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Conflict of interest in physician–pharmaceutical industry interactions: Possible interventions in Nigeria medical practice

Collaboration between physicians and the pharmaceutical, medical device, and biotechnology industries results in the development of products of great benefit to the public. However, when these interactions negatively influence professional judgments at the expense of the goals of medicine, it becomes a cause of great concern. The objective of this simple review was to bring to the fore the conflicts that exist between these two important areas of patient care and to suggest ways to prevent it in Nigeria. A literature search in the PubMed, Medline, and Web of Science databases was done using the terms conflict of interest, physician, pharmaceutical, medical practice, detailing, biomedical research, bioethics, prescribing pattern, singly or in combination to identify relevant articles. The results are arranged based on the themes of related published articles. This review shows that interactions between physicians and the pharmaceutical industry have multiple areas of conflict ranging from reduction in the quality of patient care, loss of objectivity in professional education, scientific integrity, and the public’s trust in medicine. Interaction between pharmaceutical sales representatives (PSRs) and physicians commonly occur in Nigeria, affecting prescribing behavior. There is no specific regulation in place to protect against ensuing conflicts. There is a need to put in place educational programs to increase awareness among physicians of the effects of such interactions, while also instituting and implementing stringent policies curtailing physician–pharmaceutical industry and PSR relationships.