Blog | Monday, February 4, 2013

QD: News Every Day--Gift restrictions among med students associated with less prescribing of new drugs

Graduates of medical education programs with gift restriction policies prescribed two out of three newly introduced psychotropic medications less frequently, a study found.

To examine the effect of attending a medical school that restricted gifts from drug and device salespeople on prescribing behavior, researchers reviewed 14 medical schools with an active gift restriction policy in place by 2004, and then the prescribing patterns in 2008 and 2009 of those who graduated from those school compared to matched controls.

Prescribing patterns were compared for new drugs within three psychotropic classes: lisdexamfetamine among stimulants, paliperidone among antipsychotics, and desvenlafaxine among antidepressants. "None of these medications represented radical breakthroughs in their respective classes," researchers noted.

Results appeared online Jan. 31 at BMJ.

Physicians who attended a medical school with an active conflict of interest policy were less likely to prescribe lisdexamfetamine over older stimulants (adjusted odds ratio [OR], 0.44; 95% confidence interval [CI], 0.22 to 0.88; P=0.02) and paliperidone over older antipsychotics (OR, 0.25; 95% CI, 0.07 to 0.85; P=0.03). A significant effect was not observed for desvenlafaxine (OR, 1.54; 95% CI, 0.79 to 3.03; P=0.20).

And, for each drug class, those who worked under the restrictions or were subject to stronger restrictions had even lower prescribing rates, with varying degrees but statistical significance for each drug class.

"Our findings suggest that conflict of interest policies, which have been increasingly adopted by medical schools since 2002, may have the potential to substantially impact clinical practice and reduce prescribing of newly marketed pharmaceuticals," the researchers wrote.