WHO Health Systems Library
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Drug Promotion - What We Know, What We Have Yet to Learn - Reviews of Materials in the WHO/HAI Database on Drug Promotion - EDM Research Series No. 032
(102 pages)

Table of Contents
View the documentAcknowledgements
View the documentExecutive summary
Open this folder and view contentsIntroduction
Open this folder and view contentsReview 1. What attitudes do professional and lay people have to promotion?
Open this folder and view contentsReview 2. What impact does pharmaceutical promotion have on attitudes and knowledge?
Open this folder and view contentsReview 3. What impact does pharmaceutical promotion have on behaviour?
close this folderReview 4. What interventions have been tried to counter promotional activities, and with what results?
View the document4.1 Guidelines, codes and regulations for printed and broadcast material
View the document4.2. The ‘Fair Balance’ requirement
View the document4.3 Guidelines for sales representatives
View the document4.4 Guidelines for post-marketing surveillance
View the document4.5 Guidelines on conflict of interest in research
View the document4.6 Guidelines for package inserts and compendia
View the document4.7 Guidelines about gifts
View the document4.8 Guidelines for trainee doctors and for hospitals
View the document4.9 Knowledge of these guidelines and their effect on attitudes
View the document4.10 Education about promotion
View the document4.11 Monitoring/countering promotion
View the document4.12 Research as an intervention
View the documentSummary of conclusions
View the documentDirections for future research
View the documentFinal conclusions
View the documentReferences

4.7 Guidelines about gifts

In the USA, the American Medical Association has guidelines about gifts from the pharmaceutical industry incorporated in its Code of Ethics. These suggest that gifts to doctors should primarily benefit patients and should not be of substantial value. The American College of Physicians also suggests that a useful criterion for determining acceptability is whether doctors would “be willing to have these arrangements generally known”.

In Gibbons et al.’s study of attitudes to gifts from the pharmaceutical industry to doctors, only 62% of doctors were aware of any guideline about accepting gifts34. Awareness of a guideline was the only predictor of doctors reporting that gifts were not appropriate. However these are self report data, so those who knew about guidelines may have felt more social pressure to say that gifts were unacceptable.

Drug samples, although not intended as gifts to doctors, may in fact be used in this way. Westfall, McCabe and Nicholas124 found that in their family practice residency almost all staff, including medical practitioners, office staff etc had used samples provided by sales representatives for their personal or family use. The total retail cost of these was over US$10,000. As a result of their findings they instituted new controls over access to the medicine samples.

CONCLUSION: Not enough is known about the impact of guidelines for gifts to reach any conclusions.

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Last updated: May 4, 2012