[Printed material distributed by pharmaceutical propaganda agents]

Pharmaceutical sales representatives (drug reps) frequently visit 70% to 90% of physicians during their daily clinical practice and many consider the promotional printed material to be a major source of clinical information. We evaluated samples of the promotional printed material distributed to physicians by drug reps in order to determine whether the data contained in the promotional material is correct and supported by references accessible in Argentina. A consecutive sample of all the promotional material distributed by drug reps in the general internal medicine program (Hospital de Clínicas) was collected between March 15 and April 15, 2000. Reprints and monographs were excluded. Clinical information was reviewed by two general internists and compared to information in a major pharmacology textbook and in an electronic medical information program. References cited were reviewed for correct listing and accessibility in any of the four major medical libraries in Buenos Aires. Of the sixty-four pieces of promotional material collected, thirty were randomly selected and evaluated. In twenty one (70%) the therapeutic effect promoted in advertisement appeared in Goodman & Gilman's 9th edition textbook of pharmacology, in the pharmacology section of the Up-to-Date version 8.1 or in both. Only eighteen (60%) of the thirty promotional printed material evaluated had statements supported by cited references. From a total of 131 references cited in promotional materials, sixty (46%) were incorrectly listed according to the International Committee of Medical Journal Editors. These references were inaccessible. Of the 71 references correctly cited, 49 (69%) were not available in any of the four major medical libraries in Buenos Aires and 8 were available in only two of the libraries. Twenty-two references were reviewed, and in twelve of these (54%), the objective of the research study concurred with the statement of the promotional printed material. Adverse reactions, warnings about drug interactions and contraindications were absent from all promotional printed material. It can be concluded that the promotional printed material distributed by the drug reps in Buenos Aires are biased and provide misinformation more often than not. We recommend that practicing physicians routinely disregard promotional printed material as a source of clinical information.