An article published on bmj.com claims that drug companies are still directly sponsoring the education of thousands of general practitioners. The Australian investigation is reported while the world is calling for an end to direct sponsorship by drug companies.

In Australia, it is common for drug company sponsors to recommend speakers who give presentations to thousands of general practitioners who believe that the lecturers are not associated with drug companies. Ray Moynihan of the University of Newcastle in Australia reports that industry representatives reveal similar practices occurring in the United Kingdom. In the UK, about half of doctor education is supported by drug companies.

Moynihan has had access to leaked documents and e-mails from several sources that show how the selection of speakers at recent seminars has been influenced by drug companies. However, the brochures for these seminars, given to general practitioners, maintain that “all content is independent of industry influence.”

In Australia, Medicines Australia is the representative group for drug companies. They have confirmed that inviting drug company sponsors to help select speakers is not a rare occurrence. Since educational providers and institutions have final say in who does and does not speak at conferences, the drug industry does not view their input as a conflict of interests in providing medical education.

Of course, the Australian investigation provides many examples where drug company suggestions were in fact embraced by the educational provider and doctors were not told of the “invisible sponsor influence,” says Moynihan. Australian and UK industry representatives strongly believe that the educational sessions should be transparent and “fully and explicitly” inform doctors if sponsors have had input into the selection of session speakers.

Moynihan writes that this type of disclosure could change the content of accredited education, which is thought among doctors to be free of sponsor influence.

Current evidence suggests that the prescribing habits of doctors are influenced only in the short term after attending events sponsored by drug companies.

Harvard Professor David Blumenthal – an internationally authority on relationships between doctors and drug companies – and colleagues recently wrote a paper calling for medical centers in the United States to end the allowing of drug companies to sponsor continuing education events. As an alternative, they suggest that a blind trust be created to fund education at an institutional level. Peter Mansfield of HealthySkepticism – a group critical of pharmaceutical marketing – believes that medical education should be funded by the taxpayer through competitive grants.

Moynihan argues that institutions do not desire to end drug company influence, and oversight of continuing education events is currently a “self-regulatory affair.” “Perhaps the recent revelations from Australia – confirmation from the industry itself that it is ‘not unusual’ for sponsors to suggest speakers – will sharpen the lines of debate about how to achieve more independent education or at least greater transparency,” concludes Moynihan.

The invisible influence
Ray Moynihan
BMJ
. Volume 336. pp. 416-417.
February 22, 2008.

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Written by: Peter M Crosta