Schering-Plough Discriminated Against Some Docs?
48 CommentsBy Ed Silverman // October 22nd, 2009 // 7:31 am
Earlier this week, we noted how Schering-Plough displayed this sign at the recent gathering of the American College of Emergency Physicians in Boston, the capital of Massachusetts, which is one of three states that have passed restrictive laws on what drug makers may give doctors in the way of gifts.
To comply, Schering-Plough turned away docs from Massachusetts, Vermont and Minnesota. But a source points out that the limit in Minnesota, for instance, is $50. According to state law, doctors can receive gifts from “wholesalers and manufacturers up to a combined annual limit of $50 in retail value. That is, the total retail value of gifts given to a practitioner must not exceed $50 per year (look here).
And so we wonder - how much might an ice cream cone cost? Unless Schering-Plough’s accountants factored in the expense of renting its exhibit-hall booth - and staffing employees - we guess it would be just a few dollars, at most (look). So why the sign?
Perhaps, this was Schering-Plough’s way of protesting the state laws. You know, a sort of extreme position that attempts to make a statement. You may recall that pharma and biotechs were not so subtle last year when Massachusetts was considering its legislation - industry threatened that clinical trial work in the state, which is home to numerous big hospitals and docs, might dry up.
We’ve asked Schering-Plough to clarify the reason for its sign and will update you with any reply.
Anonymous
Companies will do this so they don’t have to factor in what goes on at a convention. It is cumbersome to determine who is a Minnesota doctor and track the expense back to the Corporate Office. Also, most companies have done away with providing any gifts (including meals) to doctors in Minnesota.
Matthew Herper
I remember seeing the exact same sign, writ smaller, at a convention last year. From Eli Lilly. Maybe Effient, maybe Alimta. So this isn’t a Schering-only thing.
Christy Maginn
It is probably more of a mixture but the sign screams protest. Your ID badge at meetings is scanned regardless when taking a beverage or a freebie, etc. I’m sure they actually do this for follow-up reasons so in most places there is already the tracking.
Lilly
trying to create drama
Chris
I don’t see the issue here. The cost has little to do with it, rather, the principal. These states do not allow ANYTHING to be given away by drug companies, even food that is brought in to feed the office in order to maximize time with a provider. It is easier on an office to hear the latest about a drug over a lunch break rather than during patient visits. All SP is doing here is complying with the laws of these states, basically saying, we are not allowed, under state law, to feed you in your office, so we are staying consistent with those laws even outside your office. Funny thing with the media; they come down on pharma for supplying food and other give-a-ways, stating (inaccurately) that these costs are associated with the high cost of medicines. Now the media makes an issue out of a company complying with a state law, suggesting an ice cream cone does not cost much. You can’t have it both ways MR. Media. I applaud SP for standing up to these states.
Condor
Again — great thoughts, here, one and all.
Were I Ed, I wouldn’t hold my breath for any version of revealing commentary — out of Kenilworth — on the “why” for the over-sized sign.
Note that CEO Hassan, on this morning’s earnings call, repeatedly called Schering “the engine that will power Merck’s growth” — but Schering posted a 17% decline in EPS, while Merck tripled net income, in the period. In Kenilworth — like the Mad Hatter’s tea-party — a word means only what Fred says it means.
So, the above sign means “we are the most ethical company on the planet” — according to the Kool-Aid imbibing denizens of K-1, at least — Not. NOT. Not — that we SP-ers are ticked off, and we can do this because it will become a “Merck-ified Whitehouse Station” problem, by early 2010.
Yes, I do read it as a none-to-subtle (and not-so-gramatical!) protest against the newly-codified (in some states, as law) PhRMA Guidelines (revised as of January 1, 2009), and the tougher ADVAMED Code, effective July 1, 2009.
Namaste
Justice in MI
Hi Chris–I don’t see it as “coming down” on SP; just recognizing their use of political theater, which is entirely legit.. Likewise, as their audience, it is legit for us to respond whether we think it is, or isn’t, a good show.
I _don’t_ think this is about trying to be in compliance, though. It is about irony.
Dan Abshear
Hey Ed, I sent you an email on comcast.net. get a hold of me on facebook if you respond,
Dan
Condor
Also, completely shamelessly — I cannot resist plugging my “Fred as Soda-Jerk” graphic, just one more time.
We do have to laugh at the little things. . . .
Namaste
Peter
There is no other way to manage this mess created by the states. Because the MN limit is a hard $50 PER YEAR limit, that means that this company would have to record everyone who took that $3 ice cream and add it to anything else they received during the year to make sure they don’t violate the law.
What you and other critics fail to mention is that it costs millions of dollars for companies to build tracking and reporting systems to deal with each of these different state laws…guess who pays for that? Bad unintended consequences of a bad law with good intentions.
Condor
Peter — here’s a novel idea: how about we let peer-reviewed science journals be the arbiters of whether one drug (or protocol) ought to be preferred over another?
Where is it written that doctors must be schmo-oooo-oozed — ice cream (easy!) — but what about high-end dinners (not so), or golfing weekends, or “Speakers’ Bureau” appearances, or CME offers (all “not so easy” to condone/defend, given that peer-reviewed jornals exist)?
We should recognize that drugs are a largely opaque good, and so, the usual Madison Avenue advertising notions are less than helpful, from a public policy perspective, here.
What do you think?
Namaste
No Dog in the fight
It may have some political undertones. It is also very useful and practical. How would the folks in the booth know year to date $ for each provider that shows up? Better to “offend” the practitioner than the law!
As far as “schmoozed”…come on. The rational is easy. If we are going to discuss…let’s engage in a conversation that could take up your valuable practice time or we can do the same while you have some “down time” over lunch, etc. Peer- reviewed journals? How many are there, how many do the “average” practitioner subscribe to and READ? I do believe the information (from industry) should be vetted AND approved. I do not believe the ONLY avenue for dissemination should be through “approved” journals, scientific meetings, etc. The golf weekend, high-end dinner argument is a “red herring” these things have been “outlawed” for quite some time (why is that?). Why is it that Pharm/Med. is the only industry that has such regulation??? Products are regulated for safety and efficacy, approved for specific use, and maybe contraindicated for others. Why the need to mandate how a provider gets and can’t get the information on a product or procedure?
harpy
There is a bit of “political theater” involved (and more than a bit of snark), but the logistics involved with tracking the give-aways or food or whatever each individual state chooses to have us track is crazy! On top of that, while pharma and device companies have been freaking out about how to implement all of this since the beginning of the year (device more than pharma) you’d be surprised how many doctors still don’t get it. And then get pissed off at the innocent rep who has to say ‘no, I’m sorry, you can’t have that.’ At least the sign takes the heat off the person working the booth. And educates the doctor.
Nathan
Handing out an ice cream cone or a free lunch is just a way to “grab the attention” of a physician. It’s no different than a glossy advertizement in a medical journal. The issue is that many of you folks think that doctors should be (and ARE) reading primary literature in order to keep up-to-speed on the latest drugs and innovations. Do you have evidence to support that? I suspect that isn’t really the case, especially for primary care doctors. By opposing the distribution of little trinkets like pens and free lunches, you are essentially saying that you want no advertising to physicians. This just isn’t practical or even safe. I want my physician to be reading about the latest drugs coming out on the market. If it takes a free ice cream cone for him/her to read the literature, then so be it!!
anonymous
Okay now if Peter is correct and there is no way to manage the $50 a year limit then how are Pharmaceuticals going to comply if the Baucus Chairman’s mark with a $10 payment limit for reporting becomes the law of the land in every state versus the more generous limit in the Physician’s Sunshine Act?
Jo
Here’s what I said on Pharma Marketing Blog a week ago (see http://pharmamkting.blogspot.com/2009/10/no-schering-plough-ice-cream-for-you-ma.html):
The pharmaceutical industry doesn’t like “sunshine” laws passed in some states that either forbid or put limits on gifts to physicians. In a bid to prevent these laws from passing, the industry made threats to pick up their dollar bills and play in other states; eg, not run clinical trials in Massachusetts or not have booths at medical meetings in Vermont. As if!
Some might call it blackmail, others call it good business practice. Whatever. The ploy didn’t work and Massachusetts, Vermont, and Minnesota passed their laws anyway. And drug companies still run clinical trials and have booths at medical meetings in those states, which are renowned for their medical clinics and/or meeting venues (MA: All sorts of great medical centers; MN: Mayo Clinic; Vermont: skiing; say no more, a nod’s as good as a wink to a blind bat!).
If you can’t live without those states, you’ll just have to live with them. But you don’t have to take it lying down is how Schering-Plough views it. That company has denied MA, VT, and MN doctors a scoop of ice cream on a cool autumn afternoon in Boston! Dude, that’s rad!
Lilly
It is not only ice cream and lunch.
Eye on the Industry
The way that Shering did this I feel was both appropriate and just. If they had been in violation of the laws of the state, we would have never heard the end of it.
As far as the price for icecream being under $50.00, one does not know how much was previously invested in the doctor or if he/she was over their limit as far as gifts go. Would an honor system really work here, if the doctor wanted an icecream would they think twice of their gift limit.
This sign is that a sign of the times that we in the industry have brought upon ourselves from the abuses of the past. How I long for the days before all of the guidelines and restrictions. I must be getting old, if I can remember those days…
Greg
Ha this whole physician/ doctor gift thing is a joke. All this regulation is a joke too!! I mean were worried about docs having a turkey sandwich when the politicians who make these laws are laughing at you. The lawmakers are taking millions of dollars from corporate interests. NY senator Chuck Schumer took in 1.6 millions dollars from Wall Street Firms for campaign funds!! yes thats 1.6 Million dollars!! and what there is no influence going on???? I doubt he can be influenced for a soda and a sandwich. Yes our so called leaders are way beyond the silly sandwich like us physicians are. Politicians can take and take but hard working physicians cant have a dinner?? Its a far cry from 1.6 million. Doctors never take a stand on anything. We should say to the law makers well stop when you stop!!!
Condor
A few observations on Nathan’s positions — he and I have gone back and ‘fro on this before. So. . . .
Prior to the time (in the early 1980s) when FDA allowed DTC advertising, there was another system, altogether — it prohibited DTC, but allowed trade ads for “health care professionals only” — in peer-reviewed journals, for example.
I do hate to sound “old-fashioned“, here, but again — what didn’t work about that system?
Apparently only that such a system meant fewer dubious drugs were prescribed, and sold. Consider taht drugs are an opaque good:
. . . .The Restatement (Second) of Torts calls drugs “unavoidably unsafe products”. As the comments explain “There are some products which … are quite incapable of being made safe for their intended and ordinary use. These are especially common in the field of drugs … Such a product, properly prepared, and accompanied by proper directions and warning, is not defective, nor is it unreasonably dangerous … for this very reason [many drugs] cannot legally be sold except to physicians, or under the prescription of a physician.” Restatement (Second) of Torts § 402A cmt. k (1965); In addition, it is estimated that 125,000 Americans die each year from ingesting prescription medicines. Bryan Christopher Moody, Prescription Medication and Consumer Protection: A Time for Reform, 5 J. PHARMACY & L. 19, 19 (1995). . . .
So — why don’t we go back to peer-reviewed journals — as the method of disseminating reliable info to docs?
Afterall, the full-articles can be podcast into the docs’ iPhones now.
This is an honest question for Nathan, primarily — but anyone may jump in.
I’m thinking maybe Back to the Future is the answer, here — as big pharma simply has refused for decades, in the main — to play fair.
Namaste
Lilly
fail schering
Reality?
I guess this is for Harpy especially–is it really the case that companies could, in actuality, be “busted” because some doc had one two many ice creams? I understand the theoretic possibility. But how likely is it “on the ground”?
Chris
Nice to see you’re back at it Ed.
I have always wondered why people (Marcia A. especially) get so upset about doctor-pharmaceutical industry interactions. If you read about all the psychiatrists Grassley and others are so mad about, you realize that the “Key Opinion Leaders” consult with ALL the pharma companies! Do you really think they keep track of which one gave them the most money in 2007 and prescribe that company’s drug more often in 2007 and then check their proceeds in 2008 to decide what to prescribe in that year? Most docs I know that go to ASCO or ICAAC have a bite to eat at EVERY ONE of the booths and if you ask them later where they got the ice cream, they can’t remember. And do you think the KOL who has 500 publications and 7 books actually wote all that stuff him/herself? (While seeing patients, running clinical trials and making presentations at conferences…)
Justice in Michigan
Chris,
Sorry for being thick, but can you elucidate this: “And do you think the KOL who has 500 publications and 7 books actually wote all that stuff him/herself?”
I assume you mean the stuff was ghostwritten by companies. Is that correct?
Thanks.
Christopher
JiM
Christopher here, not Chris. You raise the subject of ghostwriting - and Chris will respond as to whether that is what he inferred - but I think the ‘ghostwriting’ genre needs yet more examination.
“..ghostwritten by companies” can mean a multitude of things, usually not positive, and so I’d like to flag that as because it’s used usually as a perjorative term it merits further examination.
An excellent commentary was published recently - which cites work from some of our friends here - and adds significantly to the debate imo.
Justice in Michigan
Christopher–Can you give me a reference?
Most of what I know about ghostwriting is from folks who do it.
Peter
OK, here are two comments:
1) To Condor and others who cannot have a conversation about one item before diverting attention to other stuff to try to score some big point.
This subject is about one thing and one thing only. Why is SP singling out physicians from one state for something so mundane as an ice cream cone. Per my answer above, it is because the MN limit is $50 PER YEAR, PER DOCTOR. Tracking is expensive and difficult.
2) To the person that asked how will companies deal with the provisions of the Federal Sunshine act? By spending millions of dollars to develop systems to track everything, not only the meals, but every payment for a bona fide service.
Condor
JiM — I am not certain, but Chris may be referring to the more benign practice of having the grad students do the actual writing, then editing and blessing the final product. . .
But to be clear, I concur that the cavalier way in which it was offered might suggest a les-benign version of the practice — that being written by paid pharma marketeers, then only shown to the supposed-”author“/doctor at the end, for a passing nod — and in a manner that strongly discourages any editing.
Namaste
Christopher
JiM
I think this is especially relevant to discussion about disclosure, ‘ghostwriting’, and conflicts of interest.
Try this: http://tinyurl.com/y9oexnp
Hope you enjoy. There is also an ccompanying editorial which can be accessed in the same issue.
Bruce
As my 10 year old would say……Epic!
anonymous
That is exactly what I meant, companies already do spend millions in tracking payments, gifts and rep visits to doctors and then look to decide the ROI. The difference here is that several states are requiring them to report payments and gifts- but not even all of them are publishing it. Nationally there is definitely going to be some changes should the Payment Sunshine Act come into play because we are no longer talking about the larger payments that Grassley uncovers with investigations to larger research KOLs but a smaller sum that will also tend to cover my doctor down the street which would be published.
But that may not be a bad thing, effective medications where the benefits outweigh the risks don’t need carnival sideshows or large physician payments to be prescribed. There is a lot of good done by the pharmaceutical companies and a lot of it is undone by pharmaceutical company marketing. It is a vicious cycle.
Former Pharma Marketing Director
Harpy, In all my years in the industry, I have never heard one Doctor complain because we weren’t giving him a free pen or hand out as in “trinket” at a booth. Most Doc I know don’t really care about it. The nurses, well that’s another subject. As for the ice cream at a booth, it is just ice cream and to tell you the truth I do not really care about it one way or another. The drug company didn’t make the ice cream, so it says nothing about the product.
Nathan, it amazes me, still that you actually think doctors will only read about your product if you entice them with ice cream or free pens. c’mon!! These are people who have survive the intense competition to become a doctor in the first place, and if they want to be good in their practice and get lots of patient referrals, then they better stay on top of it. Besides, most are starting to learn that most of the company sponsored white papers are marketing junk anyway… People read them and note the authors names so they can figure out which one of their colleagues is on “the take” or which company has deeper pockets….
Giving out trinkets at the booth is a way to make work for people and keep some reps employed and at least trying to earn their keep.
But it is superfluous, and needs to be banned in every state…
Industry Manager
You may think the sign is a shot at doctors but hereis a little reality. I had to fire an excellent rep because she spent $12 on a lunch that put a doctor over the MN $50 rule. This was because the $50 is per company (even if you have 5 divisions selling different drugs). The company fired the rep to avoid some politician using this as a campaign speach example and because it could put all the Medicaid sales at risk in the state. I am sure that this rep would consider the sign a little more than a shot at doctors. So would the other 5 reps I know in the same situation! The sad part is the apathetic doctors don’t realize that these laws degrade them and their profession by saying you can be bought off by lunch! Then again I do see a lot of high risk CV patients not at LDL goals on 20 mg of generic simvastatin so the doctor doesn’t miss his generic utilization mandates!
Justice in Michigan
Thanks, Industry Manager (and Peter)–I am interested in specific examples of the impact of these laws.
We’ve all read about the social psychological studies about gifts and reciprocity, and the relative insignificance of the size of the gift (at least up to a certain point).
So, to me, the choice seems to be either a much higher ceiling or simply banning gifts entirely.
Letting the facts be known on significant consultancies, etc., as Lilly and Merck are doing, seems to me much more important, in any event.
harpy
@Reality? - I don’t know, looks like Industry Manager fired a rep for going over the limit. But, really, what’s the chance you’ll get busted for shoplifting a penny candy? The candy isn’t worth much, but you still broke the law. Is it worth the publicity and possible fine?
@FPMD - I don’t know why you’re jumping down my throat. All I said was tracking’s a bitch, some doctors are oblivious, and reps on the booth have better things to do than quiz every doctor about where they’re from. I’m glad you so emphatically care not at all about the whole subject, but if you really think that doctors don’t care about being singled-out you’ve obviously forgotten about this. And what a lovely snide comment about nurses!
and IMHO, I hope some kind of federal law is enacted, with preemption (gasp), so there will be only one standard that has to be followed.
Bob
Good for Schering Plough!
The industry saves people’s lives, makes them better and extends lives. But this can only be done efficiently and effectively if the industry is treated with the appropriate respect that it’s due - limited government controls and freedom to act in a capitalistic society. It’s why most are moving off shore and hiring in emerging countries taking jobs and taxes with them. $2.5 billion now being invested in India by Pfizer and 400 new jobs there by Glaxo.
Maybe pharma can use the money not consumed by the Doctors for ice cream in those states to continue to give free drugs to the indigent - no questions asked?
Or maybe they can use the money to continue to support charities with millions of dollars including breast cancer, MS, etc?
Justice in Michigan
Just “for the record,” federal preemption in many (maybe most) contexts is a good thing. And, with Harpy, I’d certainly support it here.
Indeed, I’d support it also in the arena of drugs if individual states set up their own “mini FDAs” with different standards for labeling, approval, etc..
The issue with product liability is that it is a different system. One which (to quote the old saw) the FDA generally saw as complementary to, not conflicting with, its own regulation. Indeed, the minority in Wyeth (Alito, Scalia, Roberts) also saw no inherent conflict between civil liability and FDA regulation. Their reasons for supporting Wyeth were far narrower.
Peter–sorry to bring in a different topic, but my pal, Harpy, used the “p” word….
Would be fun to draft national standards. E.g., no doctor may be given more than three large scoops, four logo pens, ten golf balls, and a future draft choice.
Jen
definitely looks like a sarcastic attempt to shun the new law.
Condor
Guys, the rules you seek to draft (tongue in cheek), effectively already exist, and they apply nationally — via the PhRMA Guidelines (amended as of January 1, 2009) — to which practically every public pharma co. “claims” to adhere:
I linked it earlier, up-thread, but here it is, in context — PhRMA Guidelines Section 10:
10 Prohibition of Non-Educational and
Practice-Related Items
. . .Providing items for healthcare professionals’ use that do not advance disease or treatment education — even if they are practice-related items of minimal value (such as pens, note pads, mugs and similar “reminder” items with company or product logos) — may foster misperceptions that company interactions with healthcare professionals are not based on informing them about medical and scientific issues. Such non-educational items should not be offered to healthcare professionals or members of their staff, even if they are accompanied by patient or physician educational materials.
Items intended for the personal benefit of healthcare professionals (such as floral arrangements, artwork, music CDs or tickets to a sporting event) likewise should not be offered. . . .
Now, the even tougher code is the ADVAMED Code, as amended, effective July 1, 2009:
. . . .A Company may not give Health Care Professionals any type of non-educational branded promotional items, even if the item is of minimal value and related to the Health Care
Professional’s work or for the benefit of patients. Examples of non-educational branded promotional items include pens, notepads, mugs, and other items that have a Company’s name, logo, or the name or logo of one of its Medical Technologies. Companies also may not provide Health Care Professionals with gifts such as cookies, wine, flowers, chocolates, gift baskets, holiday gifts or cash or cash equivalents. . . . .
Namaste
ROSE
O.K. Wall Street can give their corporate moguls Billions in free gifts etc. why can we not give our docs a pen or a lunch?? Go figure!!! Wall Street is not giving us any solutions to illnesses, pharma is and the docs are. Why the hypocritical attitude and forbid a free lunch for the docs. Oh common; what is going on here call me ignorant. My docs were happy to talk to me over a lunch or cup of Starbucks.
Chris
I’m the Chris with a comment on 10/22 at 6:24 pm
I’m surprised that most comments subsequent to mine focussed on the “ghostwriter” part (because I admit, it wasn’t exactly “on the subject”). What I meant is YES, grad students, pharma company personnel and people paid by pharma companies collect, analyze and write up alot (most) of the clinical and related studies that are on KOLs CVs. I have worked as a scientist in the pharma industry and have written many manuscripts where the first author is someone else (although I am also an author). But ALL authors have input — some choose to just correct the grammer and some choose to get more involved, but nothing is published that ALL investigators (those deemed to have had a major contribution to the study) don’t agree to. I agree that if medical writers are involved and are not listed as an “author” they should be mentioned in the acknowledgements or somewhere — but very little would be published if the KOLs had to do it all on their own!
More on the actual subject — how many of you have received a “free gift” from a charity in the mail (usually return address stickers) and have used them but not given to the charity? I do it all the time — and the “Ethics” guy at the NYT says it’s OK! I am not at all influenced by the free gift but I use it anyway.
Justice in Michigan
Just fyi, studies show that those small gifts from charities _do_ make a difference in terms of donation. The fact that the NYT ethics guy commented upon it makes the psychological point. Charities, like companies, know what they’re doing.
This just a personal hunch, but address stickers have probably run their course in terms of donation efficacy. Will probably have to move on to pens or teddy bears.
Condor
Not to belabor the obvious problems with Chris’s analogy to the use, by charities, of give-aways (to increase donations), but. . .
(1) charities are not selling an entirely opaque good;
(2) The NYT guy isn’t opining on potentially dangerous medicines — things that cannot, by definition, be placed in the hands of a consumer without expert intervention;
(3) More precisely, charities are NOT “selling” something that has equal potentials — one, potentially lethal, if misprescribed — the other potential, to cure, if all goes well; and the coup de grace. . .
(4) as JiM mentions immediately above, it increases donations. That is, do we really want to increase prescriptions (in a linear fashion) this way — with ice cream and tchotchkes? I think not.
I’ll take peer-reviewed journal debate, any day.
Namaste [Hey! -- that ryhmes!]
Justice in Michigan
Wow. Somehow the image of a condor referencing “tchotkes” widens my wing span….
If anyone interested, the “classic” paper on the social psych. of gifts to docs is:
Katz, Dana.
Caplan, Arthur L.
Merz, Jon F.
All Gifts Large and Small: Toward an Understanding of the Ethics of Pharmaceutical Industry Gift Giving
The American Journal of Bioethics - Volume 3, Number 3, Summer 2003, pp. 39-46
Ironically, or not, some of the authors have themselves received gifts as “ethics consultants.”
So it goes…..
Justice in Michigan
p.s. Admit it. How many of you have had the thought that if you didn’t donate–or kept/used the gift without donating–you would probably get the disease?
harpy
Hi Condor - I think it’s interesting that you reference Section 10 of the PhRMA Code in this situation. Since it’s ice cream we’re talking about, I might have referred instead to Section 2 - Informational Presentations and Meals - but neither one is very satisfactory. The whole idea of booths is something of a black hole in PhRMA and AdvaMed guidelines - are they educational presentations or marketing? The fact that AZ was giving ice cream away at all means they must think it falls under the “meal” section, or they’d be openly admitting to not following PhRMA guidelines on tchotchkes.
Condor
Hey Harpy — I think we both agree that PhRMA barely allows the ice cream thing — and that the NEW ADVAMED code “probably” does not.
You mentioned AZ, but I think you mean SP. And, yes information is exchanged at the booth, but pages 3 and 4 of Section 2 seem not to allow (1) off-site “dining” — and seem not to allow “dine and dash”. . . . Viz:
. . . .Any such meals offered in connection with informational presentations made by field sales representatives or their immediate managers should also be limited to in-office or in-hospital settings. . . .
Offering “take-out” meals or meals to be eaten without a company representative being present (such as “dine & dash” programs) is not appropriate. . . .
So, I guess I thought the greatest chance of it being PhRMA code “kosher” (forgive me!) would be that it is plainly a NON-branded item — a melting “tchotchke” with no logo — and one that disappears as you walk away with it (even if you don’t eat it all).
In any event, I think the intent of both codes is to move away from this sort of practice.
Okay — I’ll shut up now.
Namaste
harpy
ha! Good point! And, yes, I did mean SP.