It is difficult to visit any physician’s office and not notice various items splashed with the names of prescription drugs. From pens, notepads, and tape measures to stethoscopes and anatomical posters, gifts from drug companies are so common that patients may give them no more thought that they do to the magazines in the waiting room.
However, in recent years, drug companies have become more aggressive about reaching physicians in order to educate them about their products and promote their use. As a result, there are many “behind the scenes” gifts from drug companies that might raise patients’ eyebrows if they were aware of them. Offers to attend dinners, golf outings, sporting events, wine tastings, etc., when tied in with a drug company product pitch, are now common. Physicians are peppered with such tantalizing offers so that the drug company rep can catch several precious minutes of their time, or as some allege, earn the physician’s loyalty with regard to prescribing the company’s products.
Several years ago, these marketing tactics began to draw the attention of not only the public, but also industry groups and regulators. The result: several different guidelines on physicians’ acceptance of industry gifts. But such practices continue. Last January, the Journal of the American Medical Association featured an article proposing a ban or strict limit on even small gifts from drug companies to physicians, citing research showing that the desire to reciprocate even small gifts can influence physicians’ treatment decisions.
State lawmakers have also taken action. Four states plus the District of Columbia now have laws requiring drug companies to report physician gifts. Nine other states including Ohio have legislation pending which either requires reporting gifts or bans them altogether. Ohio’s proposal, House Bill 112, was introduced last year and requires drug companies to file an annual report with the State Director of Health concerning all gifts worth $25 or more. The bill also proposes a fine up to $10,000 for each time a drug company fails to disclose any such gift. Analysts expect this trend to grow with similar laws to be introduced in states across the country.
It is easy to see why physicians would say “yes” to such offers, particularly since many have experienced significant reductions in their incomes due to declining reimbursements from insurance companies. Even so, there are many who scrupulously avoid all such offers. One physician told me that he will not write a prescription in front of a patient with a pen given to him by a drug company. He said he did not want any patient to suspect that his treatment decisions were influenced by a drug company.
It is almost a certainty that physicians, who literally can make or break the success of a prescription drug, will continue to be the focal point of pharmaceutical marketing. Accordingly, the day may come when a majority of states have enacted legislation precluding or limiting such gifts, or at a minimum, requiring the gifts to be reported. In the latter event, physicians may be reluctant to accept such gifts if they know that a description of the gift and its associated value will be the grist of public information.
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