Industry gifts and meals linked to less appropriate prescribing, review finds
A Cochrane review of 93 studies found that payments, gifts, and free meals from pharmaceutical companies are associated with doctors prescribing promoted drugs more often. The review reports that this can lead to more expensive or less suitable medicines, affecting patients and health systems. Most included studies came from the United States, aided by public reporting requirements under the Sunshine Act.
The Cochrane review pooled 93 studies, nearly all observational, to examine how drug-company promotion affects prescribing. Eighty-eight percent came from the United States, aided by the Sunshine Act’s requirement that industry payments to doctors be publicly reported.
Researchers grouped promotion into sales visits and educational materials, payments and gifts, and complimentary drug samples, while also assessing conflict-of-interest policies. Payments and gifts had the largest and most consistent evidence base; sample-related findings were too limited for firm conclusions. Opioid overprescribing was highlighted as a prominent case of promotion overstating benefits and downplaying harms.
Patients may end up with medicines that are more expensive or less appropriate if prescribing is influenced by industry promotion. Health systems could bear higher costs, and confidence in medical recommendations may suffer. Doctors and medical organizations might use transparency and conflict-of-interest safeguards to help ensure treatment choices reflect clinical evidence. The scale of these effects may vary by setting, specialty, and individual practice.