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The National Pharmacy Association (NPA) chairman Olivier Picard has warned drug companies may exert influence on pharmacists to prescribe more of their drugs as the number of independent prescribers (IPs) in England increases in the coming years.

Speaking at the Pharmacy Show in Birmingham, Picard said he was not concerned potential pharmaceutical industry influence on IPs was a big problem at the moment but suggested the issue "will need to be addressed" by regulators.

His comments come in the wake of a report by the Cochrane review this month which found pharmaceutical companies were using gifts and payments, direct sales, personal visits and free samples to try and entice doctors into prescribing their drug.

Gifts included paid meals, travel costs to medical conferences, entertainment, consulting fees, and honoraria for advisory boards. The review analysed 93 studies, 82 conducted in the US and 11 covering the UK and continental Europe, involving millions of prescribing decisions.

When asked if he thought pharmaceutical industry influence on IPs would be a big problem in the coming years, Picard said: "It's a very good question and I suppose there is a conflict and we need to acknowledge there's a conflict."

However, Picard insisted increasing numbers of IPs are refusing to provide a prescription if they do not see a clinical need to do so, and with that in mind, he was confident it would not become a big issue.

"When you look at what pharmacies do today, whether that's working on a PGD (patient group direction) or working through the clinical pathway, we are noticing more and more pharmacists not actually giving out a product at all despite receving a payment if they ensure a prescription," he said,

"I saw someone the other day in my pharmacy on a Saturday morning who said to me 'I've got a tootache, can you give me an antibiotic?' I said 'no'. Then she said 'I think I've got a sore throat.' So I said, 'well, that's different' and I looked in her throat and said 'no, you don't have a sore thraot, I'm not going to give you an antibiotic'.

"And then she was shouting at me, she literally confonted me by banging the door but I refused to prescribe. So, yes, there is a conflict but I do believe that as professionals, we are going to be very careful initially.

"I'm sure drug companies see pharmacy as a group of professionals they could potentially influence and this is something that will need to be addressed. But do I see this as a problem? No.

"Are there some bad apples in the basket? Probably. We are going to need to manage that very carefully."