Research

Medical School Gift Restriction Policies Affect Doctors' Prescribing Behavior

Marissa D. King — February 2013

Professor Marissa King compared the prescribing patterns of doctors who graduated before and after their medical schools introduced conflict-of-interest policies that restrict industry gifts. Her research showed that doctors who experienced gift restrictions during medical training are less likely to prescribe newly marketed medications.

Doctors who graduate from medical schools with policies that restrict gifts from pharmaceutical and medical device companies are less likely to prescribe new medications over existing alternatives, according to new research co-authored by Marissa King, assistant professor of organizational behavior at the Yale School of Management.

"The conflict of interest policies that have been adopted by the vast majority of U.S. medical schools have the potential to reduce the adoption of new drugs," says King.

King and her co-authors studied the prescribing patterns of doctors who graduated from 14 U.S. medical schools that have prohibited or restricted gifts since 2004. They examined the prescriptions written in 2008 and 2009 for three newly marketed mental health medications—a stimulant, an antipsychotic, and an antidepressant—that relied on active ingredients already available on the market. The researchers compared the prescribing of doctors who graduated before their schools' conflict-of-interest policies were implemented to those who graduated after.

Doctors who were exposed to a gift restriction policy during medical school prescribed the newly introduced stimulant and antipsychotic significantly less than older alternatives. Prescribing rates for the new drugs were further reduced among doctors who were exposed to the policy longer or who experienced a more stringent policy.

The prescribing rates for the new antidepressant were not significantly affected by gift policies.

The authors note that future research is needed to determine whether medical school gift-restriction policies reduce the prescribing of all newly marketed medications or if they selectively affect prescribing.

"Medical School Gift Restriction Policies and Physician Prescribing of Newly Marketed Psychotropic Medications: A Difference-in-Difference Analysis" by Marissa King (Yale School of Management), Connor Essick, Peter Berman (Columbia University), and Joseph Ross (Yale School of Medicine) is forthcoming in the British Medical Journal.