Regarding accounting for food for patients…doing what I suggested — giving the cupcakes to the docs to give to patients — probably is a stretch. I’m sure it didn’t happen that way. But that’s how the cupcakes can be expensed legitimately following the letter of AZ’s policy if not the spirit.

My other point is that AZ may not have any policy that generally forbids giving food to patients. The policy you cite is a very specific one regarding “lunch and learns” for physicians. It was drafted in repsonse to PhRMA, AMA, and OIG guidelines concerning gifts to physicians. I don’t know of any similar guidelines concerning gifts to patients!

BTW, I have consulted with many pharmaceutical companies about HIPAA and made many HIPAA privacy presentations at industry meetings — so I know a little more about this than the average person.

Thanks for writing.

And you make some interesting points. However, I believe the issue isn’t talking to patients, but accounting - in writing - for the cost of the food. Just to clarify, listing patients as itemized expenses would be an issue.

And yes, there’s a way to hide those expenses, as you suggested. But it would still appear to violate company policy if the cupcakes don’t qualify as a business meal, as described. Besides, if something doesn’t meet an IRS test, but not company policy, then perhaps the policy is out of whack.

You’re correct to suggest that there may be nuances, and one can argue there are different ways to interpret such a scenario. But there’s also the spirit of the policy - it’s worth questioning dodgy ways that may be used to circumvent standards.

Cheers
ed

About HIPAA, which many people do not understand.

Anybody, including a pharmaceutical sales rep, can go into a doctor’s office and talk to patients in the waiting room and ask their names, what medical condition they have, etc. and none of that would violate HIPAA. Why not? Because you and me and patients are completely free to identify ourselves by name and talk about our medical problems to anyone! HIPAA does not apply to us. It applies to physicians. So, only if sales reps asked physicians (or their staff) the names of patients would there be a violation of HIPAA. Still, the reps would not be violating the law, only the physician (or staff member).

Pharma companies routinely ask consumers for their names, what drugs they take, etc — you’ve undoubtedly seen the BRC cards attached to print ads in magazines. There’s no HIPAA issue there.

About Free Lunch for Patients

Regarding pharma policy about providing free lunch to patients. I don’t believe this is against AZ policy — it just would not meet the requirement of a legitimate business expense by IRS. However, I am sure that the cost of the cupcakes could easily be “hidden” under some other legitimate business expense. For example, AZ reps could give the cupcakes to physicians and suggest that they be put out for the patients to aid in the medical practice. This would then be a legitimate business expense by IRS standards and may even also comply with PhRMA and AMA guidelines regarding gifts to physicians.

The AZ policy you quote concerns “lunch and learn” sessions, which patients would not generally be invited to because it is NOT patient education. I am sure, however, that pharma companies sponsor other educational activities that ARE designed for patients such as health fairs at which food may be served. Again, this would be a legitimate business expense. The way it works is the same as the cupcape secenario I described above: give money to the hospital to support a health fair — so the recipient of the cash is a legitimate BUSINESS contact, not the patients directly.

IMHO,
John Mack