Free meals from drugmakers sway doctors' prescriptions, big review finds
Gifts, payments and even free meals from drug companies push doctors toward more prescriptions and pricier, less fitting drugs, a Cochrane review of 93 studies finds. The more meals a doctor got, the more of the company's drug they prescribed. Strict hospital rules on industry contact appeared to help.
Drug company marketing changes how doctors prescribe, and not for the better, according to a large new review of the research.
The review, published this week in the Cochrane Database of Systematic Reviews, pulled together 93 studies covering millions of prescribers. Most came from the United States, where a 2010 law, the Sunshine Act, requires drug companies to publicly report payments to doctors.
The researchers found that gifts and payments to doctors were linked to less appropriate prescribing, more prescriptions and probably higher costs. Sales visits and company-sponsored education showed a similar pattern.
Even small gifts mattered. "Doctors often think that this is trivial and doesn't influence them, that they can't be bought for the price of a sandwich," said lead author Dr. Barbara Mintzes of the University of Sydney. But the data show the more free meals a doctor received from a company, the more of that company's drug they prescribed, Medical Xpress reported. That held for blood pressure drugs, cholesterol drugs, antidepressants and opioid painkillers.
Opioids were the starkest example. One study in the review found doctors prescribed 9.3% more opioids for each extra meal they got from drug companies in the prior year, U.S. Right to Know reported.
The money is large. In 2025, drug and device makers reported $2.6 billion in non-research payments to U.S. doctors, including meals, travel and speaking fees.
There was hopeful news, too. Hospitals and medical schools with strict conflict-of-interest rules, such as bans on gifts or limits on sales rep visits, saw better prescribing. Evidence on free drug samples was too weak to judge.
Most studies looked at a single point in time, so they show a link rather than proof of cause.
Patients can look up payments their own doctors received on the federal Open Payments website, run by the Centers for Medicare & Medicaid Services.
What we know: Industry gifts are tied to more and costlier prescriptions.
What we don't: How much of that link is cause and effect.
Where outlets agree U.S. Right to Know and The Sydney Morning Herald both report that the Cochrane review covered 93 studies of drug company marketing.
Where they differ The outlets cited here report the same key facts so far.