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制药公司的诱惑对医生开处方模式的影响。天下没有免费的午餐。

The effects of pharmaceutical firm enticements on physician prescribing patterns. There's no such thing as a free lunch.

作者信息

Orlowski J P, Wateska L

机构信息

Department of Pediatrics, Cleveland Clinic Foundation 44195.

出版信息

Chest. 1992 Jul;102(1):270-3. doi: 10.1378/chest.102.1.270.

Abstract

We examined the impact on physician prescribing patterns of pharmaceutical firms offering all-expenses-paid trips to popular sunbelt vacation sites to attend symposia sponsored by a pharmaceutical company. The impact was assessed by tracking the pharmacy inventory usage reports for two drugs before and after the symposia. Both drugs were available only as intravenous preparations and could be used only on hospitalized patients. The usage patterns were tracked for 22 months preceding each symposium and for 17 months after each symposium. Ten physicians invited to each symposium were interviewed about the likelihood that such an enticement would affect their prescribing patterns. A significant increase in the prescribing pattern of both drugs occurred following the symposia. The usage of drug A increased from a mean of 81 +/- 44 units before the symposium to a mean of 272 +/- 117 after the symposium (p less than 0.001). The usage of drug B changed from 34 +/- 30 units before the symposium to 87 +/- 24 units (p less than 0.001) after the symposium. These changed prescribing patterns were also significantly different from the national usage patterns of the two drugs by hospitals with more than 500 beds and major medical centers over the same period of time. These alterations in prescribing patterns occurred even though the majority of physicians who attended the symposia believed that such enticements would not alter their prescribing patterns.

摘要

我们研究了制药公司为医生提供前往阳光地带热门度假地参加由其赞助的研讨会的全程费用全包旅行,对医生处方模式的影响。通过追踪研讨会前后两种药物的药房库存使用报告来评估这种影响。这两种药物均仅以静脉制剂形式提供,且仅可用于住院患者。在每次研讨会前22个月及研讨会后17个月追踪使用模式。邀请参加每次研讨会的10名医生就这种诱惑影响其处方模式的可能性接受了访谈。研讨会后两种药物的处方模式均出现显著增加。药物A的使用量从研讨会前的平均81±44单位增加到研讨会后的平均272±117单位(p<0.001)。药物B的使用量从研讨会前的34±30单位变为研讨会后的87±24单位(p<0.001)。在同一时间段内,这些变化后的处方模式与拥有500多张床位的医院和主要医疗中心这两种药物的全国使用模式也存在显著差异。尽管参加研讨会的大多数医生认为这种诱惑不会改变他们的处方模式,但处方模式仍发生了这些变化。

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