Pharma freebies at med school: what's the Rx?

A decade ago, medical students were raking in the pharma swag—receiving gifts or attending industry-sponsored events once a week, on average.

Then medical schools began adopting rules that restricted the drugmakers’ marketing to students. A couple of Yale professors wondered: how do the marketing bans affect prescribing decisions, once those students are out of school and practicing medicine?

“Industry has a vested interest in the adoption of its products,” says study coauthor Joseph Ross ’06MHS, an assistant professor at the Yale School of Medicine, in an e-mail. “As non-practicing physicians, medical students have little to gain from exposure to industry representatives and promotional messaging.”

Ross teamed up with Marissa King, first author and assistant professor at the Yale School of Management, to conduct the study, which was published in BMJ, the British medical journal. Other coauthors are Connor Essick ’12MPH and Peter Bearman, a social scientist from Columbia University.

The researchers compared the prescribing patterns of physicians from 14 US medical schools with “active gift restriction policies” in place by 2004. One group graduated before the policies took effect; the other group graduated after.

Looking at psychotropic drugs that were new to market and did not represent “radical breakthroughs in their respective classes,” they found that docs who’d been shielded from pharma marketing as students were less likely to prescribe two of the three new medicines. Instead, Ross says, “they were more likely to prescribe older, less costly therapies.”

That might seem obvious. But US doctors generally deny that their own prescribing decisions are influenced by marketing and by people who give them free stuff.

The Yale School of Medicine itself was not included in the study, Ross says, because it adopted a gift policy in 2005, after the cut-off.

Asked his advice for medical school deans, he says: “I would recommend the adoption of a strong policy that limits interactions between industry and medical students and faculty of medical schools.”

Ross continues: “While industry can play a key role in supporting and collaborating with academic medical centers on basic science and clinical research to advance patient care, industry should not be playing a role in medical education.”