A group of GPs are launching a new campaign to stop doctors from meeting drug company sales representatives.
Doctors and academics devised the No Advertising Please campaign to combat the hard sell used by pharmaceutical companies.
Australia's pharmaceutical industry has an annual turnover of more than $23 billion, with a large part of the marketing budget spent on sales representatives.
There are concerns drug representatives influence what medications doctors prescribe, resulting in patients getting drugs they do not really need or a certain brand being prescribed over others.
The No Advertising Please campaign is calling on all GPs to make a pledge and display a sign saying they will refuse to see drug company sales representatives.
Although the Australian Medical Association (AMA) says the companies make a valuable contribution to education and research, campaigner Dr Justin Coleman wants doctors to stop seeing drug company representatives completely.
"The pharmaceutical representatives are essentially marketing drugs and what we're after is doctors deciding which drug is best based on the best evidence, as opposed to their best marketing," he said.
GP Dr Geoff Spurling, who has reviewed 58 international studies looking at the impact of pharmaceutical marketing on the prescribing habits of doctors, said doctors who saw drug representatives were much more likely to prescribe the promoted drug than those who had not.
"It's all about the money, patient safety and patient whatever is really quite secondary, and I think doctors sometimes don't get that," Dr Spurling said.
"They kid themselves with the lunches and the little perks and the nice interaction at morning tea that they are doing something beneficial for their patients but there is no evidence for that.
"We found that doctors who saw drug reps were more than twice as likely to prescribe the promoted drug than doctors who hadn't seen drug reps.
"I think it is important to make sure you're prescribing reflects the best interests of patient safety rather than the shareholders of pharmaceutical companies."
Pressure on drug company representatives to meet sales targets
Baillie Ferris, an intern based at Queensland's Ipswich Hospital who worked as a drug company sales representative before studying medicine, said his previous job required him to make the pharmaceuticals sound as good as possible.
"You don't want to be talking about the negatives," he said.
"At the start of every quarter you are given sales targets, 'we want you to sell this much of Drug A or Drug B', and that's the underlying message; get out there and try to get GPs to prescribe your medication, basically."
Australia has a self-regulated code of conduct regarding sales representatives, created by Medicines Australia which represents companies that develop drugs.
The code states that representatives can offer free samples of drugs, other branded office items and provide perks such as meals.
Mr Ferris said he would often buy meals when trying to make a sale.
"Some surgeries would have a specific thing they would prefer, some would rather you just go to Woollies and grab some salad, some would say 'there's a good local Indian store that is pretty cheap," he said.
"So there is a bit of trying to please them on that front and trying to make sure that they are aware that your drug does this and you should use it."
Drug companies important sources of research funds
AMA representative Dr Brian Morton said he is visited by sales representatives at his Sydney medical practice most days, but does not see any need to stop the meetings.
"I think the campaign is a bit silly, it's insulting to doctors, it's also rather naive; our world revolves around education and information and the pharmaceutical companies are an important source of money for research, so every Australian will benefit from that research and pharmaceutical promotion," Dr Morton said.
"There is very little they can offer as an inducement any more and that is quite a good thing, it keeps everyone honest. The types of things are a simple meal, lunch, an educational meeting after surgery.
"If it were lunch at a hotel with wine etcetera that would be totally inappropriate, but a sandwich from a sales rep and a chance to sit with colleagues and discuss issues allows me to also be educated properly."
The pharmaceutical industry is also warning that the campaign could leave patients worse off, denying doctors the most up-to-date information about a new drug.
"We've got some of the most highly educated doctors in Australia, these are very clever people, and I can't believe they are going to be influenced by trivial things," Medicine Australia chairman Martin Cross said.