Conflicts of Interest

From Thompson’s article, “Understanding Financial Conflicts of Interest”, we see that disclosure is not enough to prevent conflicts of interest (as is evident in the case of industry gift giving). Is prohibiting small gifts to physicians the answer? I would say yes, for it would certainly remove a source of unconscious and unintentional bias for physicians. But prohibition of gifts cannot be the only answer, for this regulation does nothing to prevent other industry influences. For example, Dana and Loewenstein (2003) highlighted the positive correlation between the cost of treatment prescribed and amount of contact with pharmaceutical sales reps. Prohibiting gifts will not change this correlation, for influences resulting from industry interactions cannot be regulated. This makes the industry just as reliant on professionalism and use of good judgment as they are on regulation.
I do not believe this fallback to ‘good judgment’ is problematic seeing as any market based relationship between buy and sell sides of an industry must balance interests in a way that upholds their professional credibility to the end consumer. Even if there exists a positive correlation between cost of treatment prescribed and amount of contact with reps, it does not follow this is a conflict of interest. Reps must act in ways to uphold their credibility to their physicians in order to maintain sales, and physicians must put their patient’s interests first in order to maintain trust and integrity. Relationships between reps and physicians are necessary in any market based relationship. Because of the necessity of the interaction between them, I believe that both government and industry legislators must go as far as possible to monitor strong forms of interaction (ie. gift giving or drug samples) but allow soft forms of interaction (reps ‘befriending’ physicians, marketing presentations, sales meetings, etc) to proceed as it is in the best interest of each party to act in ways which uphold their credibility in order to maintain future sales.

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