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Association between gifts from pharmaceutical companies to French general practitioners and their drug prescribing patterns in 2016: retrospective study using the French Transparency in Healthcare and National Health Data System databases

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6015 (Published 06 November 2019) Cite this as: BMJ 2019;367:l6015

Commercial influence in health: from transparency to independence

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Linked Editorial

Declaring interests and restoring trust in medicine

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Re: Association between gifts from pharmaceutical companies to French general practitioners and their drug prescribing patterns in 2016: retrospective study using the French Transparency in Healthcare and National Health Data System databases

In their recent article, Goupil et al [1] report an association between gifts from the pharmaceutical industry to French general practitioners (GPs) and the GPs’ prescribing patterns. They assert that the higher the amount of the gift, the lower the quality of the GPs’ work

In this study, the authors confounded personal gifts and financial contributions to continuing medical education, including participation in congresses and educational meetings. This is all the more surprising since personal gifts are not legal in France. Similarly, their definition of prescription efficiency is debatable, since they use a definition that relies on adherence to the pay-for-performance programme of the French social security system, which is unrelated to quality indicators, compliance with guidelines, length of consultation [2] or patient satisfaction [3].

The take-home message given by Goupil’s paper could thus be re-interpreted as follows: the lower the amount of educational support, the worse the quality of the prescribing patterns.

François Schiele, MD, PhD
University Hospital Besancon, France

References
1. Goupil B, Balusson F, Naudet F, Esvan M, Bastian B, Chapron A, Frouard P: Association between gifts from pharmaceutical companies to French general practitioners and their drug prescribing patterns in 2016: retrospective study using the French Transparency in Healthcare and National Health Data System databases. BMJ 2019;367:l6015.
2. Saint-Lary O, Sicsic J: Impact of a pay for performance programme on French GPs' consultation length. Health Policy 2015;119 (4):417-26.
3. Saint-Lary O, Leroux C, Dubourdieu C, Fournier C, Francois-Purssell I: Patients' views on pay for performance in France: a qualitative study in primary care. Br J Gen Pract 2015;65 (637):e552-9.

Competing interests: No competing interests

15 November 2019
François Schiele
Chief of Cardiology Department; University Professor
University Hospital Besancon, France
Boulevard Fleming, 25000 Besancon, France