The delivery of modern health care entails significant involvement from the pharmaceutical industry, including developing and manufacturing drugs. However, the industry also has tremendous influence on the practice of medicine through its considerable marketing efforts, both to patients through direct to consumer advertising, and to physicians through detailing, providing samples, continuing medical education, and other efforts. This article will review the role that pharmaceutical marketing plays in health care, and the substantial evidence surrounding its influence on patient and physician behaviors, with additional discussion of the medical device industry, all with particular attention to women’s health. Understanding the effects of pharmaceutical marketing on women’s health, through discussion of relevant examples—including oral contraceptive pills, drugs for premenstrual dysphoric disorder, Pap smear cytology techniques, and neonatal herpes prophylaxis—will help ensure that women receive unbiased, evidenced-based care. We will conclude with a discussion of guidelines that have been proposed by professional organizations, policy makers, and universities, to assist physicians in managing exposure to pharmaceutical marketing.
Obstetricians & Gynecologists, Family Physicians
After completion of this article, the reader should be able to identify ways that pharmaceutical marketing can impact clinical care, modify their own personal involvement with pharmaceutical marketing if necessary to avoid conflicts of interest, and illustrate particular vulnerabilities in women’s health with respect to pharmaceutical marketing.
*Clinical Fellow, Family Planning, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco General Hospital, San Francisco, California; †Assistant Professor, Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York
Chief Editor’s Note: This article is part of a series of continuing education activities in IN TNthis Journal through which a total of 36 AMA/PRA category 1 credits™ can be earned in 2006. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.
Dr. Ross has declared that he was a consultant at the request of plaintiffs in litigation against Merck and Co, Inc related to rofecoxib. Dr. Sufrin has disclosed that she has no financial relationships with or interests in any commercial companies pertaining to this educational activity.
The Faculty and Staff in a position to control the content of this CME activity have disclosed that they have no financial relationships with, or financial interests in, any commercial companies pertaining to this educational activity.
Lippincott Continuing Medical Education Institute, Inc. has identified and resolved all faculty conflicts of interest regarding this educational activity.
Reprint requests to: Dr. Sufrin, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco General Hospital, 1001 Potrero Avenue, Ward 6D-14, San Francisco, CA 94110. E-mail: email@example.com.