Pediatricians Group Releases Guidelines on How Healthcare Personnel Can Avoid Undue Industry Influences

Healthcare personnel can be influenced directly with gifts, or indirectly through dishonest and deceptive means, such as "ghost authored" studies written by industry insiders

New research highlights the impact that medical device manufacturers and pharmaceutical companies have on shaping treatment decisions made by doctors, warning that these influences may not always result in the best course of treatment.

In a policy statement published this month in the medical journal Pediatrics, the American Academy of Pediatrics (AAP) warn that medical professionals should be aware of ways that leading healthcare industry manufacturers may influence their behaviors and decisions based on marketing, financial and non-financial incentives.

For years medical experts and regulatory agencies have warned that big pharma influences can lead to less than ideal treatment and higher costs to patients. Previous studies have found tens of millions in pharmaceutical contributions given annually to doctors that have included gifts, equipment, meals, hotel costs and non-tangible influences such as public recognition, all of which may influence a healthcare professional’s choices that are not based on the best interest of the patient.

The study released by the AAP does not focus on corrupt healthcare providers looking to increase their own financial being or status. Rather, the study focuses on ways well-intentioned professionals may not identify ways interactions with industry which may shape their decision making, which may not be direct or apparent.

Researchers outlined five ways in which the medical industry may alter healthcare professionals’ decision making, starting with commercial funding of Continuing Medical Education (CME). Industry-sponsored CME can be biased and contain influential marketing materials. Healthcare providers should be aware of these tactics and understand the purpose behind the sponsorships of industry.

Many well-intentioned healthcare professionals follow new and evolving medical research to understand the best paths forward for patients. But many are often influenced heavily by marketing from manufacturers of medical devices and drugs. One example which has garnered a lot of scrutiny in recent years is the marketing of cow’s milk-based infant formula for preterm children, such as Similac and Enfamil.

Even though their formula products have been linked to an increased risk of necrotizing enterocolitis (NEC); a devastating bowel disorder which can cause premature infants to suffer terrible, life-long injuries and even death, their marketing to hospitals have led to the products being regularly given to preterm infants as a nutritional supplement.

The manufacturers now face a growing number of Similac NEC lawsuits and Enfamil NEC lawsuits being pursued throughout the federal court system.

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Premature infants fed Similac or Enfamil cow's milk formula faced increased risk of necrotizing enterocolitis (NEC) or wrongful death.

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This latest study warns doctors should be cautious of conflicts of interest and should understand the purpose and source of funding for the research. Big pharma funded studies can be planned, designed, funded and require approval by the funding manufacturer for purposes of driving influence.

Similarly, the statement indicates medical professionals should be aware of potentially biased expert panel reviews and consensus panels who craft final recommendations and author review articles in peer-reviewed journals. The study warns healthcare providers should “pay close attention to conflicts of interest among members of expert review panels and be aware that recommendations may have been influenced by those relationships.”

Lastly, the authors warns of ghost authorships, which are considered an unethical and dishonest and “obscures important information about the paper, including whether industry instigated the study, controlled the data, performed the final data analysis, and had final control over the published draft.”

AAP states healthcare professionals have a responsibility to educate themselves and identify these ways in which they may be influenced by medical device manufacturers and pharmaceutical companies, and make every effort to prevent them from altering best medical practices for patients.

Big Pharma Influence on Healthcare Industry

Studies in recent years have raised concerns over pharmaceutical companies negatively influencing doctor’s prescription decisions . Some studies have found doctors who receive gifts from pharmaceutical companies tend to be more likely to prescribe more expensive drugs which are less effective.

A study published in 2019 by the medical journal The BMJ, report that doctors who received gifts of more than $1,100 from drug companies were more likely to prescribe brand name drugs, instead of generic drugs, which cost their patients much more. Doctors who reported no gifts in 2016 offered cheaper prescriptions to their patients and often gave prescriptions for generic medications instead of brand names.

Overall, the group of doctors that didn’t receive gifts also prescribed fewer benzodiazepine prescriptions, like Xanax, Valium, and Klonipin, for more than 12 weeks. Doctors who received more than $1,100 in gifts often prescribed these drugs for much longer than 12 weeks, which can lead to dependence and other health consequences.

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