Position Statement Provides Guidance on Interactions With Industry

In response to concerns raised in multiple public forums over the last few years about the closeness of the relationship between physicians and the pharmaceutical industry, APA has adopted a position statement designed to provide guidance to members on navigating issues that could raise conflict-of-interest concerns.

The principles and guidelines were developed to raise awareness of and help members manage conflict-of-interest issues whether they are clinical practitioners, educators, researchers, or administrators.

All of the principles focus on the concept that psychiatrists must be alert to any financial or "career-centered" issues that could affect their "judgment or behavior in a manner that detracts from or subordinates the primary interest of patients."

The position statement, which highlights six issues, is derived from a 2009 report by the Institute of Medicine titled "Conflicts of Interest in Medical Research, Education, and Practice." The APA statement was developed by the Assembly's Conflicts of Interest Work Group. The Assembly approved the document at its November 2010 meeting, and the Board of Trustees approved it in December 2010.

The six principles and guidelines state the following:

• Gifts and meals often accompanied by product endorsement and promotional literature may influence physicians' decisions about prescriptions, laboratory tests, or procedures.

• Contact with pharmaceutical representatives represents marketing and should be distinguished from balanced education and critical scientific information as a basis for prescribing. Medication samples and starter packets may influence decisions to prescribe products that have equivalent and less costly alternatives.

• Conflict-of-interest ethical principles and ongoing studies should be integrated parts of continuing medical education, including distinguishing marketing and promotion from balanced, scientific clinical evidence.

• Consulting arrangements with industry should be based on a substantive contribution and commensurate compensation.

• Constructive collaboration with industry for research on new products and public education for the benefit of the community should not be discouraged. However, funding should be commensurate with the research and should reflect active participation and documented remuneration. The role of the member in a scientific publication or sponsored information document should be specifically and accurately acknowledged.

• Physicians have a continuing responsibility to review the scientific and clinical evidence base for newly developed treatment options and incorporate new options for the patient populations they treat.

APA's conflict-of-interest position statement is posted at <www.psych.org/Departments/EDU/Library/APAOfficialDocumentsandRelated/PositionStatements/201005.aspx>. A summary of the Institute of Medicine report can be accessed at <www.nap.edu/catalog/12598.html>.