Medical professionals who receive payments, consultancy fees or even free meals from pharmaceutical companies prescribe significantly more medications—including unnecessary or potentially harmful drugs—according to an international research review analysing 93 studies, according to Bankier.pl.
The findings, published in the Cochrane Database of Systematic Reviews, raise serious questions about the independence of prescribing practices and the financial burden placed on both healthcare systems and patients.
An international team of researchers examined studies focusing on contacts between pharmaceutical firms and those authorised to write prescriptions. They sought to determine whether such relationships influenced the number and cost of prescribed medications, and how well treatment matched patients’ actual needs. The research compared practices of doctors with industry contacts against those with fewer or no such ties.
Payments and gifts drive prescribing patterns
Among the studies analysed, 62 focused specifically on payments and gifts. The evidence showed that medical professionals accepting such benefits from the pharmaceutical industry prescribed more medicines overall, with a particularly strong preference for products promoted by the paying company. These doctors were also more likely to choose treatments later judged inappropriate—meaning unnecessary for the patient or potentially harmful. The cost of prescribed medications was higher as well, affecting both healthcare systems and patients’ out-of-pocket expenses.
The research considered various forms of industry contact: visits from pharmaceutical sales representatives to doctors’ surgeries, company-sponsored training and conferences, meals provided during such events, gifts, consultancy fees, participation in advisory boards, and free drug samples for distribution to patients.
“In the United States, where companies must report payments to doctors in a public database, just over half of all licensed physicians accepted a payment, including free meals, from a pharmaceutical company,” noted co-author Professor Quinn Grundy from the University of Toronto, Canada. “This is important because it shows that companies focus their marketing resources on doctors who will provide the highest return on investment by prescribing more promoted drugs.”
Sales visits and workplace restrictions
Sixteen studies in the review examined advertising and educational activities aimed at doctors, primarily visits from pharmaceutical representatives to their practices. Such contacts were associated with higher numbers of prescriptions, less appropriate therapeutic choices and increased costs, though the certainty of these findings was somewhat lower than for direct payments.
Data concerning free drug samples did not permit firm conclusions.
Researchers also reviewed eight studies on policies that restrict conflicts of interest in medical institutions. These included limitations on sales representative visits and acceptance of gifts and drug samples. Results indicated that such policies promoted more appropriate prescribing and could reduce the overall number of prescriptions.
Professor Grundy argued this demonstrates that work environments supporting physician independence can be created. However, such measures must be implemented at the level of medical institutions and entire healthcare systems, rather than leaving the responsibility to individual doctors.
She emphasised that prescribers need independent information grounded in scientific evidence. Medical organisations, professional associations and medical schools should be more aware of pharmaceutical marketing, better recognise its influence on doctors’ decisions, and introduce policies to limit it, the authors concluded.
What this means for Poles in the UK
For Polish patients registered with the NHS, this research highlights important questions about prescription practices. While the UK has stricter regulations than some countries—the Association of the British Pharmaceutical Industry operates a disclosure database showing payments to healthcare professionals—industry influence remains a concern.
If you receive a prescription, particularly for a branded medication when a generic equivalent exists, you can ask your GP or pharmacist whether a cheaper alternative is available. Generic medicines contain the same active ingredients as branded versions but typically cost far less. On the NHS, prescription charges are fixed at £9.90 per item in England (free in Scotland, Wales and Northern Ireland), but the cost to the health service varies greatly.
Patients can also request a second opinion if they have concerns about whether a medication is necessary. Medical institutions in the UK are increasingly adopting conflict-of-interest policies, but awareness among patients can help ensure treatment decisions prioritise health over commercial interests. Check the NHS website or speak to your GP practice manager if you want to know about your surgery’s policies on pharmaceutical company contacts.