Massachusetts Gift Ban Is Removed From Bill
37 CommentsBy Ed Silverman // July 16th, 2008 // 7:59 am
The hotly-debated ban on gifts and meals provided to doctors by drugmakers was stripped out of proposed legislation a House committee approved late yesterday, The Boston Globe reports.
The panel also removed requirements that drug and device makers report payments they make to doctors for consulting and speaking to other physicians and that the Department of Public Health post that info on its website, the paper writes. A proposed $5,000 fine per violation was also dropped from the bill, which is expected to be voted on by the full House today. The bill would ban drugmakers from buying prescribing data that identifies docs and patients.
The move comes after drugmakers and biotechs threatened to reduce investment in the state and, interestingly, the BIO trade group last month named Deval Patrick the Governor of the Year at its annual convention, instead of giving him the cold shoulder that many expected.
As now proposed, the measure would simply require drugmakers to adopt a marketing code of conduct, such as the one the PhRMA trade group announced last week that would ban meals at restaurants and trinkets such as mugs and pens bearing the names of drugmakers and products, but still allow companies to cater lunches in doctors offices and hospitals.
The changes infuriated some consumer groups and longtime gift-ban advocates who say the legislation would allow drugmakers and biotechs to continue influencing doctors to prescribe new and typically more expensive brand-name drugs, driving up costs, according to the Globe.
The pharmaceutical measure was just one provision of a larger bill, sponsored by Senate President Therese Murray, intended to rein in healthcare costs. The Senate unanimously passed a version of the bill with the gift ban.
“The lobbyists said jump and, unfortunately, Beacon Hill says, ‘How high,’ ” state Senator Mark Montigny, a New Bedford Democrat who first proposed a ban on drug and device company gifts to physicians in 2005. “If you are serious about taking on cost control, you have to take on the special interests and the sacred cows of the pharmaceutical industry.”
The proposed legislation does, however, include a ban on drugmakers buying drug prescribing data that identify doctors or patients, a practice that companies use to hone their sales pitches.
“We are thrilled to see that included,” Lisa Kaplan Howe, a policy manager with Health Care for All, a consumer coalition, tells the Globe. “Pharmaceutical companies use the data to give to their salespeople so they’ll know what doctors are prescribing so they can tailor their messages, to know which doctors to spend more efforts on and which are a lost cause.”
Patricia Walrath, House chairwoman of the Joint Committee on Health Care Financing, tells the Globe that her committee’s decision to include the ban on the sale of prescription info shows its desire to balance consumers’ concerns with the needs of industry.
But she explains that her committee removed the gift-ban language because drugmakers and biotech leaders told lawmakers it could chill industry-funded educational conferences that bring doctors together with researchers.
Instead, she said, lawmakers accepted the industry’s recommendation that they adopt language used by Nevada. “We were very concerned that the Senate language would deny (doctors and researchers) the kind of information they need,” she tells the Globe. “One could interpret (the Senate’s version) to mean they would not be able to get anything.”
After Walrath’s committee revised the bill, it was passed last night by the House Ways and Means Committee. The version expected to be debated today does include a section, also approved by the Senate, that would create a doctor-led outreach and education program to provide objective info to physicians and encourage evidence-based and cost-effective prescribing practices.
The program also would have to “inform prescribers about drug marketing that is intended to circumvent competition” from less expensive generic medications or other evidence-based treatment options, the paper writes.
The trade association that represents Massachusetts medical device makers said it was pleased that the House committee deleted the gift ban, but would lobby lawmakers today to fine-tune the wording to make sure the bill applies fully to its industry, according to the paper.
Much of the language now refers to the pharmaceutical industry. “This allows education and training to continue and requires companies to develop their own codes of ethics, which many have already done,” said Tom Sommer, president of MassMEDIC.
harpy
“How high?” indeed, considering the new PhRMA Code, itself, bans gifts.
So - kudos to Massachusetts, following in the footsteps of Nevada to require drugmakers to conform to rules they already have to abide by to trade in California. The courts will take care of the prescribing data prohibition, as in New Hampshire (or was it Connecticut?), and they’ll be back where they started. One step forward, two steps back.
But, on the positive side, thank you for the correct use of “rein.”
Insider
Score one for King Billy!
Atlex
I suggest that we score one for Jim Greenwood, head of BIO. It was more more influential in this case than was PhRMA.
Justice in MI
Can someone clarify whether PhRMA’s “code” re: disclosure of gifts over $500 covers what is left out of the Mass bill? And whether the big issue - dislosure of consultancies and the like - have or have not been accepted by companies that make up PhRMA?
Thanks.
Atlex
JiM,
The code can be found at:
http://www.phrma.org/files/PhRMA%20Marketing%20Code%202008.pdf
I do not believe that there is language discussing disclosure of gifts since gifts are essentially banned. The exception “that it is appropriate for companies, where permitted by law, to occasionally offer items primarily designed for the education of patients or healthcare professionals, as long as such
items are not of substantial value ($100 or less) and do not have a value to the healthcare professionals outside of their professional
responsibilities. For example, companies may provide educational items such as a medical text book, a subscription to a relevant scientific journal, or copies of relevant clinical treatment guidelines.”
Atlex
Justice in MI
Thanks, Atlex.
I realize I was confusing the PhRMA code with the item recently on Pharmalot about full public disclosure of gifts to docs (of all kinds, in all amounts, for all work).
Is that a Grassley bill that some companies have already agreed to do? Would appreciate clarification from anyone who recalls.
Re: the code, some version of this is repeated many times:
“Companies should continue to ensure that speaking arrangements are neither inducements nor rewards for prescribing a particular medicine or course of treatment.”
While I do not assume that “speaking arrangements” are _always_ inducements or awards, we pretty much know from one case to another how often that is, the case (whatever else it may be).
As patients/consumers, I am wondering what confidence we can have that this will not continue to be the case or what other means there may be to discourage it. The threads on prescribing data certainly bear on this issue as well. And obviously whatever “honor system” will have to include docs and their relevant professional organizations.
Personally, I would be happy just to have public disclosure of such arrangements, so that I could easily look up whether a doc I’m seeing has whatever relationship with whatever companies, concerning what products, and with annual compensation from that companies over, say, the previous five years.
LILli
All Special Interests Lobbyists, espically Pharma are running and ruining our country with their deceit and corruption.
Atlex
JiM,
I think that the agreement with Grassley was to publish grants to 3rd parties.
As for your statement:
“While I do not assume that “speaking arrangements” are _always_ inducements or awards, we pretty much know from one case to another how often that is, the case (whatever else it may be).”
I don’t believe that they are inducements or rewards. In my company there are a number of checks and balances to insure that the physician is qualified and is appropriately paid according to services performed. There are very strict guidelines that are now managed at the HQ level to insure compliance. However, it should come as no surprise that the physicians most expert in the use of a particular drug usually are often high volume prescribers.
Atlex
Justice in MI
Atlex - I base my statement in a variety of internal documents from some of the more high profile cases as well as in direct discussions with people in pharma marketing.
While I don’t know what the percentages are, it is clear that speakerships (and what comes with) clearly __are_ used as rewards for high prescribing (which is, in turn, independent of expertise, since some of these speakers are in specialities unrelated to the condition the drug treats). Conversely, speeakerships (and what goes with) are taken away from docs who do not otherwise “cooperate” with marketing goals.
Candidly, I will say to deny that this is widespread (define “widespread” however you choose) in the industry is, indeed, denial.
Justice in MI
I should have added that I also base the statement on discussions with docs who were themselves “on the take” in precisely this way at one point or other, and had such speakerships. They knew very well why they were getting what they were getting from the company and the mutual benefits served.
The docs I’ve spoken with eventually stopped in moral disgust, or left practices in which their partners would not stop. Again, I don’t claim to know how widespread the pattern is. Perhaps others could help us with that.
asd
Hi,
The writing is on the wall. Gifts from Big Pharma and its device making counterparts may soon be unwelcome at all of the nation’s medical colleges.
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johni
Addiction Recovery Michigan
Addiction Recovery Michigan
Lana Keeton
The only code the pharmaceutical companies adhere to is GREED.
Atlex
JiM,
I don’t deny that it happens, but it is declining rapidly as an approach to the selection of speakers. For the large, high profile companies, it has become too risky of a practice. The major companies now have instituted robust compliance programs to ensure that levels of compensation match levels of activities.
Atlex
Justice in MI
Thanks, Atlex. I think the problem is that we “outsiders” have little sense of the scale (which is one reason this site is so useful). We read things like this on speakerships from a NY Times piece of last year (NYT, 3/21/07)
“Doctors said that lectures were highly educational, and that drug makers hired them for their medical expertise and speaking skills. But former drug company sales representatives said they hired doctors as speakers mostly in hope of influencing that doctor’s prescribing habits.” (3/21/07)
So what would the average person conclude? Like much else, it’s a kind of Rorschach. If you already are distrustful of the industry, you assume it’s “widespread.” If not, you take it with however many grains of qualification.
Anyway, as above in the thread, my personal hope would just to have the speakership info accessible by pts/consumers. Then they can make their own decisions, whether that role constitutes any reason for concern - or the opposite. I also know docs who use their relationships with industry as a point of pride, and go out of their way to make it known that they are speakers, consultants, etc.
Amy
I have to echo a previous remark stating that the only code existing in Pharma is “greed”. I think JusticeinMI, while well-meaning, gives credit where it is not, and has never been, to the industry. Pharma, as I understand it, is the top lobby (i.e., most cash, most lobbiests) in Washington, and the results show - when the corporations literally get away with murder, and there is no recourse.
Remhy
The pharmaceutical measure was just one provision of a larger bill, sponsored by Senate President Therese Murray, intended to rein in health care costs.This website is interesting.
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Joel
http://www.google.com
js15084
I sure that the doctors use their relationships with industries as a point of pride. They go out of their way to make it known that they are speakers, consultants.
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Js15084
worldinfo
harpy
Many of the high-profile companies that have robust compliance programs also have or had robust Corporate Integrity Agreements (CIAs) to aid them in reconfiguring their Sales & Marketing departments. The very smart ones learned from their competitors’ mistakes.
Justice in Michigan
harpy - I assume the CIAs were “imposed” by FDA because of “slippage” earlier on, is that right?
Amy - Thanks for seeing me as “well meaning”! When I’m here, I usually try to understand the perspectives of people who aren’t me, whether or not I agree. Sometimes I’ll say so, sometimes I won’t, depending on whether I think it is useful in general to do so.
“Useful” = having a discussion in which there is a chance that anyone would learn anything “useful” beyond whatever they’re sure they already know.
rajesh
I sure that the doctors use their relationships with industries as a point of pride. They go out of their way to make it known that they are speakers, consultants. The pharmaceutical measure was just one provision of a larger bill, sponsored by Senate President Therese Murray, intended to rein in health care costs.This website is interesting.
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stephain Lewis
i like this agreement. and also this site is very intersting and also useful to discuss about this form.
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Stephain
<a href=http://www.dhisnansolutions.com]dss
jaky
Hi, i think it is good idea for baned gifts for pharma, its enclosure to third parties. mostly pharma industry linked with doctors for introducing new drugs.
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jaky
worldinfo
jenitta
Hi, this is Jenitta. I believe it is excellent suggestion for prohibited gifts for pharma, its field to third parties. Frequently pharma industry related with doctors for introducing latest drugs.
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jenitta
worldinfo
prathap
Hi
Hi,
As per my knowledge. My suggestion to prohibited gifts for Parma, its enclosure to third parties. The company deals with the doctor to introduce the new drugs.
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prathap
worldinfo
jenitta
I am sure that the treatment center uses their associations with industries as a point of satisfaction. They go out of their way to make it recognized that they are speakers, consultants.
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jenitta
worldinfo
bhupa
Hey I am new to this site can anyone tell me more about it?
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bhupa
worldinfo
pamalq
The pharama industries related with doctors for introducing latest drugs, I think it is good idea for banned gifts for Pharma.
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pamal
worldinfo
Harvey
Today Pharma companies are increasing day by day in all countries. Doctors are now very much related with pharma companies and same with pharma companies. I think it is not bad to do like that and it is also beneficial for everyone.
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Harvey
http://www.worldinfo.com
SRISHU444
The Massachusetts House on Wednesday approved legislation that aims … a version of the bill that includes the gift ban provision
===============================================SRI
http://WWW.GMAIL.COM
kitty mittal
This is very useful sites. Gifts from Big Pharma and its device making counterparts may soon be unwelcome at all of the nation’s medical colleges.
Amit Kumar
Hi, in my view this is the acceptable idea for baned gifts for pharma, its enclosure to third parties, mostly pharma industries linked with doctors for introducing new drugs.
rishu sharma
While I do not assume that “speaking arrangements” are _always_ inducements or awards, we pretty much know from one case to another how often that is, the case (whatever else it may be). This website is interesting
jitendra
Pharmalot is a article which is related to pharma (drugs and medicine).Most of the pharma companies which supply drug and they give some gift to the doctors which is not included in their bills that is free. This website is interesting and knowledgeable for every person who is connected to this pharma sector.
nikita
I think that the agreement with grassely was to publish grants to third parties. All special interests lobbyists pharma are running and running our country with their deceit and corruption.
kamal kumar
I think it is good idea for banned gifts for Pharma, its enclosure to third parties. Mostly pharma industry linked with doctors for introducing new drugs.
priya sharma
According to my suggestion Pharma industries should provide many facilities to doctors This allows education and training to continue and requires companies to develop their own codes of ethics.
Chris
Dear Rinky/prathap/bupendra/jenitta,etc.
Please do not post multiple posts and try to pass them off as from different people. This is not a poll.