Physicians should think carefully before giving patients starter packs or signing them up to industry-run medication support schemes, according to new RACP guidelines on ethical interactions with industry.
In its fourth edition of Guidelines for Ethical Relationships Between Physicians and Industry, the College has updated and reaffirmed its 2006 advice for avoiding conflicts of interest in areas including sample and starter packs, product familiarisation schemes and medical education.
It also offers new advice pertaining to industry players across complementary medicine, biotechnology and devices and expands the definition of industry beyond the for-profit sector.
The RACP says it has repeatedly been shown that health practitioners are influenced by contact with industry and that accepting gifts, sponsorship for travel and attendance at scientific meetings, and appointment to advisory boards increases demand for specific products.
But while physicians “generally accept that there are negative effects from certain interactions with industry” many believe they are “personally immune to the influence”.
Noting there is no universal consensus about how to assess the influence of industry or manage conflicts of interest from industry interactions, the RACP says its document is a guide to help physicians consider the implications posed by various scenarios.
“While some relations with industry are inescapable or desirable, the Guidelines provide clear advice on avoiding interactions that do not further patient care or population health activities and which have the potential to bias professional judgment.”
Off-label prescribing: The advice for practitioners – to proceed with caution – remains the same as 2006 edition, but the RACP voices new concerns over off-label prescribing which it says can be “the outcome of the promotional activities of pharmaceutical companies anxious to extend the market for their products”. “While industry promotion of off-label prescribing of their products is prohibited in Australia and elsewhere, such practices are common and are known to have significant effects on prescribing behaviour”.
Gifts: All gifts, even items of small value, have the potential to exert influence and create conflicts of interest. Therefore, “the simplest, and most defensible, approach is for health professionals to err on the side of rejection of gifts, even those of trivial value”.