A study published on November 6 confirms “the hypothesis that the pharmaceutical industry can influence the prescriptions of general practitioners”.
The study shows that the group of doctors who have not benefited from laboratories are associated with more generic prescriptions for antibiotics, antihypertensive medicines and statins.
According to a study published on Wednesday 6 November, French general practitioners who receive gifts from pharmaceutical companies tend to prescribe more prescriptions that are expensive and of lower quality.
Conversely, those who “do not receive any benefit from the pharmaceutical industry, on average, are associated with better indicators established by Medicare on the effectiveness of their prescriptions and lower costs in general,” conclude the authors, doctors, researchers and engineers of the University Hospital of Rennes (CHU).
These results do not show a causal link, but “reinforce the hypothesis that the pharmaceutical industry can influence the prescriptions of general practitioners and give a view of the extent of this influence”, the University and CHU of Rennes and the School of Advanced Studies in Public Health point out in a statement.
“This influence, sometimes subconscious among physicians, can lead to a less than ideal treatment choice, at the expense of patient health and the cost to the community. »
Fewer Generic medications prescribed
The study showed that on average that the doctors who have not received any benefits are associated with:
- Cheaper prescriptions
- More generic medicines prescribed (antibiotics, antihypertensive medicines, and statins)
- Fewer prescriptions for vasodilators and long-term benzodiazepines
- Fewer prescriptions of Angiotensin II receptor blockers (ARBs) compared to the cheaper alternatives which are as effective
- On the other hand, there is no significant difference in prescribing aspirin, generic antidepressants, generic proton pump inhibitors and antacids.
A lot of spent money in promotion by big pharma
The authors also show that the higher the total benefits, the higher the average additional costs per prescription, and the higher the shortage of generic versions for antibiotics, antihypertensives and statins.
“Pharmaceutical companies spend a lot of money on the promotion of medicines (23% of their turnover, more than on research), of which gifts are only a part,” says Dr. Goupil, referring to a report by the European Commission in 2009.
“It seems unlikely that this money will be spent at a loss, and the results of our study are consistent with existing studies that support the influence on prescriptions,” he adds.
90% of general practitioners “have received at least one gift since 2013”.
The study, published in the British Medical Journal (BMJ), is based on the crossing of two databases. The first is the Transparence Santé portal, where all conflicts of interest for healthcare professionals, such as equipment, meals, transport or hotel costs offered by companies in the sector (pharmaceutical laboratories, medical device manufacturers, etc.), must be declared, starting from 10 euros about ($11).
According to this database, “almost 90% of general practitioners have received at least one gift since 2013”, says Pierre Frouard, Rennes’ general practitioner and study coordinator. “This is the first study of this scale in France”, which uses the data from this portal, stresses Bruno Goupil, the first author of the study, interviewed by AFP. The second database is the National Health Data System (SNDE), which records consultations, medical procedures, medication prescriptions and reimbursed admissions, while preserving the anonymity of the insured. The authors examined the prescriptions of just over 41,000 general practitioners working exclusively on a freelance basis and divided them into six groups, based on the level of benefits in 2016.