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Drugmakers' Gifts To Doctors Finally Get Needed Scrutiny

Oct 14, 2002 | USA Today Christmas trees. Free tickets to a Washington Redskins game, with a champagne reception thrown in. A family vacation in Hawaii. And wads of cash. Such gifts would trigger a big red ''bribery'' alert in the mind of just about any public official or government contractor. But not, it seems, in the minds of many doctors. They have been raking in jaw-dropping gifts from pharmaceutical firms battling to give their products an edge in an increasingly competitive market.

Bad enough that the practice taints the independence of doctors who are supposed to advocate for patients, not drug companies. But the ''marketing'' costs are built into skyrocketing drug prices, which have risen more than 15% a year on average since 1999. Those who pay for prescription drugs ultimately foot the generous inducements, including patients, employers and taxpayers, who spend $30 billion for drugs through Medicare and Medicaid.

Yet government regulators have largely ignored pharmaceutical-company practices that would have set off ethical and legal alarms in other industries. Until now, that is. In a welcome case of calling a bribe a bribe, the inspector general for the Department of Health and Human Services (HHS) is warning drugmakers that gifts or payments to doctors could violate federal fraud statutes.

A credible threat of fines and jail time is needed to halt the multibillion-dollar effort to buy doctors and drive up consumers' drug costs in the process. Ending the marketing tactics also would help restore patients' trust in the integrity of doctors.

The need for change is great. An April survey by the Kaiser Family Foundation, a non-profit health-research group, estimated that pharmaceutical companies spent $13.2 billion last year on promotional activities for doctors, more than $15,000 per physician. The survey found that 61% of physicians had received free meals, travel or tickets to events from pharmaceutical salespeople, 13% had accepted money, and 12% had been paid to participate in drug trials.

Such abuses mock voluntary guidelines the American Medical Association (AMA) adopted in 1990 to discourage gift taking. It bans doctors from accepting presents from pharmaceutical companies that have no patient benefit or are worth more than $100. Examples: New York Mets tickets or golf balls with company logos.

In anticipation of the critical HHS report, the pharmaceutical industry rushed out a voluntary code of ethics based on the AMA guidelines that took effect July 1. The effort has had an impact. According to ImpactRx Inc., a pharmaceutical promotion-research group, meetings between drug representatives and doctors at entertainment venues such as casinos and sports events fell from 10% of all get-togethers in May to about 1% from July to September.

Still, the code leaves big loopholes. Companies can cover some physicians' expenses at educational conferences and pay doctors as consultants. And without tough penalties, incentives are lacking to deter drug companies from reverting to bad practices once the spotlight fades.

That's what happened after the AMA issued its guidelines, which is why the threat of legal action is needed. Until the legal bribery of doctors ends, too many patients will keep paying inflated prices for medicines they might not even need.

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