Pokorny, Adrian

Bero L

Fox P

Karikios D

McEwin E

Moynihan R

Mintzes B

2023-06-01

OBJECTIVES: To understand how and why Australian cancer physicians interact with the pharmaceutical industry. DESIGN: Qualitative study using semistructured interviews, performed by a medical oncologist. Thematic analysis using a combination of deductive and inductive codes. SETTING: Given the evidence on industry influences on clinical practice and the importance to the market of oncology drugs, we sought to better understand cancer physicians' experiences. Practising consultant medical oncologists and clinical haematologists from four Australian states were interviewed over Zoom. PARTICIPANTS: 16 cancer physicians were interviewed between November 2021 and March 2022, from 37 invited (response rate 43%). Most were medical oncologists (n=12 of 16, 75%) and male (n=9 of 16, 56%). OUTCOME MEASURES: The analysis of all interviews was based on grounded theory. Transcripts were coded and then codes formed into themes with supporting quotes. The themes were then placed into categories, used to describe the broad areas into which the themes could be grouped. RESULTS: Six themes were identified that fell within two broad categories: cancer physicians' views and experiences of interactions and management of these interactions. Views and experiences included: the transactional nature of relationships, risks of research dependence, ethical challenges and varied attitudes based on interaction type. Management themes included: lack of useful guidance and reduced interactions during the COVID-19 pandemic. These led to an overarching seventh theme, on the desire for a 'middle road'. Cancer physicians identified the transactional nature of industry relationships and felt uncomfortable with several types of interactions, including those with sales representatives. Most wanted less contact with industry, and the forced separation that occurred with the COVID-19 pandemic was generally welcome. CONCLUSIONS: Cancer physicians may have difficulty balancing the perceived need to interact with industry in modern cancer care while maintaining distance to minimise conflicts of interest. Further research is needed to assess management strategies in this area.

Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia apokorny@uni.sydney.edu.au.

Department of Medical Oncology, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.

Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.

Center for Bioethics and Humanities, University of Colorado-Anschutz Medical Campus, Denver, Colorado, USA.

Central West Cancer Care Centre, Orange Health Service, Orange, New South Wales, Australia.

School of Medicine, Western Sydney University, Orange, New South Wales, Australia.

Department of Medical Oncology, Nepean Hospital, Kingswood, New South Wales, Australia.

Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia.

BMJ Open . 2023 May 26;13(5):e065719. doi: 10.1136/bmjopen-2022-065719.

0000-0002-6987-0499

0000-0003-1893-6651

0000-0002-8671-915X

https://pubmed.ncbi.nlm.nih.gov/37236664/?otool=iaurydwlib

https://hdl.handle.net/10137/12470

13

Humans

Male

Attitude of Health Personnel

Australia

Conflict of Interest

COVID-19

*Drug Industry

*Medical Oncology

Neoplasms

Pandemics

*Physicians

Qualitative Research

Female

Interactions between Australian cancer physicians and the pharmaceutical industry: a qualitative study.

Journal Article

Publication