Undue influences on drugs and device industries distort healthcare research, and practice.
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Date
2015
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Abstract
ABSTRACT: Background: Expenditure on industry products (mostly drugs and devices) has spiraled over the last
15 years and accounts for substantial part of healthcare expenditure. The enormous financial interests involved in the
development and marketing of drugs and devices may have given excessive power to these industries to influence
medical research, policy, and practice. Material and methods: Review of the literature and analysis of the multiple
pathways through which the industry has directly or indirectly infiltrated the broader healthcare systems. We present
the analysis of the industry influences at the following levels: (i) evidence base production, (ii) evidence synthesis, (iii)
understanding of safety and harms issues, (iv) cost-effectiveness evaluation, (v) clinical practice guidelines formation,
(vi) healthcare professional education, (vii) healthcare practice, (viii) healthcare consumer‘s decisions. Results: We
located abundance of consistent evidence demonstrating that the industry has created means to intervene in all steps
of the processes that determine healthcare research, strategy, expenditure, practice and education. As a result of
these interferences, the benefits of drugs and other products are often exaggerated and their potential harms are
downplayed, and clinical guidelines, medical practice, and healthcare expenditure decisions are biased. Conclusion:
To serve its interests, the industry masterfully influences evidence base production, evidence synthesis,
understanding of harms issues, cost-effectiveness evaluations, clinical practice guidelines and Healthcare
professional education and also exerts direct influences on professional decisions and health consumers. There is an
urgent need for regulation and other action towards redefining the mission of medicine towards a more objective and
patient-, population- and society-benefit direction that is free from conflict of interests.
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Keywords
undue influence, conflict of interests, evidence-based medicine, healthcare industry, medication, pharmaceutical industry
Citation
Rahman Mohammad Arifur, Farzana Laila. Undue influences on drugs and device industries distort healthcare research, and practice. Bangladesh Journal of Bioethics. 2015; 6(2): 15-22.