Interaction between physicians and the pharmaceutical industry: A scoping review for developing a policy brief

Area of Science:

• Health Policy
• Medical Ethics
• Pharmaceutical Economics

Background:

• Physician payments from pharmaceutical companies are widespread and linked to altered prescribing patterns, including increased use of brand-name and higher-cost medications.
• These financial relationships can escalate drug expenditures for patients and healthcare systems, necessitating public interest in their regulation.
• Understanding and managing physician-pharmaceutical industry interactions is crucial for cost containment and ethical healthcare delivery in Iran.

Purpose of the Study:

• To identify and evaluate policy options for managing conflicts of interest (COI) arising from physician-pharmaceutical industry interactions within Iran's healthcare system.
• To provide evidence-based recommendations for policymakers to effectively regulate these financial relationships.

Main Methods:

• A systematic literature search was conducted across major databases (Web of Science, PubMed, ProQuest) from 2000 to 2022 to identify relevant policies and interventions.
• Expert opinions from physicians, health policy specialists, transparency advocates, and industry representatives were gathered to categorize interventions.
• Policy options were developed, detailing their advantages, disadvantages, and implementation considerations.

Main Results:

• The systematic search yielded 44 relevant articles from 579 retrieved, identifying 29 distinct interventions and strategies.
• Five primary policy options emerged: prohibition, restriction, physician self-regulation, voluntary industry disclosure, and mandatory industry disclosure.
• Each policy option was analyzed for its potential benefits, drawbacks, and feasibility within the Iranian context.

Conclusions:

• The study proposes actionable policy options, supported by current evidence, to help Iranian policymakers manage conflicts of interest in physician-pharmaceutical industry relationships.
• A combined strategy, initially promoting physician and industry self-regulation for transparency, followed by mandatory disclosure and specific financial restrictions, is recommended.
• Implementing these policies can contribute to a more transparent and cost-effective healthcare system by mitigating undue influence on prescribing practices.