Undue industry influences that distort healthcare research, strategy, expenditure and practice: a review
| Autor: | John P. A. Ioannidis, Emmanuel Stamatakis, Richard Weiler |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Biomedical Research
Cost effectiveness Cost-Benefit Analysis Health Personnel Clinical Biochemistry Population Biochemistry Health care Humans Medicine education Pharmaceutical industry Health Services Needs and Demand education.field_of_study Public economics Cost–benefit analysis business.industry Health services research General Medicine Evidence-based medicine Medical research Equipment and Supplies Pharmaceutical Preparations Health Services Research Health Expenditures business Delivery of Health Care |
| Zdroj: | European Journal of Clinical Investigation. 43:469-475 |
| ISSN: | 0014-2972 |
| Popis: | Background Expenditure on industry products (mostly drugs and devices) has spiraled over the last 15 years and accounts for substantial part of healthcare expenditure. The enormous financial interests involved in the development and marketing of drugs and devices may have given excessive power to these industries to influence medical research, policy, and practice. Material and methods Review of the literature and analysis of the multiple pathways through which the industry has directly or indirectly infiltrated the broader healthcare systems. We present the analysis of the industry influences at the following levels: (i) evidence base production, (ii) evidence synthesis, (iii) understanding of safety and harms issues, (iv) cost-effectiveness evaluation, (v) clinical practice guidelines formation, (vi) healthcare professional education, (vii) healthcare practice, (viii) healthcare consumer's decisions. Results We located abundance of consistent evidence demonstrating that the industry has created means to intervene in all steps of the processes that determine healthcare research, strategy, expenditure, practice and education. As a result of these interferences, the benefits of drugs and other products are often exaggerated and their potential harms are downplayed, and clinical guidelines, medical practice, and healthcare expenditure decisions are biased. Conclusion To serve its interests, the industry masterfully influences evidence base production, evidence synthesis, understanding of harms issues, cost-effectiveness evaluations, clinical practice guidelines and healthcare professional education and also exerts direct influences on professional decisions and health consumers. There is an urgent need for regulation and other action towards redefining the mission of medicine towards a more objective and patient-, population- and society-benefit direction that is free from conflict of interests. |
| Databáze: | OpenAIRE |
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