Wednesday, July 2, 2008

Did Drug Company Gifts Kill the Gift Ban?

In April, the Massachusetts State Senate passed a total ban on all drug company gifts to physicians (see my post here). Spearheaded by Senate President Therese Murray and supported by many others, the ban appeared certain to be approved in some form by the House, and Massachusetts could have bragged about taking the hardest line of any state against this form of legalized bribery.

But in what must go down as one of the greatest ironies in political history, the legislators visited BIO 2008, a massive Biotech conference in San Diego and one of the last of the great dug company swagfests--and now even Senator Murray wonders whether gifts might be necessary for good medicine. According the the State News Service, covered here in the Policy and Medicine Blog, Senator Murray said researchers in San Diego told her the ban would prevent productive interactions between doctors and researchers who are trying to treat the same diseases. “It’s something that we didn’t discuss when we did it, because we were looking purely at gifts to doctors,” Murray said in a telephone interview with the News Service. “But the fact is that some of these companies do bring researchers and doctors together to go over the latest research.”

Wow. Something happened at the convention to hoodwink our finest legislators into believing that doctors can't learn about research without being given free lunches. I didn't attend BIO 2008, but my colleague Harry Tracy did. Dr. Tracy is the writer and publisher of NeuroInvestment, quite possibly the best single source of cutting edge information for those investing in the pharmaceutical industry. Here is his review of BIO 2008, reprinted with his permission from his latest newsletter:

“At the BIO International Convention, 24,000 attendees had the opportunity to watch companies who were limited to fifteen minute sound bites, and much of the fun was to be had in the Exhibits area, where various companies, countries, and municipalities handed out tapas, wine, single-malt scotch, novelty pens, and miniature stuffed koalas, while holding raffles for everything from laptops to trips to London. Indeed, the local paper of record, the San Diego Union-Tribune, devoted a high-profile article to the bounty of "swag" available to attendees. Apparently they overlooked the gift available at the State of New Hampshire booth, which was a plastic band-aid dispenser. While we will treasure ours forever, this stretches the definition of "swag" beyond recognition. But these silly 'Freebies' are just a minor symptom of a larger problem with public relations and perception. San Diego, as it does for other large conventions, literally walled off for an afternoon and evening a five block section of the Gaslamp District, for a BIO-only party. There were three soundstages and seemingly acres of free food laid out for the occasionally semi-intoxicated revelers. Of course, those without a BIO badge were not allowed in, the party was only for "VIP's." As much as NI enjoys VIP treatment, there was something unsettling about seeing the excluded public peering over the barriers at the party-goers. At a time when the pharma industry is widely perceived as concerned with profit rather than with patient care, at a time that the industry is under siege by the Charles Grassley's of the world who believe that the industry deserves to be taken down a notch, this seems unwise. It is probably naive to think that the industry will police its excesses, but if it does not, its losses in the court of public opinion will continue to mount, and few in the audience will protest when the guillotines are brought out.”

I don't mean to imply that Senator Murray, or any other legislators, accepted any of these freebies in San Diego. But there's no question that they allowed their opinions to be influenced in a carnival of swag. Meanwhile, BIO 2008 has announced that Massachusetts Deval Patrick is their "Governor of the Year" on the strength of his support for a $1 billion Life Sciences initiative. I assume they will honor the Massachusetts Legislature with a similar award, depending on the outcome of the vote on S 2660.

5 comments:

Joseph Arpaia, MD said...

WOW!!!!! So much for getting legislative assistance.
Maybe its time for physicians who are willing to be free of drug company gifts to develop some marketing strategies ourselves. I think patients could go for something like that.
For example, since I started practice over 10 years ago I have never allowed drug company "freebies" in my office. None, nada, not even a pen. My office manager knows to throw these away if any drug rep stops by unannounced and leaves stuff. And, my patients have told me they appreciate this. So that may be something physicians can use to their advantage. The "just the facts" group perhaps?
It also makes the office vibe much cleaner. Drug company stuff is like the stench of a pit toilet. If you are sitting in it for awhile you stop noticing it. But get out, and get some fresh air and walk back inside and gosh does it stink.
Having had a ad-free environment in my office for so long I find it nauseating when I take one of my kids to the doctor's and am assaulted from all side by ads. So by freeing our offices of garbage maybe we and not just our patients will benefit.
--Joe

Anonymous said...

I hate to hijack this post, but I just noticed this. In regards to Schatzberg, Stanford wrote: “We would like to underscore that Dr. Schatzberg has not been involved in managing or conducting any human subjects research involving Mifepristone, a pharmaceutical that Corcept licenses for the treatment of psychotic major depression.”

But Schatzberg has published studies involving human subject research and mifepristone.

Here’s one in 2003: “Mifepristone versus Placebo in the Treatment of Psychosis in Patients with Psychotic Major Depression.”
http://linkinghub.elsevier.com/retrieve/pii/S0006322306007645

Another study in 2006: “Clinical and biological effects of mifepristone treatment for psychotic depression.”
http://www.nature.com/npp/journal/v31/n3/full/1300884a.html

James M. La Rossa Jr. said...

FYI: The LA Times reported yesterday that the The U.S. pharmaceutical industry (voluntarily) revised its code of conduct, banning gifts to doctors such as pens, mugs and restaurant meals.

The complete article can be viewed at:
http://www.latimes.com/business/
la-fi-gifts11-2008jul11,0,5130059.story

Anonymous said...

The BIO is not free, you actually have to pay to get in and enjoy all the "free" staff.

Anonymous said...

To Anonymous in the last comment: What is your point? You have to pay to attend pretty much ANY conference. And yet other conferences seem to get by without the excesses like those bestowed upon physicians at their conferences. And other groups of professionals aren't telling people to put potentially dangerous chemicals in their bodies. So, I think it's appropriate to hold medicine to a higher standard. I just don't understand the point of your comment.