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[Ethics in drug industry relations. Opinions poll of family physicians in Catalonia].

OBJECTIVE: To document the opinion of members of the Catalonian Society of Family and Community Medicine regarding the acceptance of gifts and other arrangements from the drug industry, and their influence on prescribing. DESIGN: Cross-sectional study with triangulation involving quantitative and qualitative methods. SETTING: Catalonia (northeastern Spain), June 2002. PARTICIPANTS: Family physicians who were members of the Society and who had a known e-mail address. MAIN MEASURES: Standardized questionnaire. Quantitative and qualitative data analysis. RESULTS: The types of gifts and other arrangements that were considered ethically acceptable by the largest percentage of respondents were publicity items (82.5%), free samples (78.1%), and financial support for training activities (74.3%). Accepting direct economic compensation (2.2%), coverage of travel expenses (20.6%) or a free dinner (40.1%) was considered less ethical. More than 50% of the participants felt that accepting these arrangements did not influence their prescribing practices, and only 38.3% felt that economic compensation for prescribing a given medication did influence these practices. Arrangements by industry representatives that benefited professionalism, the center or the patients, but that did not represent any purely personal benefit, were considered acceptable. Participation by the industry in training events was accepted, although participants would prefer less industry involvement. Some participants described strategies to prevent gifts and other arrangements from influencing prescribing practices. CONCLUSIONS: The percentage of members surveyed who considered that gifts from industry influenced prescribing was low, despite evidence to the contrary. A finding of note was that some professionals considered ethical certain types of relationships of questionable legality. Informants noted the need to initiate debate on this topic.

Attitude of Health Personnel↗

The drug industry and clinical research in interwar America: three types of physician collaborator.

This essay describes collaborations between American pharmaceutical companies and clinical investigators, mainly in academic medical centers and other research institutions, during the interwar period. I argue that efforts on the part of early twentieth-century "scientific medicine" reformers to impose higher standards on the testing and promotion of pharmaceuticals led both to the intended disciplining of the drug industry and also, as a reciprocal but unintended consequence, to a deep involvement with industry among medical scientists. Three basic patterns of collaboration between clinical trialists and sponsoring drugs firms are described. These patterns may help illuminate the mutual accommodation between ethical drug firms and academic clinical researchers (and institutions) that still prevails today.

Biomedical Research↗