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Healthy Skepticism Library item: 2034

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.


Publication type: Journal Article

Stryer D, Bero LA.
Characteristics of materials distributed by drug companies. An evaluation of appropriateness.
J Gen Intern Med 1996 Oct; 11:(10):575-83


OBJECTIVES: To describe material distributed to physicians by pharmaceutical companies; to describe characteristics of the drugs discussed in the material; to determine whether the material complies with Food and Drug Administration (FDA) regulations and whether it contains promotional and educational characteristics.

DESIGN: Cross-sectional study.

SETTING: An academic internal medicine residency program, a private internist’s office, and a health maintenance organization (HMO).

PATIENTS/PARTICIPANTS: A consecutive sample of 486 items, excluding gifts and drug samples, distributed by drug companies between August 11, 1993 and March 1, 1994.

MEASUREMENTS AND MAIN RESULTS: Of the 486 items collected, 207 were reprints, 196 were advertisements, 51 were general information, and 32 were other. Reprints were delivered to residents significantly more often than to the HMO (p < .001) or to the private internist’s office (p < .001). By contrast, the internist’s office received a greater proportion of personal correspondence compared with the other locations (p < .001 for both). Of the drugs publicized, 10] were substantial improvements over other therapeutic choices. Forty-two percent of the items failed to comply with at least one of three FDA regulations assessed, including 17 items that discussed unapproved uses for drugs. Advertisements, as well as items that were not obviously promotional, contained promotional characteristics. Thirty-nine percent of the items offered scientific support for their claims.

CONCLUSIONS: Little of the material distributed by pharmaceutical companies to physicians conveys information about important therapeutic breakthroughs; some of it fails to comply with FDA regulations. The material contains both educational and promotional characteristics.

Publication Types: Review Review, Tutorial MeSH Terms: Advertising Attitude* Conflict of Interest Cross-Sectional Studies Drug Industry*/education Drug Industry*/standards Drug Utilization/trends Government Regulation Humans Information Dissemination* Interprofessional Relations* Sampling Studies United States United States Food and Drug Administration*


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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909