. In Asian countries the study of medical sciences is very costly but expectations from them are very high. The medical study should be totally on merit basis and free then to impose such ethical restrictions on physician.

Dear Nelson,

I hope NOT. Because it puts the life of patients at risk, and medicine stops being a social service. Obviously, subsidizing physicians is suspicious and unethical.

pharmaceticals or medical device companies sponsoring/ paying for anything other than that declared in the contract of sponsorship is unethical. We have examples from past like that of rafecoxib and valdecoxib. Where such unethical And lavish spending of companies on personal lifestyle of doctors does affect clinical decisions but laws and regulations are required to be made more stringent to stop such acts completely

I think no,Hope this articles will help.

1. Keller F, Marczewski K, Pavlović D. The relationship between the physician and pharmaceutical industry: background ethics and regulation proposals. Croatian Medical Journal. 2016;57(4):398-401. doi:10.3325/cmj.2016.57.398.

2. D’Arcy E, Moynihan R. Can the Relationship between Doctors and Drug Companies Ever Be a Healthy One? PLoS Medicine. 2009;6(7):e1000075. doi:10.1371/journal.pmed.1000075.

3. Birendra Kumar MandalSantosh Kumar YadavAbhishek KarnAbhishek KarnAjit SahAjit Sah.Relationship between Doctors and Pharmaceutical Industry: An Ethical Perspective. International Journal of Pharmaceutical & Biological Archives 2012; 3(3):415-417.

Pharmaceutical promotional activities take many forms, including provision of samples, face‐to‐face meetings between industry representatives and prescribers, advertising in print and electronic media, and support for meetings and travel. There are a number of studies which report that the amount spent by pharmaceutical companies on promotional activities exceeds the amount spent on research and development of new drugs.

See, for example, a free-access paper by Komesaroff PA: “Ethical issues associated with gifts provided to physicians by the pharmaceutical industry” (available at doi:10.1111/j.1445-5994.2010.02215.x) published in the Internal Medicine Journal in 2010. It is a useful source of information on the influence that pharmaceutical companies have on clinicians. The author argues that “The concern is not merely that the evidence shows that all promotional activities influence prescribing behaviour (contrary to the protestations of many physicians) .… What is [also] of concern is the possible impact of this influence on both the form and content of healthcare delivery.” The paper also has many useful references.

One of these references, a pay-to-view paper by Wazana A: “Physicians and the pharmaceutical industry: Is a gift ever just a gift?” published in JAMA in 2000 (available at doi:10.1001/jama.283.3.373), the author notes that: “Meetings with pharmaceutical representatives were associated with requests by physicians for adding the drugs to the hospital formulary and changes in prescribing practice. Drug company–sponsored continuing medical education (CME) preferentially highlighted the sponsor's drug(s) compared with other CME programs. Attending sponsored CME events and accepting funding for travel or lodging for educational symposia were associated with increased prescription rates of the sponsor's medication. Attending presentations given by pharmaceutical representative speakers was also associated with nonrational prescribing.”

A pay-to-view paper by Greenway T & Ross JR published in The BMJ in 2017, titled “US drug marketing: how does promotion correspond with health value” (available at doi.org/10.1136/bmj.j1855) assesses the effectiveness, usefulness, and affordability of the drugs that get the heaviest promotion. This article also has useful references.

A free-access article by De Ferrari A, Gentille C et al., published in PLoS in 2014, titled “Attitudes and Relationship between Physicians and the Pharmaceutical Industry in a Public General Hospital in Lima, Peru” (available at doi: 10.1371/journal.pone.0100114) presents a study described as being in a undertaken in a resource-poor setting, “where a close relationship between physicians and industry still exists”.

This De Ferrari et al. paper also summarises a number of earlier studies as follows: The interaction between physicians and the pharmaceutical representatives adversely influences doctors’ behaviour and knowledge. There is a tendency for non-rational prescribing, more favourable attitudes towards industry representatives, preference for newer, more expensive drugs and an inability to identify incorrect claims about medications. Moreover, this effect on doctors’ behaviour and knowledge is dose-dependent: frequent contacts and acceptance of gifts (independent of the gift's value) imposes a need to reciprocate that affects medical judgment.