No more free pens for doctors
It just got more expensive to be a doctor. Now they have to buy their own pens.
For years, drug companies plastered their products’ names on trinkets to get the message across to people who write prescriptions. Ballpoint pens were the most popular freebie, and the more creative companies passed out stress balls, calendars, scissors, staplers and flashlights.
But as of Jan. 1, all "non-educational" gifts to doctors are banned according to a voluntary ethics policy written by the Pharmaceutical Research and Manufacturers of America, a trade organization made up of the largest drug companies. Some 40 companies signed off on the change, which doesn’t affect complimentary drug samples — although doctors say those have been less than free-flowing recently because of the struggling economy.
A statement by the trade group said the ban on gifts wasn’t an admission that the trinkets influenced doctors, only that an "appropriate transparency in relationships with health care professionals can help build and maintain patient trust in the health care system."
The move comes as Congress is considering the Physician Payments Sunshine Act, which would establish a national registry of payments from drug companies to doctors for research and consultation. Recent Senate investigations have shown that some university researchers don’t report income, sometimes reaching into the millions of dollars, from drug companies.
Skeptics say the ban on gifts is an empty gesture that doesn’t adequately address the financial relationships between pharmaceutical companies and the doctors whose decisions on drugs have a direct impact on patients.
In 2006, drug companies spent more than $7 billion on marketing to doctors, according to a report from IMS Health, a research group that follows the health care industry.
Some worry that money will be turned toward less transparent ways, such as medical education and research, of influencing doctors. Drug companies fund about 85 percent of clinical trials, whose results tend to favor the companies’ products. The findings are printed in medical journals, considered a legitimate source of information for doctors.
"It’s impossible even for the most dedicated doctor to be able to see the bias in many of the commercially sponsored articles," said Dr. John Abramson, author of "Overdosed America" and a clinical instructor at Harvard Medical School.
"It’s time for doctors to understand that when information comes from drug companies, the primary purpose is to get them to use the drug and not to inform them of what’s best for their patients."
Abramson proposes that doctors take a leading role in legislation that would require independent auditing of medical research. As for the costs of independent auditing, Abramson points to the billions spent on the failed painkillers Vioxx from Merck and Bextra from Pfizer, which were pulled from shelves after the drugs were linked to heart problems.
Officials for Pfizer, which employs 1,200 people in its labs in the St. Louis area, did not respond to requests for comment. Pfizer is one of the 40 companies that agreed to the new rules banning gifts.
The rules against gifts are the first change since 2002 when the trade group banned larger gifts such as vacations and tickets to concerts and sporting events.
‘MUTUAL BENEFIT’
Doctors say the pens and other tchotchkes didn’t influence them and won’t be missed. Buying pens "is basically just a rounding error in the expense of running a practice," said Town and Country dermatologist Dr. George Hruza.
Looking around his office, Hruza saw a notepad for the arthritis drug Humira, which he doesn’t prescribe. "(The gifts) really don’t affect our prescribing habits," Hruza said. "Hopefully, most physicians get their information not just from drug reps."
Drug company sales representatives are frequent visitors to doctors’ offices, not only to pass out pens but to educate staff on their products. Under the new standards, the representatives still will be allowed to bring in lunch for these office-based lessons.
Area doctors said they welcomed the education from drug reps as one source of information.
"Most of what I look for is the quality of the product and its pricing, not necessarily what the salesperson is trying to push me," said Dr. Ravindra Shitut, a spine surgeon in south St. Louis County.
Dr. Elie Azrak, a cardiologist and incoming president of the St. Louis Metropolitan Medical Society, said he supported relationships between drug companies and doctors, as long as they were conducted in the open.
"There is mutual benefit as well as benefit to the consumer when the industry improves the product based on physician input, and when the physician uses the product if (he or she is) better educated about the product from the manufacturer," he said.
bbernhard@post-dispatch.com
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Filed under: management by Specialist