Physician's perceptions regarding the pharmaceutical industry: a Brazilian national study

Gameiro, Giovana Rosa; Gameiro, Gustavo Rosa; Silva, Renan Magalhães e; Guilloux, Aline Gil Alves; Cassenote, Alex Jones Flores; Scheffer, Mario César

doi:10.1590/1806-9282.20231317

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Revista da Associação Médica Brasileira

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Original Article • Rev. Assoc. Med. Bras. 70 (5) • 2024 • https://doi.org/10.1590/1806-9282.20231317 copy

Physician's perceptions regarding the pharmaceutical industry: a Brazilian national study

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

The objective of this study was to investigate the newly graduated physicians' attitudes and perceptions regarding the medical relationship with the pharmaceutical industry and identify the sociodemographic patterns related to such thinking.

METHODS:

A structured questionnaire was administered to 4,601 participants selected from a pool of 16,323 physicians who were registered with one of the 27 Regional Medical Councils of Brazil in 2015. Answers were analyzed using two stratification variables: type of medical school (public vs. private) and the sex of the respondents.

RESULTS:

Out of the participants, 61.8% believed that industry funding could support medical conferences and education, and 48.4% felt that small gifts and conference travel funding were acceptable. Conversely, 64.7% disagreed with industry-sponsored social events. Views on whether pharmaceutical representatives' visits influenced prescriptions were divided. Statistically significant differences were observed between genders and medical school types, with men and private school graduates being more accepting of certain industry interactions.

CONCLUSION:

The study highlights the nuanced attitudes of new doctors toward industry relationships, indicating the need for clearer ethical guidelines and education in medical schools to align practice with evolving societal values.

KEYWORDS:
Medical education; Pharmaceutical industry; Physicians; Medical ethics; Conflict of interest

	I agree			Disagree			I prefer not to answer
	n	Freq. %	95%CI	n	Freq. %	95%CI	n	Freq. %	95%CI
Medical conferences, publications, and continuing education programs can be financed by the industry.	1,988	61.8	58.5–65.0	724	21.5	19.3–23.8	527	16.7	14.8–18.9
The doctor can receive gifts of small value and travel funding for conferences.	1,559	48.4	44.2–52.6	1,063	32	29.6–34.5	614	19.6	16.9–22.5
The industry representative visit influences the doctor's prescription practices.	1,447	42.6	38.1–47.2	1,391	44.2	41.1–47.4	397	13.2	11.7–14.9
It is correct for the industry to finance "cervejadas," barbecues, and cocktails for students and residents.	525	16.2	12.6–20.6	2,094	64.7	60.0–69.2	617	19.1	17.2–21.2
The physician should be prohibited from linking medical prescription practices to the receipt of material benefits or financial support.	2,369	72.9	70.4–75.2	385	11.6	10.4–12.9	478	15.5	13.6–17.7

		Gender
		Male			Female			Total
		Freq. %	95%CI	n	Freq. %	95%CI	n	Freq. %	95%CI	n
¹ 1 p=0.019 Medical conferences, publications, and continuing education programs can be financed by the industry.
	I agree	66	64.8–67.8	961	59.3	57.8–60.8	1,027	61.4	58.5–65.0	884
	Disagree	19.5	16.1–23.4	307	22.7	20.9–24.5	417	22.4	19.3–23.8	2,023
	I prefer not to answer	14.5	12.7–17.2	210	18.1	17.0–19.2	317	16.3	14.8–18.9	770
² 2 p=0.037 The doctor can receive gifts of small value and travel funding for conferences.
	I agree	53.9	52.3–55.6	778	45	43.4–46.7	781	48.4	44.2–52.6	1,559
	Disagree	29.9	25.9–34.2	466	33.3	31.9–34.8	597	32	29.6–34.5	1,063
	I prefer not to answer	16.2	13.4–19.4	235	21.6	20.4–23.0	379	19.6	16.9–22.5	614
³ 3 p=0.002. It is correct for the industry to finance "cervejadas," barbecues, and cocktails for students and residents.
	I agree	21.6	17.7–26.2	317	12.9	11.4–14.5	208	16.2	12.6–20.6	525
	Disagree	59.8	56.4–63.0	905	67.7	66.2–69.2	1,189	64.7	60.0–69.2	2,094
	I prefer not to answer	18.6	14.1–24.2	256	19.4	17.8–21.2	361	19.1	17.2–21.2	617

		Type of medical school
		Public			Private			Total
		Freq. %	95%CI	n	Freq. %	95%CI	n	Freq. %	95%CI	n
¹ 1 p=0.037 The doctor can receive gifts of small value and travel funding for conferences.
	I agree	50.3	47.0–53.6	725	47.7	42.4–53.1	834	48.4	44.2–52.6	1,559
	Disagree	34.4	33.3–35.6	498	31.2	28.2–34.3	565	32	29.6–34.5	1,063
	I prefer not to answer	15.3	12.1–19.1	226	21.1	18.8–23.5	388	19.6	16.9–22.5	614
² 2 p<0.001. The industry representative visit influences the doctor's prescription practices.
	I agree	51.5	48.8–54.1	728	39.5	38.4–40.7	719	42.6	38.1–47.2	1,447
	Disagree	38.2	35.2–41.3	570	46.3	45.4–47.1	821	44.2	41.1–47.4	1,391
	I prefer not to answer	10.3	8.8–12.1	150	14.2	13.6–14.9	247	13.2	11.7–14.9	397
² 2 p<0.001. The physician should be prohibited from linking medical prescription practices to the receipt of material benefits or financial support.
	I agree	77.9	75.2–80.4	1,110	71.1	69.3–72.9	1,259	72.9	70.4–75.2	2,369
	Disagree	10.9	9.2–12.8	166	11.8	10.3–13.6	219	11.6	10.4–12.9	385
	I prefer not to answer	11.2	9.6–13.1	171	17	16.6–17.5	307	15.5	13.6–17.7	478

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[1] *Corresponding author: gustavo.gameiro@fm.usp.br