New pharma ethics rules eliminate gifts and meals

By MARLEY SEAMAN
12 july2008--Drug company sales representatives will have to stop doling out coffee mugs and pens that push their products when they visit doctor's offices. But they can still sneak in the occasional free lunch.
Pharmaceutical Research and Manufacturers of America announced Thursday that it has revised its conduct code for interacting with health care professionals. The updated guidelines ban the knicknacks bearing company and product logos.
Sales representatives are prohibited from providing restaurant meals and entertainment or recreation. But they can still provide the occasional, modest meal in a healthcare professional's office "in conjunction with informational presentations," according to a statement from PhRMA.
The updated code also emphasizes that drug companies should separate any funding they provide for continuing medical education from their sales and marketing departments. It notes that the funding should support education "on a full range of treatment options and not to promote a particular medicine."
PhRMA said meetings between sales representatives and doctors should be focused on informing health care professionals about products, sharing scientific and educational information and supporting research and education.
The new rules take effect Jan. 1.
The association represents pharmaceutical and biotechnology companies and is made up of executives from companies in the industry. Its CEO, Billy Tauzin, said he hopes the code additions will create "more credible" standards for doctor-sales rep interactions.
"I don't think you'll find a physician who will acknowledge that the gift of a pen or a cup with a company's name on it influences their prescribing patterns," he said. "But there are people who believe that, and as long as that's a perception out there we felt we ought to end that.
Tauzin said his association got conflicting reactions from doctors about whether to eliminate the free lunches, but he noted doctors are free to stop the meals themselves.
The trade association said in January that it was considering revisions to its 2002 code. Its executives said then that they've seen a backlash over sales and marketing practices.
Critics of these sales practices have included the nonprofit organization No Free Lunch, which is run by a New York-based internist. It urges medical school students to pledge that they'll shun free gifts or meals from the drug industry.
No Free Lunch also promotes a pen amnesty program on its Web site, where it offers to replace with "no questions asked" drug company pens that doctors receive. It states that the pens will be "donated to a worthwhile cause."
Sen. Herbert Kohl, D-Wisc., said in a statement that he was "encouraged by the industry's attempt to clean up its act." Kohl co-sponsored the Physician Payments Sunshine Act to create a national registry for payments doctors take from companies.
Dr. Brian Hurley, president of the American Medical Student Association, said the new rules are an improvement but they don't go far enough. He said gifts given to doctors as educational materials or occasional meals are still gifts. "Aggressive" marketing practices have made drug companies a lot of money, he said, and they have little incentive to stop those tactics.
"Educational gifts or educational programming that pharma's member companies put together are marketing in disguise," he said.
Members of PhRMA are required to state their intention to comply with the code, and Johnson & Johnson, Merck & Co., Amgen Inc., Eli Lilly & Co. AstraZeneca PLC and EMD Serono were among the companies that did so Thursday.
AstraZeneca said its U.S. representatives will not give doctors items including pens, pads of paper, hand soap and tissues as part of sales visits. The company said its sales representatives will still be able to offer educational items like teaching models if they "are not of substantial value."
AstraZeneca said it will still support medical events for health care professionals through grants to independent providers, and the British company says it will not give any guidance about the content or faculty of those events and will provide no direct support for meals.
Lilly said in a separate statement that it will comply with or exceed the new guidelines. It said the revised code will help ensure "the information exchange with healthcare providers continues to be appropriate and ethical."