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Posted on Tuesday 29 January 2013

It was the best of times…
Conflicts Policies And Antidepressant Prescribing
By Ed Silverman
January 29th, 2013

Do conflict of interest policies adopted by residency programs actually work? To test this notion, a group of researchers examined prescribing data for several widely promoted antidepressants and found that psychiatrists who encountered restrictive policies were less likely to prescribe the drugs than those who did not have to contend with such policies. Specifically, the University of Pennsyvlania researchers compared psychiatry residents who graduated in 2001, before such policies were instituted, and 2008, when the Association of American Medical Colleges developed consensus principles of conflict of interest policies and one year after the American Medical Student Association began a ‘PharmFree’ scorecard. They found that, relative to 2001 graduates in the same residency group, 2008 graduates in programs with ‘maximally restrictive’ conflict policies prescribed heavily marketed antidepressants significantly less than 2008 graduates in programs with ‘minimally restrictive’ and ‘moderately restrictive’ policies, or 4.3 percent and 3.6 percent, respectively…

“The study is the first of its kind to show that exposure to COI policies for physicians during residency training – in this case, psychiatrists – is effective in lowering their post-graduation rates of prescriptions for brand medications, including heavily promoted and brand reformulated antidepressants,” the reseachers say in a statement.

psychiatry coi prescribing

The researchers, whose study appears in Medical Care, analyzed the proportion of prescriptions written by 1,652 psychiatrists, about half of whom graduated in 2001 and the others in 2008. They accounted for 901,805 prescriptions written for antidepressants in 2009 [here is the abstract]…

“Contact with the pharmaceutical industry may have important informational benefits for physicians. And, by exposing trainees to industry representatives, we may be helping them prepare to navigate these relationships after graduation,” says Andrew Epstein, research associate professor of medicine at the Perelman School of Medicine at the University of Pennsylvania, and lead author on the study. “Nevertheless, while these relationships may be useful in some ways, our study clearly shows that implementation of COI policies have helped shield physicians from the often persuasive aspects of pharmaceutical promotion,” he concluded…

Last year, the AMSA noted that more medical schools are adopting policies that warrant good grades. In the most recent annual scorecard last March, 102 medical schools out of a total of 152 – or 67 percent – were given a grade of A or B for their policies governing interactions between drugmakers and faculty and students [back story].
This is my favorite kind of study because it addresses a question I didn’t know the answer to. Can you change prescribing behavior  by restricting access to pharmaceutical representatives. Looks like the answer is "Yes!"

and the worst of times…
Commercialization as a Tenure Criterion: A Powerful Incentive for Faculty Inventors
Technology Transfer Tactics
Formats: Live Webinar, On-Demand Video, DVD, or PDF Transcript
March 19, 2013

The push for commercialization of university research has become more like a giant shove. Federal and state governments are pinning their hopes on it, economic development agencies work hard to enable it, and university presidents demand it. Pitch competitions, accelerators, funding schemes, outreach efforts, partnerships, incubators, and mentoring programs abound, all trying to encourage it. But there is one glaring, gigantic disconnect in the innovation ecosystem: tenure policy.

While the drumbeat sounds for new models of entrepreneurship and commercialization support, a very old model — steeped in the academic traditions of yesteryear — presents a major barrier to realizing the full potential of university innovations. Tenure policies, which reward publishing and teaching but do nothing to incentivize commercialization, arguably represent the single biggest missing link in the innovation ecosystem that so many now agree is critical to economic growth, jobs, and global competitiveness.

These policies — if they are adjusted to take commercial-focused research into account — also represent a tremendous untapped opportunity for universities to unleash a deluge of research with market potential, by simply rewarding the behavior that forms the essential foundation for the dynamic innovation activity the world is clamoring for. But changing the entrenched system is anything but simple…
When I got this link, I thought it was a Satire or a joke someone was playing on me. My mind started generating titles like "Conflict of Interest: Making it work for you!", "How to get the most out of your ghost-witer", or "Key Opinion Leader: Making a reputation you can sell". But then I realized they were dead serious. There’s a subgroup in the specialty of psychiatry that is a living testimony to what’s wrong with this idea. Oy vey!

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