Study: Med students cozy with pharma reps more likely to dole out branded drugs

Doctors aren't the only ones to fall prey to free lunches and fuzzy promotional talks. Medical students who spend more time with pharma reps are more likely to dole out brand-name products, and less likely to rely on evidence when choosing which drugs to use, Medscape reports.

According to a study published online in JAMA Internal Medicine, physician trainees who interacted more with industry reps were 15% less likely to prescribe medications based on evidence. Researchers also found strong correlation between the amount of time students spent with pharma reps, and their odds in prescribing brand-name drugs.

In a survey of first- and fourth-year medical students and third-year residents, researchers asked how frequently the students had interacted with pharma reps in the previous 6 months, and how often they expected to interact with reps during their careers. The study also posed multiple-choice questions to the more advanced students about appropriate drugs for patients with common ailments.

As medical students became more experienced, they were twice as likely to use pharma reps as a source of drug information, researchers discovered. In an accompanying editor's note, Dr. Joseph Ross emphasized the importance of students developing good "habits of clinical practice" early on--in other words, making decisions based on training, not reps.

"It is becoming increasingly clear that restricting these interactions during medical school and postgraduate training leads to higher-quality, more evidence-based prescribing among physicians, which is good for the profession, for patient care, and for the public's trust in medicine," Ross said (as quoted by Medscape).

The findings piggyback on earlier studies that examine the pharma industry's not-so-subtle influence on physicians. Last year, a study published by the Social Science Research Network showed that doctors who accepted free gifts from a drugmaker were more likely to prescribe the company's brand-name products--even compared with cheap generics of the same brand.

In April, a new research paper in the Journal of the American Medical Association (JAMA) found that nearly every U.S. pharma company counted at least one board member who also held a leadership position at a U.S. academic medical center--a list that included med school deans, CEOs, department chairs and university presidents. Drugmakers contend that the relationships are critical to drug research and development, but experts are not so easily persuaded.

"I don't know how they can manage a conflict like that," medical conflict-of-interest expert Susan Chimonas told the Milwaukee Journal-Sentinel at the time. "My gosh, there is so much money they are making for a little side job."

Meanwhile, the government is putting pressure on the industry through its recently implemented Physician Payment Sunshine Act. The mandate requires pharma companies to record payments to doctors, and to report the information to the Center for Medicare and Medicaid Services (CMS). The agency plans to put together a public database and post it online later this year.

- read the Medscape story (reg. req.)
- here's the JAMA Internal Medicine abstract
- get more from the Journal-Sentinel