The degree to which U.S. physicians are on the take from the drug industry decreased between 2004 and 2009, according to the repeat version of a major national survey.
Dr. Eric G. Campbell and colleagues were responsible for the survey published in 2007, that used 2004 data to show that 94% of American docs had some sorts of financial ties with the drug industry. Repeating the survey in 2009 (subscription needed to access), they found this had dropped to 84%.
There were similar drops in just about every category of "gift": drug samples fell from 78% to 63.8%; food and beverages from 83% to 70.6%; speakers bureau payments, 16% to 8.6%; consulting payments, 18% to 6.7%. In one area, the new PhRMA code of conduct may actually have nearly omitted one egregious sort of payola--tickets to cultural or sporting events fell from 7% to 1.3%.
The investigators noted specialty-specific differences in which of these categories fell the most. Overall, cardiologists remained most "on the take" of any specialty. The data also showed that physicians reporting financial ties to Pharma were less likely than physicians with no tie to report that they prescribed generic drugs instead of equivalent brand-name drugs.
The biggest weakness in this study, as the authors gamely noted, is that it's strictly self-report. Therefore the falling figures may reflect not actual behavior, but rather the fact that it's now less socially acceptable to admit taking bribes.
In sum, we have seen (and have reported in HOOKED and on this blog) a number of events occurring between 2004 and 2009 that tended in the direction of urging physicians to take a harder look at financial ties to the drug indutry and to take actions to limit those entanglements. The data would provide some suggestion that maybe a few docs are listening--and also that we have a long way yet to go.
Campbell EG, Gruen RL, Mountford J, et al. A national survey of physician-industry relationships. New England Journal of Medicine 356:1742-50, 2007.
Campbell EG, Rao SR, DesRoches, CM, et al. Physician professionalism and changes in physician-industry relationships from 2004 to 2009. Archives of Internal Medicine 170:1820-26, Nov. 8, 2010.