Re: Margaret McCartney: Forever indebted to pharma—doctors must take control of our own education
Dear Dr Goh
Many thanks, you are quite right, I should have said that associations were found between pharma sponsored education and higher prescribing frequency, higher cost, or lower prescribing quality, but also that associations were also not found. We have no good RCTs of the effect of sponsorship on guideline writing or sponsorship; but in the absence of safety data we have allowed this potential bias to take root underneath our feet without safety studies. There is other evidence that should be taken into consideration; namely that such effort and money goes into marketing to doctors. Or then there is the quality of the leaflets that still manage to get into my practice (much like the invitations to Hogwarts via owl to Harry Potter). The pharmaceutical claims are frequently based on surrogate outcomes, small study sizes, and are of poor quality, eg http://www.biomedcentral.com/1471-2296/7/13 or http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3157133/. There are many biases in medical practice that are hard to avoid. But there are others which are. So why not seek sources of information which are as unbiased as possible?
Competing interests: I wrote the article, DOI is here http://www.whopaysthisdoctor.org/doctor/6