Abstract
BackgroundA training physician has his first interaction with a pharmaceutical representative during medical school. Medical students are often provided with small gifts such as pens, calendars and books, as well as free lunches as part of drug promotion offers. Ethical impact of these transactions as perceived by young medical students has not been investigated in Pakistan before. This study aimed to assess the association of socio-demographic variables with the attitudes of medical students towards pharmaceutical companies and their incentives.MethodsAs part of a cross-sectional survey, a validated questionnaire previously used for assessing attitude of medical students towards pharmaceutical industry, was modified, pre-tested and distributed among consenting clinical year students at DUHS and AKU. Questions included acceptability of pharmaceutically sponsored gifts, events and tuition fee, and their impact on future prescription. Responses were graded as agree, disagree or neutral which were then scored according to the AMSA guidelines of ethical conduct.ResultsOut of a total of 353 targeted students 303 responded, corresponding to a response rate of 85.8%. Responses indicated that 42.7% students believed in no interaction with drug companies during medical school. However, 81% of students favored pharmaceutical sponsorship of student-body events/seminars at medical colleges. More than one-third of the students were comfortable receiving gifts from drug companies. Overall, the results of this study offer an interesting comparison between the students of a private medical school (AKU) and a public medical school (DUHS); AKU students exhibited a greater degree of mistrust towards drug information provided by pharmaceutical companies compared to DUHS students (p = 0.040). Furthermore, when asked if there was a need to incorporate guidelines in the undergraduate curriculum with regard to interaction with drug companies, 84.2% students at AKU agreed, compared to 54.9% at DUHS. Medical student Attitude Scores are more or less similar to each other independent of their various demographical differences.ConclusionThis study highlights that medical students in our population have a high level of acceptability towards incentives offered by pharmaceutical industry and that formal guidance regarding the subject should be incorporated into medical curriculum.
Highlights
A training physician has his first interaction with a pharmaceutical representative during medical school
Representation from the two medical schools was not uniform; 38.3% (114) of the respondents were from Aga Khan University (AKU) and the remaining 62.7% (184) belonged to Dow University of Health Sciences (DUHS) Medical College
Literature has repeatedly shown the widespread interaction between medical students and pharmaceutical representatives, and a high level of acceptability towards their gifts and incentives, giving rise to a concern that whether such an early exposure will influence prescribing practices of future physicians and how this issue might be addressed
Summary
A training physician has his first interaction with a pharmaceutical representative during medical school. Medical students are often provided with small gifts such as pens, calendars and books, as well as free lunches as part of drug promotion offers. Ethical impact of these transactions as perceived by young medical students has not been investigated in Pakistan before. Incentives include drug promotional offers and free samples, gifts and sponsorship of conferences among others At this point, three key factors need to be considered: the appropriateness of accepting these incentives, favoring a particular company based on such incentives, and being able to objectively scrutinize the worth of the drug as well as that of the research being presented to support it. AMSA recommendations discourage physicians and students from accepting gifts from drug companies, urge hospitals and residency programs to discontinue drug company-funded lectures and lunches, and oppose continuing medical education (CME) granted credit for drug company-sponsored events [2]
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