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Exposure to Conflict of Interest Polices has a Powerful Effect on Psychiatrists


In a first of its kind study, researchers have found that psychiatrists who are exposed to conflict-of-interest (COI) policies regarding pharmaceutical companies during residency training are significantly less likely to prescribe brand-name antidepressants to their patients than those whose residencies did not include such policies.

The study, conducted by researchers from the University of Pennsylvania, Yale School of Public Health, Harvard Medical School and Johns Hopkins Bloomberg School of Public Health, involved the analysis of prescriptions written in 2009 by the 1,652 psychiatrists who participated in 162 different residency programs. The data was obtained from IMS (Intercontinental Medical Statistics) Health, a company that provides information, services, and technology to the healthcare industry.

Nearly half of the participants in the study completed their residencies in 2001, before conflict-of-interest training policies had been adopted. The other half graduated residency in 2008, after many major medical centers adopted COI policies. The level of restrictiveness of the COI policies implemented at the medical centers where the residences were completed was factored into the study.

The findings show that the rates of prescription of brand name drugs were higher among the 2001 class than they were for the 2008 class. The lowest rates were found among 2008 graduates of residency programs with the most restrictive COI policies.

“Our study focuses on antidepressants because they have been among the most heavily marketed drug classes,” said Andrew J. Epstein, Ph.D., research associate professor of medicine at the Perelman School of Medicine and first author on the study.

“Data show that antidepressant use increased nearly 400 percent from 1988 to 2008. The goal for this study was to determine whether exposure to COI policies during residency would influence psychiatrists’ antidepressant prescribing patterns after graduation.”

The dramatic rise in prescriptions for antidepressants has become a growing concern for healthcare professionals and policymakers concerned that closer ties between makers of pharmaceutical drugs and those who prescribe them might influence the decision-making processes of the doctors involved regarding medications. Interactions between representatives of pharmaceutical or medical device companies and doctors considered to represent a conflict-of-interest include the giving of gifts, free meals, and medication samples by the companies to physicians and trainees.

One major concern is that brand name antidepressant medications marketed heavily by pharmaceutical companies are favored by doctors when lower cost generic drugs are both available and equally effective.

Despite these fears, some contact between doctors and pharmaceutical representatives is not only appropriate and ethical, but can be beneficial to both the doctor and patient alike.

“Contact with the pharmaceutical industry may have important informational benefits for physicians. And, by exposing trainees to industry representatives, we may be helping them prepare to navigate these relationships after graduation,” said Epstein.

“Nevertheless, while these relationships may be useful in some ways, our study clearly shows that implementation of COI policies have helped shield physicians from the often persuasive aspects of pharmaceutical promotion.”

Results of the study can be found both online and in the February 2013 issue of Medical Care.



  1. Gutierrez, David. “Conflict-of-interest training reduces brand-name antidepressant prescription.” Natural News. 09 February 2013. Web. 13 February 2013.
  2. Nauert, Rick. “Psychiatrists with Ethics Training Less Likely to Push Brand-Name Drugs.” Psych Central. 22 January 2013.
  3. Overview. IMS Health. na. Web. 13 February 2013.


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Filed under: Research, Uncategorized · Tags: CIO and Psychiatrists, CIO Policies, Conflict of Interest Polices, Ethics and Psychiatrists, pharmaceutical companies and psychiatrists is operated by Recovery Brands LLC, a subsidiary of American Addiction Centers, Inc.
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