Med school gift restriction policies linked to subsequent prescribing behavior

Physicians who attended a medical school with an active gift restriction policy were subsequently less like to prescribe newly marketed psychotropic medications over older, cheaper alternatives, according to a study published in the January 2013 issue of BMJ.

In the study, Marissa King of the Yale School of Management, and colleagues compared the prescribing behavior of physicians who attended a medical school when a gift restriction policy was being enforced to the prescribing behavior of students who graduated from the same schools prior to the policy being enacted.

They identified 14 US medical schools with an active gift restriction policy in place by 2004. Next, they analyzed prescribing patterns in 2008 and 2009 of physicians attending 1 of these 14 schools compared with physicians graduating from the same schools before the implementation of the policy, as well as a control sample of 20 schools that only adopted a gift restriction policy in 2008.

“The majority of medical schools have now adopted policies that govern interactions between representatives of the pharmaceutical industry and students,” King, who is assistant professor of organizational behavior, told Formulary. “However, no one knew whether these policies actually effect subsequent prescribing behavior.”

King and her team found that gift restriction policies reduced prescribing for 2 of the 3 (stimulant, antidepressant, and antipsychotic) newly introduced medications that they examined.

“All of these medications relied on active ingredients that were already on the market,” she said. “Future work will need to assess whether these policies have any effect on prescribing of truly innovative medications.

“Our work suggests that gift restriction policies may influence physician prescribing behavior,” King continued. “A key question is whether similar policies may also influence formulary decisions.”