During my college days in the seventies, I worked for a photography store, and it wasn’t uncommon for drug companies to purchase expensive photographic equipment such as $500 camera lenses and have us deliver them to physicians as gifts from the drug companies. Changes in federal and state fraud and abuse laws have limited such practices, and such gifts would today violate many medical societies’ code of ethics. However, it seems that the public—or at least some lawmakers—are still not happy with marketing practices employed by some drug companies. Vermont is the first state to legislatively address such practices.
A new Vermont law aimed at prescription drug cost containment has a number of controversial provisions, including the disclosure of drug company gifts to physicians. The law requires that drug companies file annual reports with the Vermont Board of Pharmacy disclosing the “value, nature and purpose of any gift, fee, payment, subsidy or other economic benefit provided in connection with detailing, promotional or other marketing activities by the company, directly or through its pharmaceutical marketers, to any physician, hospital, nursing home, pharmacist, health benefit plan administrator or any other person…” See Vt. Stat. Ann. Tit. 33 §2005(a)(1).
First reports under the new law are due January 1, 2004. The pharmacy board is directed to provide the Vermont attorney general complete access to the information required to be disclosed, and the attorney general in turn reports annually to the governor and legislators.
The law contains a number of exemptions from disclosure, including:
The Pharmaceutical Research and Manufacturers of America (PhRMA) adopted
a new voluntary marketing code effective July 1, 2002. The full text
of the code is available on PhRMA’s web site at http://www.phrma.org.
The code governs the pharmaceutical industry’s relationships with physicians
and other healthcare professionals. Under the code, drug company
representatives may only offer to pay for meals if they are “modest as
judged by local standards” and “occur in a venue and manner conducive to
informational communication and provide scientific or educational value.”
Even paying for a spouse’s meal is considered inappropriate, as are “take-out”
meals, and “dine & dash” programs. The code prohibits all cash
payments to physicians except for legitimate documented consulting or speaking
fees. The code does not regulate compensation to physicians in connection
with clinical trials. For gifts, the code distinguishes between those
that could benefit patients or be used in the physician’s practice and
those solely for the personal benefit of the physician. For example,
pens and pads with the drug company name are appropriate since they could
be used in the physician’s office. Golf balls with the drug
company name are not allowed under the code, however, since they cannot
be used in the physician’s practice.
* A version of this article was originally published in the
Internal Medicine World Report, September 2002.