How to manage conflicts of interest with industry?

Abstract

The use of medications has risen steadily in psychiatry. Perhaps in response, during the past few years there has been increasing scrutiny of alleged unethical behaviours by medical researchers, educators, and practitioners secondary to influence by the pharmaceutical industry. Research is quite consistent that gifts and generous financial arrangements can dampen skepticism, sometimes unconsciously, and thereby persuade recipients to advocate for or prescribe medications that are more expensive, but no more effective, than alternatives. Interestingly, this research-backed premise that physicians can be lured by gifts remains often disbelieved by recipients. Adding to such inducements to prescribe new, expensive medications are pressures from patients due to the increasing ubiquity of direct-to-consumer advertising.

Criticism from patient advocate groups, government agencies, and the press has sparked debate within the profession. Many medical journals, academic medical centre research and educational endeavours, and medical organizations are reviewing policies to eliminate, or better manage, their conflicts of interest with industry. The basic ethical standard is that although pharmaceutical companies’ primary concern is for its shareholders, physicians’ primary concern must be for their patients.