To a surprising amount of fanfare and press, Johns Hopkins has voted to ban free samples and to restrict some gifts from drug companies. But it is hardly a “ban” on gifts, though you wouldn’t know it from the news reports.
Here’s what has been reported, followed by what the new guidelines actually do.
1. NO MORE FREE DRUG SAMPLES. This is true. Here is the relevant excerpt:
The practice of accepting free pharmaceutical samples risks interference with one’s prescribing practices since industry representatives often provide the newest and most costly drugs. Therefore, free pharmaceutical samples and vouchers for free pharmaceutical samples may not be accepted.
2. NO MORE FREE GIFTS…er, at least no pens, mugs, and notepads, a redundant rule because these were already banned months ago under PhRMA’s updated Code on Interactions with Health Professionals, eg., the “no tchotchkes rule.” But expensive textbooks, anatomical models, and informational posters are okay. Therefore, while a company cannot simply hand a Hopkins doctor a new i-pod nano, it can save the doctor the $100 he or she would have otherwise spent on a new textbook. Said doctor can then use these savings to buy a fourth generation i-pod nano online for $99.99.
3. NO MORE FREE FOOD…er, except at industry-supported CME events, where you can enjoy a nice meal free of charge as long as you are also getting free CME credit as well. Otherwise, NO FREE MEALS...umm, well, you can have meal if it’s part of an industry sponsored consultation gig…and, let’s see, if it is offered at a professional society meeting… and, oh yeah, if it’s part of a “research meeting”…and if the drug company gave an “unrestricted grant” to the department which decided to use that money for free food, that’s okay, as long as the company HAD NO INPUT INTO WHICH ENTRÉE WAS OFFERED. But if a drug rep invites you out to dinner in order to try to convince you to prescribe more of his drug, you must refuse the invitation…wait a minute…you CAN go out to dinner with him, but you have to pay for your own meal! (He can share an appetizer with you though) (Okay, and you can have a sip of his martini).
4. NO MORE CASH GIFTS. Johns Hopkins will no longer allow drug reps to hand doctors thick wads of money in unmarked envelopes! HOWEVER, (quoting directly from the new policy) “Gifts from industry may be used by the department to support faculty and staff education, research, and/or patient education. Distribution of the funds will be at the discretion of the department director, who will disseminate the criteria for requesting funds to all faculty members in the department.”
Okay, so let me get this straight. Companies are still allowed to give unlimited amounts of cash to academic departments, and the departments can do anything they want with the cash. Now that’s the kind of gift ban any key opinion leader on the gravy train can support!
Oh, and here’s a nice bonus. Drug companies can still give individual doctors thick wads of cash, as long as it is called a “prize” for “scientific or medical achievements.” To quote again from the policy: “For purposes of this policy, prizes and awards are not considered gifts.”
The bottom line is that Johns Hopkins has crafted a policy to generate good PR for the university, but which continues to allow a free flow of money, food, and educational gifts from the pharmaceutical industry to doctors. Let’s hope that our other academic medical centers can do better.