El origen de la actitud positiva de los médicos frente a la publicidad de medicamentos: una reflexión para educadores y estudiantes de medicina

Contenido principal del artículo

Jonathan Tipán-Barros
https://orcid.org/0000-0002-5648-4265
Jennifer Freire-Ochoa
https://orcid.org/0000-0002-1278-7811
German Novoa-Heckel
https://orcid.org/0000-0003-1892-3607

Resumen

La evidencia disponible demuestra que los estudiantes de medicina están prematuramente relacionados con la publicidad de medicamentos. Esta relación genera un fenómeno denominado: “socialización”, en donde los estudiantes cooperan naturalmente con la industria farmacéutica. Por consiguiente, el objetivo de la presente revisión es indagar sobre la socialización como origen de la actitud positiva frentea la publicidad de medicamentos durante la práctica profesional. A través de una revisión bajo metodología prisma se analizó la literatura académica en inglés y español desde enero de 2019 hasta junio de 2024, obteniendo tres situaciones emergentes: 1) impacto negativo de la publicidad de medicamentos al sistema de salud; 2) socialización en los estudiantes de medicina; y, 3) carentes políticas regulatorias universitarias. Se concluye que la socialización genera actitud positiva para la publicidad de medicamentos durante la formación médica y en el ejercicio profesional.

Descargas

Los datos de descargas todavía no están disponibles.

PLUMX Metrics

Detalles del artículo

Cómo citar
Tipán-Barros, J., Freire-Ochoa, J., & Novoa-Heckel, G. (2025). El origen de la actitud positiva de los médicos frente a la publicidad de medicamentos: una reflexión para educadores y estudiantes de medicina. Medicina Y Ética, 36(2), 693–739. https://doi.org/10.36105/mye.2025v36n2.06
Sección
Artículos

Citas

Brax H, Fadlallah R, Al-Khaled L, Kahale LA, Nas H, El-Jardali F. Association between physicians’ interaction with pharmaceutical companies and their clinical practices: A systematic review and meta-analysis. PLoS ONE. 2017; 12(4):e0175493. Disponible en: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0175493 DOI: https://doi.org/10.1371/journal.pone.0175493

Fickweiler F, Fickweiler W, Urbach E. Interactions between physicians and the pharmaceutical industry generally and sales representatives specifically and their association with physicians’ attitudes and prescribing habits: a systematic review. BMJ Open. 2017; 7(9):e016408. Disponible en: https://doi.org/10.1136/bmjopen-2017-016408 DOI: https://doi.org/10.1136/bmjopen-2017-016408

Fadlallah R, Alkhaled L, Brax H, Nasser M, Rajabbik MH, Nass H. Extent of physician-pharmaceutical industry interactions in low-and middle-income countries: a systematic review. Eur J Public Health. 2018; 28(2):224-30. Disponible en: https://doi.org/10.1093/eurpub/ckx204 DOI: https://doi.org/10.1093/eurpub/ckx204

Mitchell AP, Trivedi NU, Gennarelli RL, Chimonas S, Tabatabai SM, Goldberg J. Are Financial Payments from the Pharmaceutical Industry Associated with Physician Prescribing? A Systematic Review. Ann Intern Med [Internet]. 2021 [citado 15 de octubre de 2021]; 174(3):353-61. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8315858/ DOI: https://doi.org/10.7326/M20-5665

Genta-Mesa G, Flórez ID. Relación médico-industria y los conflictos de interés: aspectos históricos y normativos, impactos negativos y propuestas. Iatreia [Internet]. 2019 [citado 31 de mayo de 2020]; 32(4):298-310. Disponible en: DOI: https://doi.org/10.17533/udea.iatreia.16

https://revistas.udea.edu.co/index.php/iatreia/article/view/333905

Davari M, Khorasani E, Tigabu BM. Factors Influencing Prescribing Decisions of Physicians: A Review. Ethiop J Health Sci [Internet]. 2018 [citado 1 de septiembre de 2020]; 28(6):795-804. Disponible en: DOI: https://doi.org/10.4314/ejhs.v28i6.15

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6308758/

Altisent R, Delgado-Marroquín MT, Astier-Peña MP. Conflictos de interés en la profesión médica. Aten Primaria [Internet]. 2019 [citado 9 de noviembre de 2021];51(8):506-11. Disponible en: https://www.elsevier.es/es-revista-atencion-primaria-27-articulo-conflictos-interes-profesion-medica-S0212656719303634 DOI: https://doi.org/10.1016/j.aprim.2019.05.004

Giubilini A, Savulescu J. Beyond Money: Conscientious Objection in Medicine as a Conflict of Interests. J Bioeth Inq. 2020; 17(2):229-43.

https://doi.org/10.1007/s11673-020-09976-9 DOI: https://doi.org/10.1007/s11673-020-09976-9

Ebrahimi A, Zand S, Bagheri Amiri F, Shahi F, Jafarian A, Kaviani A. Conflict of Interest: Are Iranian Breast Cancer Specialists Prone to it? Asian Pac J Cancer Prev [Internet]. [citado 16 de mayo de 2021]; 21(6):1653-8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568883/ DOI: https://doi.org/10.31557/APJCP.2020.21.6.1653

Hollander MAG, Donohue JM, Stein BD, Krans EE, Jarlenski MP. Association between Opioid Prescribing in Medicare and Pharmaceutical Company Gifts by Physician Specialty. J Gen Intern Med. 2020; 35(8):2451-8. Disponible en: https://link.springer.com/article/10.1007/s11606-01905470-0 DOI: https://doi.org/10.1007/s11606-019-05470-0

Moynihan R. Commentary: The Voice of the People, Funded Now by Your Friendly Pharmaceutical Company. Bioethical Inquiry [Internet]. 2020 [citado 31 de agosto de 2020]; 17(1):61-3. Disponible en:

https://doi.org/10.1007/s11673-020-09965-y DOI: https://doi.org/10.1007/s11673-020-09965-y

Parker L, Williams J, Bero L. Ethical drug marketing criteria for the 21st century. BMJ [Internet]. 2018 [citado 18 de abril de 2020]; 361. Disponible en: https://www.bmj.com/content/361/bmj.k1809 DOI: https://doi.org/10.1136/bmj.k1809

Prasad P, Bajracharya SR, Deo S, Lamichhane S, Pradhan PMS, Ghimire R. Adherence of Drug Promotional Literatures Distributed by Pharmaceutical Companies to World Health Organization Ethical Criteria for Medicinal Drug Promotion. Journal of Nepal Health Research Council [Internet]. 2019 [citado 24 de septiembre de 2020]; 17(3):345-50. Disponible en: http://jnhrc.com.np/index.php/jnhrc/article/view/1840 DOI: https://doi.org/10.33314/jnhrc.v17i3.1840

Gul R, Saeed H, Saleem Z, Rasool F, Hashmi FK, Islam M. Perceptions of and barriers to ethical promotion of pharmaceuticals in Pakistan: perspectives of medical representatives and doctors. BMC Med Ethics. 2021; 22(1):2. Disponible en: https://doi.org/10.1186/s12910-020-00569-0 DOI: https://doi.org/10.1186/s12910-020-00569-0

Datta A, Dave D. Effects of Physician-directed Pharmaceutical Promotion on Prescription Behaviors: Longitudinal Evidence. Health Econ. 2017; 26(4):450-68. Disponible en: https://doi.org/10.1002/hec.3323 DOI: https://doi.org/10.1002/hec.3323

DiStefano MJ, Levin JS. Does Incorporating Cost-Effectiveness Analysis Into Prescribing Decisions Promote Drug Access Equity? AMA journal of ethics. 2019; 21(8):E679-685. DOI: https://doi.org/10.1001/amajethics.2019.679

Howard JN, Harris I, Frank G, Kiptanui Z, Qian J, Hansen R. Influencers of Generic Drug Utilization: A Systematic Review. Res Social Adm Pharm [Internet]. 2018[citado 9 de agosto de 2020]; 14(7):619-27. Disponible en: DOI: https://doi.org/10.1016/j.sapharm.2017.08.001

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5910277/

Das M, Choudhury S, Maity S, Hazra A, Pradhan T, Pal A. Generic versus branded medicines: An observational study among patients with chronic diseases attending a public hospital outpatient department. J Nat Sci Biol Med [Internet]. 2017 [citado 28 de septiembre de 2020]; 8(1):26-31. Disponible en: DOI: https://doi.org/10.4103/0976-9668.198351

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320819/

Desai RJ, Sarpatwari A, Dejene S, Khan NF, Lii J, Rogers JR. Comparative effectiveness of generic and brand-name medication use: A database study of US health insurance claims. PLoS Med [Internet]. 2019 [citado 28 de septiembre de 2020];16(3). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415809/ DOI: https://doi.org/10.1371/journal.pmed.1002763

Ammous A, Bou Zein Eddine S, Dani A, Dbaibou J, El-Asmar JM, Sadder L. Awareness and attitudes of the Lebanese population with regard to physician-pharmaceutical company interaction: a survey study. BMJ open. 2017; 7(3):e013041. Disponible en: https://bmjopen.bmj.com/content/7/3/e013041 DOI: https://doi.org/10.1136/bmjopen-2016-013041

Kanter GP, Carpenter D, Lehmann LS, Mello MM. US Nationwide Disclosure of Industry Payments and Public Trust in Physicians. JAMA Netw Open. 2019; 2(4):e191947. Disponible en: https://jamanetwork.com/journals/jamanetworkopen/ fullarticle/2730473 DOI: https://doi.org/10.1001/jamanetworkopen.2019.1947

Hwong AR, Sah S, Lehmann LS. The Effects of Public Disclosure of Industry Payments to Physicians on Patient Trust: A Randomized Experiment. Journal of General Internal Medicine. noviembre de 2017; 32(11):1186-92. Disponible en: https://doi.org/10.1007/s11606-017-4122-y DOI: https://doi.org/10.1007/s11606-017-4122-y

Fadlallah R, Nas H, Naamani D, El-Jardali F, Hammoura I, Al-Khaled L. Knowledge, Beliefs and Attitudes of Patients and the General Public towards the Interactions of Physicians with the Pharmaceutical and the Device Industry: A Systematic Review. PLoS ONE. 2016; 11(8):e0160540. Disponible en: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0160540 DOI: https://doi.org/10.1371/journal.pone.0160540

Ganashree P, Bhuvana K, Sarala N. Critical review of drug promotional literature using the World Health Organization guidelines. J Res Pharm Pract [Internet]. 2016 [citado 18 de abril de 2020]; 5(3):162-5. Disponible en: DOI: https://doi.org/10.4103/2279-042X.185711

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4966233/

Lundh A, Lexchin J, Mintzes B, Schroll JB, Bero L. Industry sponsorship and research outcome: systematic review with meta-analysis. Intensive Care Med [Internet]. 2018; 44(10):1603-12. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30132025/ DOI: https://doi.org/10.1007/s00134-018-5293-7

Lundh A, Lexchin J, Mintzes B, Schroll JB, Bero L. Industry sponsorship and research outcome. Cochrane Database Syst Rev. 16 de 2017;2:MR000033. DOI: https://doi.org/10.1002/14651858.MR000033.pub3

Devji T, Busse JW. Cochrane in CORR®: Industry Sponsorship and Research Outcome. Clin Orthop Relat Res [Internet]. 2017 [citado 29 de septiembre de 2020]; 475(9):2159-64. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539042/ DOI: https://doi.org/10.1007/s11999-017-5421-7

Tipán Barros JM, Zavala-Calahorrano A, Estévez Montalvo LE. Bioética y la promoción de medicamentos. ATENEO [Internet]. 2021 [citado 3 de julio de 2021]; 23(1):89-100. Disponible en: https://colegiomedicosazuay.ec/ojs/index.php/ateneo/article/view/136

Yimenu DK, Demeke CA, Kasahun AE, Siraj EA, Wendalem AY, Bazezew ZA. Health professional’s exposure, attitude, and acceptance of drug promotion by industry representatives: A cross-sectional study in Ethiopia. Sci Prog. 2021; 104(2):368504211029435. DOI: https://doi.org/10.1177/00368504211029435

Shakeel S, Nesar S, Iffat W, Fatima B, Maqbool T, Jamshed S. A quantitative insight of the interactions of prescribers with pharmaceutical organization’s representatives in clinical settings of Karachi. Integr Pharm Res Pract [Internet]. 2019 [citado 18 de abril de 2020]; 8:75-83. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613537/ DOI: https://doi.org/10.2147/IPRP.S196318

Khazzaka M. Pharmaceutical marketing strategies’ influence on physicians’ prescribing pattern in Lebanon: ethics, gifts, and samples. BMC Health Serv Res. 2019; 19(1):80. DOI: https://doi.org/10.1186/s12913-019-3887-6

Altawalbeh SM, Ibrahim IA, Al-Shatnawi SF. Influence of pharmaceutical promotion on prescribers in Jordan. Int J Clin Pharm. 2020; 42(2):744-55. DOI: https://doi.org/10.1007/s11096-020-01006-3

Ding M, Eliashberg J, Stremersch S. Innovation and Marketing in the Pharmaceutical Industry. 1.a ed. New York: Springer; 2014. DOI: https://doi.org/10.1007/978-1-4614-7801-0

Bhatt P. Study on Influence of Medical Representative in Conversation of Doctor’s Prescription in India. Global Journal of Management And Business Research [Internet]. 2018 [citado 30 de mayo de 2020]; Disponible en:

https://pubmed.ncbi.nlm.nih.gov/33623031/

Hailu AD, Workneh BD, Kahissay MH. Influence of pharmaceutical marketing mix strategies on physicians’ prescribing behaviors in public and private hospitals, Dessie, Ethiopia: a mixed study design. BMC Public Health. 2021; 21(1):65. DOI: https://doi.org/10.1186/s12889-020-10063-2

World Health Organization. Ethical criteria for medicinal drug promotion. 1988;16. Disponible en: https://apps.who.int/iris/handle/10665/38125

Red Panamericana de Armonización de la Reglamentación Farmacéutica. OPS / OMS. 2013 [citado 24 de mayo de 2020]. Criterios éticos para la promoción, propaganda y publicidad de medicamentos. Disponible en: https://www.paho.org/hq/index.php?option=com_content&view=article&id=9145:2013-criterios-eticos-promocion-propaganda-publicidad-medicamentos-2013&Itemid=3562&lang=es

World Health Organization, Health Action International. Understanding and responding to pharmaceutical promotion: a practical guide for educators and students [Internet]. IGI Global; 2016 [citado 29 de abril de 2024]. Disponible en:

http://haiweb.org/wp-content/uploads/2015/05/Pharma-Promotion-Guide-English.pdf

Lexchin J. Models for financing the regulation of pharmaceutical promotion. Global Health. 2012; 8:24. DOI: https://doi.org/10.1186/1744-8603-8-24

Pashley D, Ozieranski P, Mulinari S. Disclosure of Pharmaceutical Industry Funding of Patient Organisations in Nordic Countries: Can Industry Self-Regulation Deliver on its Transparency Promise? Int J Health Serv. 2022; 52(3):347-62. DOI: https://doi.org/10.1177/00207314221083871

Salmane-Kulikovska I, Poplavska E, Mezinska S, Dumpe V, Dauvarte H, Lazdina L. Medical, pharmacy and nursing students in the Baltic countries: interactions with the pharmaceutical and medical device industries. BMC Med Educ [Internet]. 2020 [citado 27 de septiembre de 2020];20. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137495/ DOI: https://doi.org/10.1186/s12909-020-02008-5

Saito S, Maeno T, Miyata Y, Maeno T. Medical students’ attitudes toward interactions with the pharmaceutical industry: a national survey in Japan. BMC Medical Education [Internet]. 2018 [citado 30 de mayo de 2020]; 18(1):286. Disponible en: https://doi.org/10.1186/s12909-018-1394-9 DOI: https://doi.org/10.1186/s12909-018-1394-9

Scheffer P, Guy-Coichard C, Outh-Gauer D, Calet-Froissart Z, Boursier M, Mintzes B. Conflict of Interest Policies at French Medical Schools: Starting from the Bottom. PLoS One [Internet]. 2017 [citado 27 de septiembre de 2020]; 12(1). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5221756/ DOI: https://doi.org/10.1371/journal.pone.0168258

Cuellar LRO, Sandoval RNC, Benavides WJP. Actitud de los estudiantes de medicina frente al marketing farmacéutico en Perú. Revista Cubana de Salud Pública [Internet]. 2020 [citado 10 de noviembre de 2021]; 46(2). Disponible en: https://pubmed.ncbi.nlm.nih.gov/33623031/

Domeyer PJ, Katsari V, Sarafis P, Aletras V, Niakas D. Greek students’ attitudes, perception and knowledge regarding generic medicines in times of economic crisis: a cross-sectional study. BMC medical education. 2018; 18(1):262. DOI: https://doi.org/10.1186/s12909-018-1379-8

Filippiadou M, Kouvelas D, Garyfallos G, Tsakiridis I, Tzachanis D, Spachos D. Exposure to the drug company marketing in Greece: Interactions and attitudes in a non-regulated environment for medical students. Annals of Medicine and Surgery [Internet]. 2017 [citado 9 de octubre de 2020]; 19:23-8. Disponible en: http://www.sciencedirect.com/science/article/pii/S2049080117301577 DOI: https://doi.org/10.1016/j.amsu.2017.05.013

Makowska M, Kaczmarek E, Rodzinka M. Transparency or restricting gifts? Polish medical students’ opinions about regulating relationships with pharmaceutical sales representatives. Monash Bioeth Rev., 2021. DOI: https://doi.org/10.1007/s40592-021-00128-2

De Ferrari A, Gentille C, Davalos L, Huayanay L, Malaga G. Attitudes and Relationship between Physicians and the Pharmaceutical Industry in a Public General Hospital in Lima, Peru. PLoS One [Internet]. 2014 [citado 1 de septiembre de 2020]; 9(6). Disponible en: DOI: https://doi.org/10.1371/journal.pone.0100114

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4076259/

Rafique S, Sarwar W, Rashid A, Sheerin F. Influence of free drug samples on prescribing by physicians: A cross sectional survey. J Pak Med Assoc. 2017;67(3):465-7.

Lussier MT, Diallo FB, Pluye P, Grad R, Lessard A, Rhéaume C. Drug samples in family medicine teaching units: a cross-sectional descriptive study. Can Fam Physician [Internet]. 2018 [citado 26 de septiembre de 2020]; 64(12):e546-52. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371885/

Leonardo Alves T, Lexchin J, Mintzes B. Medicines Information and the Regulation of the Promotion of Pharmaceuticals. Sci Eng Ethics [Internet]. 2019 [citado 2 de septiembre de 2022]; 25(4):1167-92. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647516/

Chen X. Pharmaceutical Sales Representatives in the United States and China: The Need for Professional Public Space. Health Care Anal [Internet]. 2021 [citado 2 de enero de 2022]; 1-22. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8580741/ DOI: https://doi.org/10.1007/s10728-021-00438-w

Piller C. Disgraced researchers can still reap drug industry payouts. Science. 2020; 370(6512):27. DOI: https://doi.org/10.1126/science.370.6512.27

Cialdini RB. The Psychology of Persuasion. [Internet]. Quill. New York; 1984 [citado 1 de septiembre de 2020]. Disponible en:

https://www.goodreads.com/work/best_book/29303-influence-how-and-why-people-agree-to-things

Faisal A, Ahmad MS, Thurasamy R, Ahmed R. Doctors’ Interactions with Pharmaceutical Sales Representatives: Modelling Doctors Prescription Behaviour. Community Ment Health J. 2020; 56(3):456-63. DOI: https://doi.org/10.1007/s10597-019-00501-w

Jandhyala R. Influence of Pharmaceutical Company Engagement Activities on the Decision to Prescribe: A Pilot Survey of UK Rare Disease Medicine Prescribers. Pharmaceut Med. 2020; 34(2):127-34. DOI: https://doi.org/10.1007/s40290-019-00323-x

Leonardo Alves T, Lexchin J, Mintzes B. Medicines Information and the Regulation of the Promotion of Pharmaceuticals. Sci Eng Ethics [Internet]. 2019 [citado 11 de octubre de 2020]; 25(4):1167-92. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647516/ DOI: https://doi.org/10.1007/s11948-018-0041-5

Tijdink JK, Smulders YM, Bouter LM, Vinkers CH. The effects of industry funding and positive outcomes in the interpretation of clinical trial results: a randomized trial among Dutch psychiatrists. BMC Med Ethics. 18 de 2019; 20(1):64. DOI: https://doi.org/10.1186/s12910-019-0405-7

Mitchell AP, Winn AN, Lund JL, Dusetzina SB. Evaluating the Strength of the Association Between Industry Payments and Prescribing Practices in Oncology. Oncologist. 2019; 24(5):632-9. DOI: https://doi.org/10.1634/theoncologist.2018-0423

Strong C. Why academic medical centers should ban drug company gifts to individuals. Am J Bioeth. 2010; 10(1):13-5. DOI: https://doi.org/10.1080/15265160903441061

Hajjar R, Bassatne A, Cheaito MA, Naser El Dine R, Traboulsy S, Haddadin F. Characterizing the interaction between physicians, pharmacists and pharmaceutical representatives in a middle-income country: A qualitative study. PLoS ONE. 2017;12(9):e0184662. DOI: https://doi.org/10.1371/journal.pone.0184662

Jacob NT. Drug promotion practices: A review. Br J Clin Pharmacol. 2018; 84(8):1659-67. Disponible en: https://doi.org/10.1111/bcp.13513 DOI: https://doi.org/10.1111/bcp.13513

Cialdini RB. Influence: The Psychology of Persuasion. New York: Harper Collins USA; 2006.

Makowska M. How Polish medical students are socialised to cooperate with the pharmaceutical industry: a focus group study of the importance of informal, hidden and null curricula. Health Sociol Rev. 2021;1-15. DOI: https://doi.org/10.1080/14461242.2021.1899842

Al-Areefi MA, Ibrahim MIM, Hassali MAA, Alfadl AA. Relationships between physicians’ characteristics and practice-setting factors and their attitude towards drug promotion. Journal of Pharmaceutical Health Services Research [Internet]. 2019 [citado 9 de noviembre de 2021]; 10(3):325-32. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/jphs.12284 DOI: https://doi.org/10.1111/jphs.12284

Williams J, Lipworth W, Mayes C, Olver I, Kerridge I. Should disclosure of conflicts of interest in medicine be made public? Medical students’ views. Med Educ. 2017; 51(12):1232-40. Disponible en: https://doi.org/10.1111/medu.13383 DOI: https://doi.org/10.1111/medu.13383

Chimonas S, DeVito NJ, Rothman DJ. Bringing Transparency to Medicine: Exploring Physicians’ Views and Experiences of the Sunshine Act. Am J Bioeth. 2017; 17(6):4-18. Disponible en: https://doi.org/10.1080/15265161.2017.1313334 DOI: https://doi.org/10.1080/15265161.2017.1313334

Schwartz LM, Woloshin S. Medical Marketing in the United States, 1997-2016. JAMA [Internet]. 2019 [citado 31 de agosto de 2020]; 321(1):80-96. Disponible en: https://jamanetwork.com/journals/jama/fullarticle/2720029 DOI: https://doi.org/10.1001/jama.2018.19320

Stark TJ, Brownell AK, Brager NP, Berg A, Balderston R, Lockyer JM. Exploring Perceptions of Early-Career Psychiatrists About Their Relationships With the Pharmaceutical Industry. Acad Psychiatry [Internet]. 2016 [citado 12 de diciembre de 2020]; 40(2):249-54. Disponible en: https://doi.org/10.1007/s40596-015-0403-0 DOI: https://doi.org/10.1007/s40596-015-0403-0

Austad KE, Avorn J, Kesselheim AS. Medical students’ exposure to and attitudes about the pharmaceutical industry: a systematic review. PLoS Med. 2011; 8(5):e1001037. Disponible en: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001037 DOI: https://doi.org/10.1371/journal.pmed.1001037

Grande D, Frosch DL, Perkins AW, Kahn BE. Effect of exposure to small pharmaceutical promotional items on treatment preferences. Arch Intern Med. 2009; 169(9):887-93. Disponible en: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/773513 DOI: https://doi.org/10.1001/archinternmed.2009.64

Fadare JO, Oshikoya KA, Ogunleye OO, Desalu OO, Ferrario A, Enwere OO. Drug promotional activities in Nigeria: impact on the prescribing patterns and practices of medical practitioners and the implications. Hosp Pract (1995). 2018; 46(2):77-87. Disponible en: https://doi.org/10.1080/21548331.2018.1437319 DOI: https://doi.org/10.1080/21548331.2018.1437319

Makowska M, Sillup G, Lee M. Pharma’s marketing influence on medical students and the need for culturally competent and stricter policy and educational curriculum in medical schools: A comparative analysis of social scientific research between Poland and the U.S. Journal of Healthcare Ethics & Administration [Internet]. 2017 [citado 1 de mayo de 2024];2(2). Disponible en: https://www.researchgate.net/publication/321873999_Pharma’s_Marketing_Influence_on_Medical_Students_and_the_Need_for_Culturally_Competent_and_Stricter_Policy_and_Educational_Curriculum_in_Medical_Schools_A_Comparative_Analysis_of_Social_Scientific_Res DOI: https://doi.org/10.22461/jhea.6.7161

Ehringhaus SH, Weissman JS, Sears JL, Goold SD, Feibelmann S, Campbell EG. Responses of medical schools to institutional conflicts of interest. JAMA. 2008;299(6):665-71. DOI: https://doi.org/10.1001/jama.299.6.665

Bechoux L, De Vleeschouwer O, Vanheuverzwijn C, Verhegghen F, Detiffe A, Colle F. Conflict of interest policies at Belgian medical faculties: Cross-sectional study indicates little oversight. PLoS One. 2021; 16(2):e0245736. DOI: https://doi.org/10.1371/journal.pone.0245736

Carlat DJ, Fagrelius T, Ramachandran R, Ross JS, Bergh S. The updated AMSA scorecard of conflict-of-interest policies: a survey of U.S. medical schools. BMC Medical Education [Internet]. 2016 [citado 1 de mayo de 2024];16(1):202. Disponible en: https://doi.org/10.1186/s12909-016-0725-y DOI: https://doi.org/10.1186/s12909-016-0725-y

Casado M, López M. Manual de Bioética Laica. Edicions de la Universitat de Barcelona. Barcelona y Sevilla; 2018.

Malik F, Junaid M, Sharif I. Exploring the Role of Pharmaceutical Marketing on Physician Ethical Behaviors: A Grounded Theory Study; 1991.

Mirzaei A, Carter SR, Schneider CR. Marketing activity in the community pharmacy sector – A scoping review. Research in Social and Administrative Pharmacy [Internet]. 2018 [citado 30 de noviembre de 2020]; 14(2):127-37. Disponible en: http://www.sciencedirect.com/science/article/pii/S1551741117303315 DOI: https://doi.org/10.1016/j.sapharm.2017.03.056

Workneh BD, Gebrehiwot MG, Bayo TA, Gidey MT, Belay YB, Tesfaye DM. Influence of Medical Representatives on Prescribing Practices in Mekelle, Northern Ethiopia. PLoS One [Internet]. 2016 [citado 30 de mayo de 2020]; 11(6). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911221/ DOI: https://doi.org/10.1371/journal.pone.0156795

Kruijtbosch M, Göttgens-Jansen W, Floor-Schreudering A, van Leeuwen E, Bouvy ML. Moral dilemmas of community pharmacists: a narrative study. Int J Clin Pharm [Internet]. 2018 [citado 22 de junio de 2021]; 40(1):74-83. Disponible en: https://doi.org/10.1007/s11096-017-0561-0 DOI: https://doi.org/10.1007/s11096-017-0561-0

Ortiz SE, Rosenthal MB. Medical Marketing, Trust, and the Patient-Physician Relationship. JAMA [Internet]. 2019 [citado 8 de abril de 2022]; 321(1):40-1. Disponible en: https://doi.org/10.1001/jama.2018.19324 DOI: https://doi.org/10.1001/jama.2018.19324