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Epidemiology

Interactions with the pharmaceutical industry and the practice, knowledge and beliefs of medical oncologists and clinical haematologists: a systematic review

Abstract

Background

No previous review has assessed the extent and effect of industry interactions on medical oncologists and haematologists specifically.

Methods

A systematic review investigated interactions with the pharmaceutical industry and how these might affect the clinical practice, knowledge and beliefs of cancer physicians. MEDLINE, Embase, PsycINFO and Web of Science Core Collection databases were searched from inception to February 2021.

Results

Twenty-nine cross-sectional and two cohort studies met the inclusion criteria. These were classified into three categories of investigation: (1) extent of exposure to industry for cancer physicians as whole (n = 11); (2) financial ties among influential cancer physicians specifically (n = 11) and (3) associations between industry exposure and prescribing (n = 9). Cancer physicians frequently receive payments from or maintain financial ties with industry, at a prevalence of up to 63% in the United States (US) and 70.6% in Japan. Among influential clinicians, 86% of US and 78% of Japanese oncology guidelines authors receive payments. Payments were associated with either a neutral or negative influence on the quality of prescribing practice. Limited evidence suggests oncologists believe education by industry could lead to unconscious bias.

Conclusions

There is substantial evidence of frequent relationships between cancer physicians and the pharmaceutical industry in a range of high-income countries. More research is needed on clinical implications for patients and better management of these relationships.

Registration

PROSPERO identification number CRD42020143353.

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Data availability

No additional data is available.

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Acknowledgements

The authors thank Dr. Patrick Donald, medical oncologist, Darwin, Australia, for his assistance in assessing the quality appraisal of three included studies.

Funding

AP was supported by a University of Sydney Postgraduate Award.

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Contributions

All authors contributed to the protocol development, selection of studies, interpretation of data and final manuscript. AP undertook the literature searches and extracted data. BM confirmed the extracted data. AP, BM and AF performed the quality appraisals.

Corresponding author

Correspondence to Adrian M. J. Pokorny.

Ethics declarations

Competing interests

In 2020, Barbara Mintzes acted as an expert witness for Health Canada in a legal case related to the marketing of an unregistered product in Canada. There are no other conflicts to declare.

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No ethics approval was necessary as all data analysed exist in the public domain.

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Pokorny, A.M.J., Fabbri, A., Bero, L.A. et al. Interactions with the pharmaceutical industry and the practice, knowledge and beliefs of medical oncologists and clinical haematologists: a systematic review. Br J Cancer (2021). https://doi.org/10.1038/s41416-021-01552-1

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