Responding to a growing chorus of criticism about pharmaceutical company influence over medical practice, the Pharmaceutical Research and Manufacturers of America (PhRMA
) recently imposed a new code of conduct for its members.
Under the "Code on Interactions with Healthcare Professionals
" that took effect last week, pharmas and biotech companies will no longer gift doctors or clinics with office supplies, clothing or other items displaying product brand names or company logos. The guidelines also require that grant money allocated for continuing medical education (CME) programs be handled by staff outside sales and marketing departments; reiterate the group’s 2002 code prohibiting more costly gifts such as tickets to professional sports games and trips to fancy resorts; stipulate that “modest” meals may be provided to physicians during a presentation only when they are provided at a hospital or office; and clarify what are considered appropriate gifts.
In general, items deemed purely educational, such as medical text books, subscriptions to relevant scientific journals, or copies of relevant clinical treatment guidelines are appropriate to give as gifts, but golf balls, gasoline and “clipboards, pens, mugs or similar items with or without company logos or product names printed on them” are not.
Some suggest the ban on promotional goodies is less about self-policing and more about self-serving. The pharmaceutical industry spends an estimated $6 billion on promotional gifts (referred to as “detailing” by industry insiders) to America’s 850,000 practicing physicians. The new code will address about $1 billion worth of details.
David Edelson, an assistant clinical professor of medicine at Albert Einstein College of Medicine, said in a letter to the New York Times:
"Having done the math and realizing that $1 billion could be better spent elsewhere, they cleverly packaged this ban as a step to the higher moral ground."
The voluntary PhRMA code has beat some -- but not all -- states to the punch with the self-policing code. Massachusetts and other states have already passed or are considering legislation that bans such gifts.
The guidelines deal with the relatively smaller expenditures of pens, mugs and post-it notes while not addressing the larger sums paid as honorariums and consultant fees to physicians who speak on pharmaceutical companies’ behalf, or the free drug samples provided to doctors. Last year, drug companies gave physicians $16 billion in drug samples.
Taken at face value, the new promotion guidelines may represent a shift in industry priorities. Since its launch three years ago, PhRMA’s Partnership for Prescription Assistance
program has provided free or low-cost prescription medicines to more than 5 million patients who are uninsured, according to a PhRMA press statement.