EDITORIAL: State should ban gifts to doctors

Monday, May 11, 2009

Pharmaceutical and medical devices companies spend lavishly to convince doctors to use their products. Consumers Union estimates the companies spend from $7 million to $11 million a year in Connecticut giving doctors everything from notepads and pens to meals, trips and refresher courses.

The money is not being spent out of charity, but to drive sales. This aggressive marketing drives up health care costs and affects treatment decisions and research, while undermining public faith in the integrity of medical decisions.

Doctors and drug makers have attempted to respond to this long-standing problem. In recent years, the medical schools at Yale, Stanford and the University of Pennsylvania, among others, have adopted gift bans. The International Federation of Pharmaceutical Manufacturers and Associations — which includes large drug makers such as Pfizer — has revised its code of ethics to bar the priciest gifts to doctors, such as trips to golf resorts and luxury hotels, that might influence what drugs a doctor prescribes. However, the revised code still allows “work-related” gifts and trips that aren’t blatant junkets.

Another area of potential conflict of interest is continuing education courses for doctors sponsored by drug and medical device makers. The Pharmaceutical Research and Manufacturers Association of America, the American Medical Association and the accreditation association for continuing medical education have agreed that the organizer of a course, not its commercial sponsor, should control its content.

These steps within the medical community are being followed by government regulation and laws. Massachusetts has approved rules that bar gifts, put limits on meals and requires companies to disclose publicly payments of more than $50 to physicians for consulting and speaking fees.

The Institute of Medicine, part of the National Academy of Sciences, wants Congress to require drug and medical device makers to disclose all payments to physicians. The legislation is pending in Washington.

The same week that the Institute of Medicine issued a report saying doctors, medical schools and hospitals should stop taking payola, a press conference was held in Hartford in support of state legislation to either ban or severely limit the gifts. The legislation reflects a solid consensus among academic and professional leaders of the medical community and a growing acceptance by manufacturers of a need for restraint. It should be approved.

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