Trinkets, samples, food and drinks, trips, and other gifts from drug makers have long been an accepted part of the medical profession, but those practices are changing and gifts pharmaceutical companies have been giving doctors are now banned from drug maker’s marketing campaigns under a new voluntary guideline. The industry’s Code on Interactions with Health Care Professionals—written by the Pharmaceutical Research and Manufacturers of America, the industry’s trade association—will ask chief executives of large drug makers to certify in writing that “they have policies and procedures in place to foster compliance with the code.”
The code does not outline limits on drug makers’ speaking and consulting arrangements and does not ban office breakfasts, lunches, or educational dinners at restaurants. “Informative, ethical, and professional relationships between health care providers and America’s pharmaceutical research companies are instrumental to effective patient care,” said Richard T. Clark, chief executive of Merck and chairman of the trade association. “We’ve been pushing to see reforms like this for some time now,” said Senator Herb Kohl, a Democrat from Wisconsin. “Consumers will undoubtedly be the beneficiaries of these industry changes.” Kohl co-sponsored a bill to require drug and medical device companies to publicly disclose payments to doctors in excess of $500.
Critics point out that the rules are voluntary. “It strikes me as an attempt to persuade people against doing anything that’s serious,” said Sharon Treat, executive director of the National Legislative Association on Prescription Drug Prices. Meanwhile, more and more states have passed or are considering legislation requiring drug makers to disclose payments to doctors. Minnesota banned gifts to doctors valued at more than $50, including food; Massachusetts is considering a similar ban. In January we reported that SMDC Health System purged its facilities of 18,718 pens, notepads, clipboards, clocks, mouse pads, stuffed animals, coffee mugs, and other promotional trinkets with logos from drug companies.
Earlier this year, Christopher A. Viehbacher, president for North American pharmaceuticals at GlaxoSmithKline, wrote to Governor Deval Patrick of Massachusetts and Speaker Salvatore F. DiMasi of the state’s House, suggesting his company might not invest as much in Massachusetts if political developments” worked to “devalue” its assets. Viehbacher said the proposed gift ban would make Massachusetts “the most hostile state in the nation when it comes to biopharmaceutical sales.”
The new marketing code requires drug makers set annual limits on the amounts they will pay doctors to deliver educational lectures to colleagues, although the code does not say what the limit should be. Such a cap will require drug makers to track across divisions the amounts paid to doctors, which could make complying with a national registry far easier.
The drug industry last updated its marketing code in 2002, when it banned “dine and dash” events in which drug makers provided free take-out dinners, Christmas trees, and gas to doctors who agreed to listen to brief sales pitches. That code also banned golf outings and free tickets to sporting events. None of the rules apply to biotechnology or medical device makers, many of which continue to give expensive gifts and resort vacations to high-profile physicians.