Psychiatrists who are exposed to conflict-of-interest (COI) policies during their residency are less likely to prescribe brand-name antidepressants after graduation than those who trained in residency programs without such policies, according to a new study by researchers from the Perelman School of Medicine at the University of Pennsylvania. The study is the first of its kind to show that exposure to COI policies for physicians during residency training - in this case, psychiatrists - is effective in lowering their post-graduation rates of prescriptions for brand medications, including heavily promoted and brand reformulated antidepressants. Full results of the study will be published in the February issue of Medical Care and are now available online.
"Our study focuses on antidepressants because they have been among the most heavily marketed drug classes," said Andrew J. Epstein, PhD, research associate professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania, and first author on the study. "Data show that antidepressant use increased nearly 400 percent from 1988 to 2008. The goal for this study was to determine whether exposure to COI policies during residency would influence psychiatrists' antidepressant prescribing patterns after graduation."
In recent years, as a result of the dramatic increase in prescription drug use, relationships between pharmaceutical representatives and physicians have come under extensive scrutiny both within the medical profession and by policy makers. Penn Medicine in 2006 implemented policies placing restrictions on physician interactions with pharmaceutical representatives. In 2008, the Association of American Medical Colleges developed COI policy guidelines for gifts, free meals, and medication samples provided by pharmaceutical representatives to physicians and trainees. The concern was that these interactions could influence clinicians to prescribe brand medications even if they were more expensive or less suitable for patients than generic alternatives.