Evolution of Physician-Industry Relationships in Producing Knowledge of Drug Therapy - Comparison of the United States and Finland

This paper presents a historical perspective on the evolution of relationships between the pharmaceutical industry and physicians in two countries, the United States and Finland. Despite divergence early the twentieth century, and the absence of any large pharmaceutical firms based in Finland, by the 1950s a similar partnership between medical experts and drug companies had developed. In the US, commercial influence in medical research can be divided into five periods: pre-reform (late 19th century – 1905), first reform wave (1905-1930), growing collaboration (1930-1945), merger of interests (1945-1950s, and second reform wave (1960s and 1970s). The history in Finland until the War was different: a preindustrial pattern persisted into the ‘teens, followed by an interwar period in which the fostering of a domestic pharmaceutical industry was a national project and collaboration officially encouraged. After the Second World War the drug industry was no longer local, but the close physician-drug industry relationship largely continued as before. There are indications today that both countries have entered another reform period, this time international in origin. It is hoped that understanding of the origins and nature of relationships between biomedical experts and drug industry will help physicians offer better patient care.