Abstract
Conflicts of interest, stemming from relationships between health professionals and the pharmaceutical industry, remain a highly divisive and inflammatory issue in healthcare. Given that most jurisdictions rely on industry to self-regulate with respect to its interactions with health professionals, it is surprising that little research has explored industry leaders’ understandings of conflicts of interest. Drawing from in-depth interviews with ten pharmaceutical industry leaders based in Australia, we explore the normalized and structural management of conflicts of interest within pharmaceutical companies. We contrast this with participants’ unanimous belief that the antidote to conflicts of interest with health professionals were “informed consumers.” It is, thus, unlikely that a self-regulatory approach will be successful in ensuring ethical interactions with health professionals. However, the pharmaceutical industry’s routine and accepted practices for disclosing and managing employees’ conflicts of interest could, paradoxically, serve as an excellent model for healthcare.
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References
Al-Areefi, M.A., M. Hassali, and M. Ibrahim. 2012. A qualitative study exploring medical representatives’ views on current drug promotion techniques in Yemen. Journal of Medical Marketing 12(3): 143–149.
Al-Hamdi, A.Y., M. Hassali, and M. Ibrahim. 2012. Impact of pharmaceutical promotion on healthcare professional’s practices and behaviour: views from general practitioners, medicine dispensers and medical representatives in Yemen. Journal of Medical Marketing 12(4): 240–246.
American Medical Students Association (AMSA). 2014. PharmFree Scorecard 2014. http://amsascorecard.wpengine.com/executive-summary/. Accessed July 19, 2016.
Benner, P. 1994. The tradition and skill of interpretive phenomenology in studying health, illness, and caring practices. In Interpretive phenomenology: Embodiment, caring, and ethics in health and illness, edited by P. Benner, 99–127. Thousand Oaks, CA, Sage Publications.
———. 1996. Appendix A. In Expertise in nursing practice: Caring, clinical judgment and ethics, edited by P. Benner, C. Tanner, and C. Chesla, 351–372. Thousand Oaks, CA: Sage.
Benner, P., C. Tanner, and C. Chesla. 2009. Expertise in nursing practice, 2nd ed. New York, NY: Springer Publishing Company.
Campbell, E.G., S.R. Rao, C.M. DesRoches, et al. 2010. Physician professionalism and changes in physician-industry relationships from 2004 to 2009. Archives of Internal Medicine 170(20): 1820–1826.
Campsall, P., K. Colizza, S. Straus, and H.T. Stelfox. 2016. Financial relationships between organizations that produce clinical practice guidelines and the biomedical industry: A cross-sectional study. PLoS Medicine 13(5): e1002029.
Chan, G.K., K.A. Brykczynski, R.E. Malone, and P. Benner. 2010. Interpretive phenomenology in health care research. Indianapolis, IN: Sigma Theta Tau International.
Crigger, N., K. Barnes, A. Junko, S. Rahal, and C. Sheek. 2009. Nurse practitioners’ perceptions and participation in pharmaceutical marketing. Journal of Advanced Nursing 65(3): 525–533.
Dana, J., and G. Loewenstein. 2003. A social science perspective on gifts to physicians from industry. Journal of the American Medical Association 290(2): 252–255.
DeAngelis, C.D. 2000. Conflict of interest and the public trust. Journal of the American Medical Association 284(17): 2237–2238.
Dunn, A.G., E. Coiera, K.D. Mandl, and F.T. Bourgeois. 2016. Conflict of interest disclosure in biomedical research: a review of current practices, biases, and the role of public registries in improving transparency. Research Integrity and Peer Review 1(1): 1–8.
Jutel, A., and D.B. Menkes. 2009. “But doctors do it …”: Nurses’ views of gifts and information from the pharmaceutical industry. Annals of Pharmacotherapy 43(6): 1057–1063.
Korenstein, D., S. Keyhani, and J.S. Ross. 2010. Physician attitudes toward industry: A view across the specialties. Archives of Surgery 145(6): 570–577.
Lave, R., P. Mirowski, and S. Randalls. 2010. Introduction: STS and neoliberal science. Social Studies of Science 40(5): 659–675.
Lexchin, J. 1993. Interactions between physicians and the pharmaceutical industry: What does the literature say? The Canadian Medical Association Journal 149(10): 1401.
Lipworth, W., and M. Little. 2014. Deriving and critiquing an empirically-based framework for pharmaceutical ethics. The American Journal of Bioethics Empirical Bioethics 5(1): 23–32.
Martin, E. 2006. Pharmaceutical virtue. Culture, Medicine and Psychiatry 30(2): 157–174.
McDermott Will & Emery. 2014. Snapshot of Sunshine rules in EU countries for the pharmaceutical industry. Chicago, IL: McDermott Will & Emery.
Mirowski, P. 2009. Postface: Defining neoliberalism. In The road from Mont Pèlerin: The making of the neoliberal thought collective, edited by P. Mirowski, and D. Plehwe. Cambridge, MA: Harvard University Press.
Pew Prescription Project. 2009. Addressing cost and quality: The Physician Payments Sunshine Act. Pennsylvania, PA: Pew Foundation.
Pharmaceutical Research and Manufacturers Association (PhRMA). 2009. Code on interactions with healthcare professionals. Washington, DC: PhRMA.
QSR International Pty Ltd. 2012. NVivo qualitative data analysis software. QSR International Pty Ltd.
Relman, A.S. 1984. Dealing with conflicts of interest. New England Journal of Medicine 310(18): 1182–1183.
Rodwin, M. 1993. Medicine, money, and morals: Physicians’ conflict of interest. Oxford, UK: Oxford University Press.
Rosenbaum, L. 2015a. Beyond moral outrage—Weighing the trade-offs of COI regulation. New England Journal of Medicine 372(21): 2064–2068.
———. 2015b. Reconnecting the dots—Reinterpreting industry–physician relations. New England Journal of Medicine 372(19): 1860–1864.
———. 2015c. Understanding bias—The case for careful study. New England Journal of Medicine 372(20): 1959–1963.
Steinbrook, R., J.P. Kassirer, and M. Angell. 2015. Justifying conflicts of interest in medical journals: A very bad idea. British Medical Journal 350: h2942.
Tengilimoglu, D., A. Kisa, and A. Ekiyor. 2005. The pharmaceutical sales rep/physician relationship in Turkey: Ethical issues in an international context. Health Marketing Quarterly 22(1): 21–39.
Thompson, D. 1993. Understanding financial conflicts of interest. New England Journal of Medicine 329(8): 573–576.
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Grundy, Q., Tierney, L., Mayes, C. et al. Health Professionals “Make Their Choice”: Pharmaceutical Industry Leaders’ Understandings of Conflict of Interest. Bioethical Inquiry 14, 541–553 (2017). https://doi.org/10.1007/s11673-017-9804-y
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DOI: https://doi.org/10.1007/s11673-017-9804-y