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Exposure to COI policies during residency reduces rate of brand antidepressant prescriptions
Date:1/18/2013

nd medications even if they were more expensive or less suitable for patients than generic alternatives.

To assess the effects of COI policies on physicians' prescribing patterns after residency, the research team examined 2009 prescribing data from IMS Health for 1,652 psychiatrists from 162 residency programs. The physicians fell into two categories: about half graduated residency in 2001, before COI training guidelines were implemented, while the other half graduated residency in 2008, after many medical centers adopted COI policies. Physicians were also categorized based on the restrictiveness of the COI policies adopted by their residency programs' medical centers. Results of the study show that, although rates of prescribing brand antidepressants, including those that were heavily promoted and brand reformulations, were lower among 2008 graduates than 2001 graduates in general, the rates were lowest for 2008 graduates of residency programs with very restrictive COI policies.

The results suggest that COI policies reduce the appeal of antidepressant medications marketed heavily by pharmaceutical companies. Because brand-name medications tend to be more expensive, Epstein says a shift away from them could help reduce cost growth. However, he cautions that lower costs achieved through stringent COI policies may come at a price.

"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," said Epstein. "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."

The study provides the first empirical evidence of the effects of COI policies, specifically pertaining to antidepressants. Epstein n
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Contact: Katie Delach
katie.delach@uphs.upenn.edu
215-349-5964
University of Pennsylvania School of Medicine
Source:Eurekalert

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