TORONTO, Oct 8, 2026 – Doctors’ prescribing habits are heavily influenced by payments, gifts, and free meals from pharmaceutical companies, leading to more expensive, less appropriate and more drugs being prescribed, a new Cochrane review finds. This can seriously harm both individual patients and health systems.

Pharmaceutical companies use a variety of strategies to market and promote their drugs. This can include one-on-one visits by sales reps to doctors' offices and hospitals, gifts and payments including for example paid meals, travel costs to conferences, entertainment, consulting fees, honoraria for participation in advisory boards, and advertising.

For all new medicines, pharmaceutical companies target prescribers with offers of free meals and other gifts and payments. These payments and gifts lead to prescribing of the company's promoted drug, which may not always be needed or be the most appropriate or affordable medicine for each patient.

Less appropriate prescribing and higher medicine costs

The review included 93 studies involving a number of different study types. Almost all of these studies observed real-world prescribing patterns rather than running controlled experiments. The majority of the studies (88 per cent) came from the United States, in part because the requires pharmaceutical companies to publicly report details of all payments to doctors, which are compiled in a publicly searchable and analyzable database.

However, co-author 91��ɫ Professor Emeritus Dr. Joel Lexchin, who has studied drug prescribing in Canada for the past 40 years, points out that the ways drugs are prescribed in Canada generally follows what the U.S. does.

“This review puts to rest the myth that doctors prescribing benefit from exposure to drug company promotors. Overwhelmingly, we found in the three dimensions of prescribing that we examined – appropriateness, cost and quantity – that prescribing deteriorates,” says Lexchin of the Faculty of Health.

Analyzing millions of prescribers, the authors grouped industry interactions into three distinct categories to examine how each one affects a doctor's prescribing habits. These were advertising and education, gifts and payments, and free samples. The authors also looked at conflict-of-interest policies as a mitigation strategy.

Advertising and education, such as sales rep visits, seemed linked to prescribing that was less clinically suitable and pricier, with fairly strong evidence that it also drove up prescription volume.

The largest and most consistent body of evidence covered gifts and payments. Gifts and payments were also linked to less appropriate prescribing, more prescriptions, and probably increased costs.

The evidence was too sparse or weak to draw clear conclusions on free drug samples and whether promotion affects hospitals’ approved formularies, although what little exists suggests it might.

“Overall, when doctors have more contact with drug company promotion, prescribing tends to become less appropriate, more frequent, and more expensive”, says study author Dr Lisa Bero from the University of Colorado Anschutz, USA. “This is problematic for a number of reasons and it matters because it directly affects patient care. These less appropriate, more expensive drugs can have fewer benefits or more side-effects than alternatives, or simply be unnecessary in the clinical context.”

The overprescription of opioids is the most infamous example of pharmaceutical companies’ promotion exaggerating benefits and minimizing harms. This review found that even inexpensive meals increased opioid prescribing and that the more payments a doctor received from opioid manufacturers, the more likely they were to prescribe dangerously high opioid doses. The widespread inappropriate overprescribing of opioids has led to an epidemic of addiction and deaths from overdoses.

“Patients should be offered the most appropriate treatment for their condition, based on clinical evidence not industry marketing,” adds Dr Bero. “The opioid crisis in North America was perhaps the most egregious example of inappropriate over-prescribing, but this was not an isolated incident. It was high-profile due to the significant harms involved, but the systems that enabled it are unfortunately considered business-as-usual within the industry. Interactions between pharmaceutical companies and prescribing physicians are widespread, and the harms they cause are rarely so visible.”

More meals paid for, more drugs prescribed

Notably, the research shows a clear dose-response relationship between paid-for meals and inappropriate prescriptions. The more meals a doctor received from a company, the more of the company's drug they prescribed. This was true for a range of different types of drugs, from drugs for high blood pressure and cholesterol to antidepressants and opioid painkillers.

The authors also point out that this practice is seen as normal and unproblematic in the medical field.  

“It's very common for doctors to receive free meals from companies,” says lead author, Dr Barbara Mintzes from the University of Sydney, Australia. “Doctors often think that this is trivial and doesn’t influence them, that they ‘can’t be bought for the price of a sandwich’, but the data shows this is an effective marketing strategy. The more free meals a doctor receives, the more likely they are to prescribe less appropriate or more expensive drugs.”

Restricting industry interactions may improve prescribing

Some hospitals and medical centres have rules or institutional restrictions in place, also known as conflict-of-interest policies, to limit how much contact industry reps can have with doctors or what gifts or samples they are allowed to provide. The review found that these can mitigate the negative impact of pharma strategies on doctors’ prescribing habits.

“It’s encouraging to see that robust conflict-of-interest policies in place tended to be effective,” Dr Mintzes says. “The data shows that they probably improve prescribing appropriateness and possibly reduce the number of prescriptions.”

While this review found that drug promotion negatively influences prescribing within a broad range of drugs and clinical settings, the authors wish to emphasize that this is not about a few "bad apples”, but about improving the system and a key positive finding is that strict conflict-of-interest policies are a way forward.

was published in the Cochrane Database of Systematic Reviews.  

-30-

For further information, contact:  

Sandra McLean, 91��ɫ, sandramc@yorku.ca

Mia Parkinson, Cochrane Press Office, mparkinson@cochrane.org o�� press@cochrane.org,  +44 20 4591 8310  

The post Pharmaceutical company marketing negatively influences prescribing appeared first on News@91��ɫ.

91��ɫ posted strong results in global rankings in this year’s Times High Education (THE) World University Rankings by Subject, competing against almost 1,500 universities across 11 subjects worldwide. 91��ɫ’s Osgoode Hall Law School’s held firmly with a 65th in the world spot, while rankings for programs in Medical & Health and Engineering & Technology subjects, a sign of the University’s growing momentum in these areas, also increased.

91��ɫ’s strength in Medical & Health subjects is bolstered with a new School of Medicine set to open in 2028. The medical school is being designed to strengthen community health through unique curriculum and physician training and will help meet Ontario’s urgent healthcare needs.

"Our upward trajectory in global standings reflects 91��ɫ’s growing expertise in health and medicine. By strengthening our research environment and innovative academic programming, we are building a robust foundation for our new School of Medicine within 91��ɫ’s Faculty of Health, where our researchers and learners are equipped to advance health equity for the diverse communities we serve," says School of Medicine Dean David Peters, Faculty of Health.

In addition, Psychology was ranked in the top 150 worldwide and in the top 10 nationally, along with Business & Economics and Law. Psychology and Engineering & Technology rose across all five pillars – teaching, research environment, research quality, industry and international outlook.

“This ranking reflects the strength of Osgoode’s academic community and the impact of the teaching, research, and scholarship taking place at the law school,” says Dean of Osgoode Hall Law School Trevor Farrow. “It’s encouraging to see that work recognized globally.”

The subject ranking results follow on a year of positive results, including the , where the University scored 15 subject areas in the top 10 and is ranked sixth in Canada and second in Ontario for the Arts and Humanities, and in the top 100 worldwide for English language and literature. The University also went up three spots from seventh to fourth in the country for Geography, while 91��ɫ ranked eighth in Canada and fourth in Ontario for Social Sciences and Management. The University also moved up 29 spots globally in the 2026 QS World University Rankings.

In the Times Higher Education (THE) Impact Rankings results, 91��ɫ earned a top 40 spot demonstrating continued leadership in the United Nations Sustainable Development Goals.  And in the , 91��ɫ placed in the top five as one of the best comprehensive universities in Canada, a spot it’s held for several consecutive years. It also ranked fourth for reputation, third for student scholarships and bursaries, and fourth for social sciences and humanities grants.

For more than a decade, 91��ɫ has been named as one of Canada’s Greenest Employers and for the second consecutive year it also made the list for Canada’s Best Diversity Employers.

The post 91��ɫ ranks highly in key categories in THE World University Rankings by Subject appeared first on News@91��ɫ.

Professor says this could lead to better treatments for late-stage cancer patients

TORONTO, Dec. 8 2025 — While targeted radiation can be an effective treatment for brain tumours, subsequent potential necrosis of the treated areas can be hard to distinguish from the tumours on a standard MRI. led by a 91��ɫ professor in the Lassonde School of Engineering found that a novel AI-based method is better able to distinguish between the two types of lesions on advanced MRI than the human eye alone, a discovery that could help clinicians more accurately identify and treat the issues.

“The study shows, for the first time, that novel attention-guided AI methods coupled with advanced MRI can differentiate, with high accuracy, between tumour progression and radiation necrosis in patients with brain metastasis treated with stereotactic radiosurgery,” says 91��ɫ Research Chair Ali Sadeghi-Naini, senior author of the paper and associate professor of biomedical engineering and computer science. “Timely differentiation between tumour progression and radiation necrosis after radiotherapy in brain tumours is a crucial challenge in cancer centers, since these two conditions require quite different treatment approaches.”

The study, published in the International Journal of Radiation Oncology, Biology, Physics, was conducted in close collaboration with imaging scientists, neuro-oncologists and neuro-radiologists at Sunnybrook Health Sciences Centre using data acquired from more than 90 cancer patients whose original cancer had metastasized to the brain.

Sadeghi-Naini says the incidence of brain metastasis  is rising as treatments improve and survival rates increase. Stereotactic radiosurgery (SRS), where a concentrated doses of radiation are applied to the cancer lesions only, is effective at controlling the tumours.  In up to 30 per cent of cases, SRS is not able to control the tumour and it continues to grow. Where it is successful, healthy brain tissue immediately surrounding the tumour may also die off, called brain radiation necrosis, and it can come with significant side effects.

Sadeghi-Naini and his colleagues introduced a 3D deep learning AI model with two advanced attention mechanisms to differentiate between tumour progression and radiation necrosis using a specialized MRI technique, called chemical exchange saturation transfer (CEST), and found that the AI was able to differentiate between the two conditions with over 85 per accuracy. Sadeghi-Naini says with a standard MRI the two conditions are accurately diagnosed about 60 per cent of the time, and with more advanced MRI techniques alone, the rate increases to about 70 per cent.

“Differentiating tumour progression and  radiation necrosis is very important — one needs more anti-cancer therapies and may need to be aggressively treated with more radiation, sometimes surgery.  The other may require observation, anti-inflammatory drugs, so getting this right is crucial for patients.”

-30-

91��ɫ is a modern, multi-campus, urban university located in Toronto, Ontario. Backed by a diverse group of students, faculty, staff, alumni and partners, we bring a uniquely global perspective to help solve societal challenges, drive positive change, and prepare our students for success. 91��ɫ's fully bilingual Glendon Campus is home to Southern Ontario's Centre of Excellence for French Language and Bilingual Postsecondary Education. 91��ɫ’s campuses in Costa Rica and India offer students exceptional transnational learning opportunities and innovative programs. Together, we can make things right for our communities, our planet, and our future.

Media Contact:

Emina Gamulin, 91��ɫ Media Relations, 437-217-6362, egamulin@yorku.ca

The post Novel AI technique able to distinguish between progressive brain tumours and radiation necrosis, 91��ɫ U study finds appeared first on News@91��ɫ.