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Dealing with the pharmaceutical industry

This guidance is aimed at providing students with information and advice on how to professionally interact with the pharmaceutical industry at medical school and beyond.

The pharmaceutical industry is a hub of scientific innovation that develops, produces, and markets drugs licensed for use as medicines.

A healthy, transparent relationship between the medical profession and the pharmaceutical industry is important so that patient trust is maintained and patients continue to receive the best possible care available.

 

Pharmaceutical marketing and medical students

Concern
There is some controversy over how pharmaceutical marketing targeted at medical students is likely to influence patient care in the future. There are a number of techniques used, for example:

  • free lunches and branded gifts
  • pharmaceutical representatives

Medical students may cope less effectively with such marketing techniques than qualified doctors with many years of prescribing experience. Although there is little evidence surrounding this issues, the BMA Medical Students Committee notes that pharmaceutical marketing may influence prescribing habits such that they are not based on the principles of evidence based medicine.

In order to avoid the possibility of such influence, medical students should:

  • not accept gifts including meals and branded products
  • avoid meetings with pharmaceutical representatives unless a medical faculty member of staff is present

Further guidance

  1. The Influence of the Pharmaceutical Industry - Fourth Report of Session 2004-05, Volume I (House of Commons Health Committee, 2005)
  2. Innovating for Health - Royal College of Physicians: Patients, physicians, the pharmaceutical industry and the NHS - pp 27-28 (Feb 2009)
  3. Medsin's Pharmaware campaign

 

Evidence Based Medicine

Concern
There is concern that studies conducted by the pharmaceutical industry may be more likely to come out in favour of the company's own products than comparable studies. It has been noted that some of these published studies advocate the use of expensive new drugs, even though there may be little improvement in outcomes.

The Medicines and Health Products Regulatory Agency (MHRA) was set up to independently monitor and regulate clinical trials in organisations that include pharmaceutical companies, universities, charities and contract research organisations, and makes sure that good clinical practice is being followed.

However, healthcare publications should not always be taken as gospel, and as a medical student, it is important to learn how to critically evaluate papers and judge their credibility yourself.

Some factors to take into consideration:

  • Authorship - who are the authors? Are they affiliated to a respected research institute?
  • Is the research sponsored? Is there the question of conflicting interests?

Who do you agree with?
Ben Goldacre argues that the financial interests of drug companies lead to distorted evidence but Vincent Lawton believes that adequate safeguards exist to keep bias in check.

 

Best practice

Throughout your career as a doctor, you will work side-by-side with members of the pharmaceutical industry.

The Royal College of Physicians have produced some guidance, named 'The Seven Principles of Public Life applied to doctors' (Table 1), that provides an excellent basis for governing the relationship between doctors and the pharmaceutical industry.

They are a set of seven personal attributes that every health professional should portray in order to maintain a healthy, transparent relationship with the pharmaceutical industry. These principles do not only apply to doctors, but also to medical students so read them carefully and keep them in mind.

(Source: Royal College of Physicians)

 

The Seven Principles of Life applied to doctors
Selflessness Doctors should act solely in the public interest. Their responsibility to patients must override all other interests.
Integrity Doctors should not place themselves under any financial or other obligation to industry, which might influence the performance of their duties as a doctor.
Objectivity Doctors should make decisions based on the best available independent scientific evidence.
Accountability Doctors are accountable for their decisions and actions. They must submit themselves to whatever scrutiny is appropriate to assure the integrity, objectivity, and honesty of their work.
Openness Doctors must be as open as possible about the decisions and actions they take. They must be prepared to give reasons for their decisions.
Honesty Doctors have a duty to declare any private interests relating to their public duties. They should take steps to disclose or resolve any conflicts arising in a way that protects the public interest.
Leadership Doctors should promote and support these principles through leadership and example.