I think it is a kind of bribe, it is not ethical at all! You have the opinions of doctors about the issue, as well as the patient's opinions!

Dear @Costas, You have stated very well about 

http://apps.who.int/medicinedocs/pdf/s8109e/s8109e.pdf

I think it is unethical and should be banned. The pharmaceutical  companies naturally expect a quid pro quo from these doctors, who  take benefits of such offers from the pharmaceutical  companies. They  are bound to promote their products by prescribing to the patients even when they do not need them. This practice is quite rampant in many countries. The attached paper shows an unholy alliance between manufacturers, chemists and doctors in Mumbai, who make profits at the expense of the  consumers and the public's health.

http://www.ijme.in/index.php/ijme/article/view/168/1380

It's not as simple as being ethical or unethical. Pharmaceuticals put a lot of effort when they develop a drug and conferences and their input in it is a part of their research and buissiness strategy. These drugs are developed by scientists and tested at all levels by doctors who are paid by the industry and they do have a conflict of interest. These papers are published even with a declared conflict of interest. The pharmaceutical companies then develop seminars and conferences where an amount earned from their sales is spend and that's when scientists are invited and sponsored. The drug that comes out goes through the same process and when it goes to the end user it's price is far escalated which the pharmaceuticals would actually sell out. They therefore develop a strategy that the drug would be sold at a certain price to whole sale, then to retailer and then end user. If we thoroughly go through all this, all seems unethical that a person who just picks medicine from

a cupboard and hand it over to the patient should earn from

this. If the whole process does not involve him. This is a huge topic and can't be discussed in a single forum.

It's okay to spend corporate sponsorship. But it should not be affected by this support.

Dear Ahed Thank you (some doctors make a pressure on companies to sponsor their trips at the same time they are sponsored by their organizations.) you highlighted very important issue which is double sponsors for the same trip in you opinion how common is this problem

Dear Javad  I think  pharma companies knows that most of the institutes either less sponsoring or even not sponsoring some of important meetings and they utilize this as point of weakness

Costs of meetings is so high, that for many physicians it would be unaffordable, and pharma industry used to consider financing travel with an apparent CME purpose as an aproach to marketing their products, however, the amount of money spend in this is so high, that it became a heavy burden on pharma budgets, some times without a visible benefit for sales, and, the cost of R&D in fast growth, resources for this 'congress budget' are in its way down, it can be thought that pharma industries itselves are pushing ahead the reduction in this type of expense.

By choosing the practioners that are paid travels to CME and those who are not, industry is influencing the Curricula of physicians, favoring some and putting a restriction on others, and this is an element of importance in career development.

Another dubious practice may be those heading oppinion or having a high patient or publication turnover being promoters of  a scientific meeting, the head receives money from industry for paying speakers, a possibility exists of location of congress giving some money to the organizers, the publicity and stands industry places in symposia also yield money, and the number of symposia or small congresses in some medical specialities became so high, that it's impossible tfor practitioners to compatibilize an acceptable level of working hours and attending just a little bit of the congresses offered.

Some of the activities in connection to CME and congresses in front of sponsors and industry could be considered equivalent to those of beggars, and an old Disney cartoon presented an: 'Idol of beggars', named. 'Gimme more'. This may be the issue, the cow is exhausted, too many on the same tit..

Salut +

Dear Jose

Thank you for your interesting answer  as usual we get valuable comments from you

There are many ethical problems concerning this practise, since after accepting a sponsoring somebody maybe could not resist to write drugs from the sponsor. It is a hidden kind of doctors bribe, although it is not called so.

That's what separates docs from each other. Some will be travelling and others cannot. It's sad

it is depended to doctor. if a doctor goes a trip by a company sposoring and prescription  more drug. it is very bad.

Sometimes I was wondering if they could  sponsor Mathematical Conferences! This situation is the worts of all corruption's!!

I think it is a kind of bribe, it is not ethical at all! You have the opinions of doctors about the issue, as well as the patient's opinions!

Dear @Costas, You have stated very well about 

http://apps.who.int/medicinedocs/pdf/s8109e/s8109e.pdf

Sponsoring medical doctors to go to regional or international conferences, by pharmaceutical companies, is more of a bribe than a gift for supporting research & development. Let us call a spade a spade !

Dear Mohamed,

Dear All,

International pharmaceutical companies do not want to waste their money. Doctors accepting the support of these corporations should prescribe the medicaments of sponsoring companies. Everybody knows this cannot be ethically accepted. However, many doctors like money and enjoy visiting exotic countries paid by corporations. This is a simple barter business. Unfortunately, similar corruption can be found even among some scientists.

It´s all about money, first they posien us whit sugar! yes is it a mixture of fructose and glucose and as you now fructose can only be metabolized by liver so how do you think our very advanced body / cells react when they get a substance they not know?  

offcuorse in the end it damaged the DNA in cells and they start to consume glucose 200* times more and a healthy cell.

so in this scenario we have big conflict between ethics and practice

the ethics are so clear but in reality most of clinical trials and conferences sponsored by pharma companies  so what to do to break this chain

I can't see the total mistake of such act. It depends on the situation.  If sponsors have a strategic plan to sponsor conferences and the organizers invite doctors as guests speaking personal,  there will be no problem.  However if sponsor selected doctors for helping them attending conferences to market their products, this will be a bribe and should not be allowed. 

I think that pharmaceutical companies sponsoring Medical Doctors to regional or international conferences is illegal and unethical. What will the pharmaceutical companies get in reciprocity. Do the sick persons, eventually, bear the cost?

Dear All,

I have heard some information about such conference sponsoring: some doctors do not even visit the conference because their aim is the holiday making.

This is obviously a disguised corruption until authorities do ban it.

Dear Cecilia,

I think this kind of corruption has nothing to do with the efficiency of medicaments. This is a consequence of the very “wild” competence among companies.

This is a shameful act. period

It is unethical and a sort of bribery on the cost of patients who not only suffer fro spurious or low grade medicines but also develop more complications.

This kind of holidays sponsoring is a corruption and a bribery... A conscious doctor shouldn't accept it. People are not mouses of laboratory. Pharmaceutical companies should sponsor scientific research in laboratories not people for commercial issue

Dear, Companies are looking for their income, but doctors should write prescriptions based on scientific principles.

There are two reasons for this: firstly, to introduce more of their goods, and secondly that more prescriptions written by doctors.

Hi,

Doctors should not accept such offer because this considered a favor 

To avoid is the best but sometimes it is non-avoidable. One day i payed to attend a conference but after the end of conference, my money was returned to me because all the conference was sponsored by a big company.  

ok.it is depended.

It sounds like the presents for the doctors from industry, and here we have a well disputed QR in RG with differentiated and clear statements.

"Can_doctors_accept_gifts_from_patients_or_pharmaceutical_companies?"

Dear All,

Unfortunately, doctors in some countries are very badly remunerated not to speak on their not material appreciation.

I may be wrong but in a country where physicians are properly paid and honoured, gifts and other sponsoring from pharmaceutical companies cannot influence and corrupt them. Perhaps, am I too naïve?

Nothing!

LOL!

I think that it one more common accepted 'crime' of our hypocritical structured society: We are all against those practises, but they live long time period... So, if everybody is against, who are the gift-receivers?

Dear Demetris,

could be, that we all are liars, or that you are talking to a special selection here in RG and you get a not representative picture.

I think the pharmaceutical companies  who participate in the trail therapy responsible to  cover the conferences but it is not logic to sponsor medical doctors individually

Dear Hanno, I don't write about RG participants, the word "we" is for scientific community in general: If you ask someone else, outside RG, he/she will state that is against those practises... It is a fashion to declare ethical behaviour and then act just like a money collector.

Dear Demetris,

you are right, this behaviour is common, but I know a lot of scientists, who really follow the ethical rules.

It is one of the greatest unethical Marketing techniques in Pharma Industries, using their money power to satisfy the drive of a doctor.

The objection is true though there are a number of doctors who try to be honest in their job. Likewise there are good and reliable Pharma companies which do not act in this unjustified manner.

Dear Hanno, a positive added value of RG will be to promote ethical practises to a wider audience and posts like the above help to that direction.

My objection the direct contact of the companies with persons. The companies my participate in the sponsoring of the conference according to the ethical regulation of science and technology

Example - Australia

Patients will remain in the dark about whether their treating doctors receive payments from pharmaceutical companies that could influence prescribing habits, after a bill aimed at increasing transparency ground to a halt. The rejection of legislative approach means that achieving transparency across the therapeutics goods industry will require up to nine industry associations to reform their disparate codes of conduct. Currently, only one (Medicines Australia) has commenced work in this area and at best, it will be 2016 before it reports to the public.

What did the bill propose?

Government reviews - Improving the transparency of financial relationships between pharmaceutical companies and clinicians has been on the government’s agenda for a number of years. In 2013, the government set up a Therapeutic Goods (Codes of Conduct) Advisory Group to assess the uptake of the Working Group’s recommendations and provide an independent evaluation of the effectiveness of the self-regulatory framework.

Industry reforms

Alongside these government reviews, other influences have been at work. Medicines Australia established a Transparency Working Group. The group has developed transparency principles applicable to all therapeutic goods companies and all health professions and is currently finalising a draft reporting model for consultation. This consultative document is expected to be published in the next few days and then be open for debate until mid 2014.

The Senate committee reviewed overseas experience. The US Physician Payment Sunshine Act requires pharmaceutical and device companies to report to the Centers for Medicare and Medicaid Services (CMS) all payments, or other transfers of value, made to individual doctors and teaching hospitals that total more than US$100 per year.

http://www.latrobe.edu.au/news/articles/2013/opinion/pharma-payments-to-doctors-remain-secret

Big Pharma should not provide any type of payments or gifts, including sample medicines, to the medical community.  The medical community should refuse offers of the same as a conflict of interest.

A gain we should distinguish between sponsoring a scientific research that is going to be presented in a conference and that a bribe to advertise for specific product.

Dear Dr. Mohammed

I have worked for more than 30 years dealing with Pharmaceutical companies, the companies are interested to recrute doctors to support their products. The appreciation of the companies is usually in the form of Gifts, sponsoring to meeting, travelling to exotic places and even buying houses and expensive gifts. This is very unethical, where some doctors makes recommendations that are not scientifically sound just to please the pharmaceutical companies. In US many doctors are given full clinics furnitures, computers and other services for promoting some medications. This can't be stoped because money is the biggest motivator for individuals and the companies know that. We hope that no damage happens to the patients. But that is life

In my country, Portugal, there is new legislation, that implies that we should declare to the State, as a form of permitting taxes, concerning any gift from private companies to medical practitioners...

If the gifts are tickets, congress registrations or any activities will contribute to the doctor's formation, it seems ok to me. If gifts are houses, swimming pools, cars, then there is no question that it is wrong. Maria Pires said above that in Portugal health professionals needed to declare the amount received in gifts to the fiscal authorities so that they could be taxed. It seems a very good idea. At least the gifts may be public and it will no longer be dealt when the sun goes down.

Sponsoring Medical Doctors, would be OK, if and only if they sponsor pure mathematicians as well!

No one gifts anyone for free, there is always an expectation that is attached to the cost incurred, which is probably an investment for returns.

There is new kind of Gift

Some doctors have always had friends who showered gifts for prescribing medicines or treatment. The unethical practice has taken a much more dangerous turn: doctors are now getting authorship of studies in internationally peer reviewed journals as gifts.

Publishing papers in international journals means higher professional standing, a declaration of professional ability and knowledge. Increasingly, both private and public sector healthcare facilities are using publications as a measure of academic performance and expertise for job offers, promotions and increments.

http://timesofindia.indiatimes.com/city/chennai/Want-to-bribe-a-doctor-Gift-authorship-of-medical-papers/articleshow/34213775.cms

The following Medscape document is about results of a survey including questions on this subject. In Medscape, an username and password is required, but once you've registered, no fees exist

Have a good year 2015. Best regards. Salut †

 http://www.medscape.com/features/slideshow/public/ethics2014-part2?src=wnl_edit_specol&uac=157834SN#27

Doctors have become the primary customers and most important players in pharmaceutical marketing system. Pharmaceutical companies try to influence prescription pattern of doctors in favour of their brands by offering various kinds of promotional inputs like samples, gifts and sponsorships etc, thereby persuading them to write the prescriptions that determine which drugs (brands) will be used by the patient. A study in this context have revealed that promotional information by pharmaceutical companies plays a greater role in the decision process of the doctors to prescribe the drugs than even scientific sources of the information. It is also unrealistic to expect the pharmaceutical industry that contribute large sums of money in different manner to doctors, will not influence their attitude and behaviour towards them. By receiving gifts and other benefits from the pharmaceutical firm doctors are bound to compromise with their decision making thus violating the principles and morality of this dignified profession.'it is a kind of bribe, and not ethical at all' as rightly said by Dear Ljubomir.

@Yogesh is very right about  doctors as an important players in pharmaceutical marketing system! Here are some resources about, a few research papers!

http://www.academia.edu/7860205/Impact_of_Pharmaceutical_Industry_Promotion_Mix_on_Doctor_s_Prescribing_Behaviour

http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2487031

https://ispub.com/IJAPA/7/1/10273

How would you feel if your local GP or specialist was pocketing money from a drug company to promote its products? If your gut tells you that this falls squarely into the category of Very Bad Ideas then it turns out that you’re out of step with most Australians — or, you would be if you believe the PR efforts of drug companies.

A recent press release trumpeted “Majority support sponsorship between pharmaceutical companies and healthcare professionals if publicly declared.” It was issued by GlaxoSmithKline, which manufactures everything from Panadol to the asthma medication Ventolin to the antidepressant Aropax.

http://theconversation.com/gifts-that-keep-on-giving-pharma-should-disclose-all-links-to-doctors-5584

Dear M Yassin to attend a conference as developing countries citizen, specially if it is one of the sanctions, here you expect some support but it doesn't mean that you pay your ethics to gain that support. Usually as regards my experience no one company put terms to sponsor you for a conference, but in the contrary sometimes you receive invitation from some companies interested to attend with them symposium or seminar some where..    

Absolute bribe for business

As an anecdote, I met a team who owned a surgery for making health certifications for driver's licenses, among the requirements, an ophthalmologist was to be present, and examine customers during all the opening hours, this was impossible, there where not enough specialists to meet the center's demand If an inspection found the ophthalmologist or the psychologist were absent from site, a fine resulted, with a warning to have the center closed on repeating the fault, their preventive measure was offering some fancy dresses to a girl in the traffic office who warned the surgery when the inspector was to make a visit, the same, for obtaining an opening license for any kind of business in the city council, you had to pay a bribery to the officer in charge, or having the approval indefinitely delayed; when I was told about this, my only answer was that I wasn't able to make this type of payments, and not because of lack of money to pay

For any doctors ,patient visiting them are with the hope & aspirations that by visiting they may leave the clinic with hopes & happiness .With this ,Dr have to appreciate that their patient are god;s given gift & they have to be treated according .

Presently Dr trend are after money .Various medical representative of different companies visit the Dr for the products by requesting them to apply their medicine for the patient .

If the pharmaceutical companies for the Dr sending them to the conference both within outside different countries & if their end is to help the patient with the training & knowledge acquire by the DR  ,the ends demand '' Respectable'' but if the end serves the said purpose.

Industry could face a shake-up if pharmaceutical firms slash sponsorship budgets for doctors to attend conferences!

"One doctor who addressed the 100 delegates admitted that without support from pharmaceutical companies, lower- and middle-grade healthcare professionals would struggle to afford to attend congresses..."

Some other regulation for such conferences should be established in order to be ethical. 

http://www.meetpie.com/Modules/NewsModule/newsdetails.aspx?newsid=20086

I think pharmaceutical companies should sponsor the continuous education of the physicians through conferences, meeting and other activities. However, even conference attendance is some times manipulated and biased to affect physician decision toward certain pharmaceutical product. The solution may be in a national / international independent bodies like medical associations to have a fund for these activities which is formed by the participation of companies without directly being involved (by their product).

I agree with Ayoub as education of the physicians through conferences and meeting specially in poor countries is mandatory and the presence of national / international independent bodies to replace the role of pharmaceutical Co. might solve the problem to some extent, but it doesn't mean that to cancel its role as not always pharmaceutical Co. biased to affect physician decision toward certain pharmaceutical product as mentioned before.

I think  there is no  problem  in accepting  these things

The pharmaceuticals' malaise seems to be rooted in making their practices.

I visited Lisbon and Copenhagen under these circumstances, and I really had a good time, -I had visited these places before on my own-, so I can't say much evil about this: 'Onco-tourism'.

That Scandinavian trip was sponsored by the producers of Imatinib, but I didn't attend the GIST sessions, but the one about early results of Gefitinib in NSCLC. 

My prescriptions would have never paid for the expenses even if the whole price of Drug was used for this, I worked then as assistant of the one who was responsible of most expending.

One of the issues not much discussed about pharmaceutical industry sponsoring scientific meetings may be that without attending meetings, and this was worse when things as 'Webinars' were not available, it was very hard being up to date, and this has an influence in professional careers, it may yield a vicious circle such as the ones described in a song (in Spanish), entitled just the same: 'Circulos viciosos' (La mandrágora)  https://youtu.be/keYG73CR-1A

This is a story from Indonesia about  Battling Doctor Bribery!

Health is Wealth: Gratification in the Healthcare Sector in Indonesia!

"The plan to collect and manage funds from pharmaceutical companies for doctors is an interesting idea.

However, this effort would not be effective in preventing gratification from pharmaceutical companies if not followed by law enforcement.

Collecting funds from pharmaceutical companies has recently been approved by the Corruption Eradication Commission (KPK), the Health Ministry, the Indonesian Doctors Association (IDI) and the Indonesian Pharmaceutical Association (GPFI).

The funds will be used to sponsor doctors who are going to attend seminars...

It is expected that this measure can prevent direct gratification from pharmaceutical companies to the doctors...

Costs needed by pharmaceutical companies to bribe the doctors is quite big, reaching 40 to 45 percent of the price of the medicines.

The dirty practice has been done for years.

14 years ago, Tempo also investigated the same phenomena with the same results.

There is no guarantee that the practice will no longer be done with this sponsorship funds collection scheme.

We have to make sure that the management of the funds be done professionally.

Doctors who receive the sponsorship funds must not be informed about the pharmaceutical companies who provide the funds. Equally, pharmaceutical companies also must not be informed about the doctors who receive the funds.

This will be difficult to be implemented indeed..."

http://globalcompliancenews.com/gratification-in-the-healthcare-sector-in-indonesia-20160221/

http://en.tempo.co/read/news/2016/02/08/080743029/Battling-Doctor-Bribery

China hands drugmaker GSK record $489 million fine for paying bribes

http://www.reuters.com/article/us-gsk-china-idUSKBN0HE0TC20140919

I feel very unhappy accepting direct sponsorship, I feel that there should be block donations to departments to sponsor doctors attending meetings and not given to the individual doctor.

what happened to you guys, aren't we all spending our lives seeking sponsorship and grants for our research and students?  

I do not mind getting money from the devil himself for research purposes, if I used the  money wisely, travelling to attend a conference is part of the research process, having fun after the session is not taboo though.

My wife and I attended one such conference. It had brought over 200 participants-if i remember right- from Canada to Arizona. 

You may call it a bribe, but my wife - the doctor- saw no obligation to prescribe the pharma's drugs. I am sure they gave their evidence to support their products. They probably write off this exercise as advertising, necessary to make business.

Their advertising budget must be proportional to their profits. Why people go and buy drugs when herbal medicines may suffice, like the old days? We have to stop doing that if we want to reverse that trend.

Thanks Michael Issigonis  for sharing  us your experience