No more gifts to doctors, trade group rules

Aim is to stop influencing which drugs to prescribe

By Andrea Gerlin
January 4, 2007

Pharmaceutical companies can no longer lavish gifts on doctors to sway
prescribing practices, the trade group that represents the world's
largest drugmakers said yesterday.

Companies that belong to the International Federation of Pharmaceutical
Manufacturers & Associations must adhere to a revised code of ethics
that bars them from giving doctors money or other gifts that might
influence drug choices, such as paying for trips to golf resorts or
luxury hotels.

The code, updated for the first time in a decade, applies to the
group's 26 member companies, including Pfizer Inc., and hundreds of
other drugmakers that belong to its 46 industry associations.

"What we're trying to do is prevent as many of the activities as
possible that have not helped the reputation of the industry," said
Harvey E. Bale, federation director general. "We need to make sure
the product is the best product for the patient and it's not influenced
by gifts and it's not influenced by hospitality or vacations."

Large pharmaceutical companies spend about one-third of their revenue
on sales and marketing, much of it aimed at doctors. The resulting
entanglements between the companies and doctors have become widespread,
Bale said. Studies cited in the British Medical Journal have found that
the relationships influence doctors' prescribing behavior.

The pharmaceutical federation has also assembled a network of industry
sources who will serve as its "eyes and ears" and a panel of
compliance experts to hear complaints and appeals, Bale said. The
federation will publicize practices that violate the 21-page code.

The group's members also include drugmakers GlaxoSmithKline Plc,
Sanofi-Aventis SA, Eli Lilly & Co., AstraZeneca Plc, Merck & Co. and
Novartis AG.

Merck's U.K. unit was reinstated to a different trade group, the
Association of the British Pharmaceutical Industry, after a three-month
suspension for violating the organization's ethics policy. The unit was
suspended Oct. 2 after supplying extra services to doctors prescribing
its Cozaar heart treatment.

U.S. academic medical centers at Stanford University, Yale University
and the University of Pennsylvania have banned doctors from accepting
industry gifts in a bid to limit outside companies' influence.
Stanford's ban extends to free meals, drug samples, pens and
sponsorship of continuing medical education, according to the
university's Web site.

The the federation's new code limits companies to gifts that are
work-related and of modest value, such as stethoscopes or medical
dictionaries, Bale said. Arthur Caplan, director of the Center for
Bioethics at the University of Pennsylvania in Philadelphia, said these
items should be banned, too.

"There's no reason to be giving away anything," he said. "If they
want to have marketing and education separate, then leave aside the
stethoscope, key ring or pen because that is pure marketing."

Also covered in the revised code are the locations of medical and
scientific meetings. These events shouldn't be held in "renowned or
extravagant venues" and the hospitality shouldn't exceed what doctors
would normally be willing for pay themselves, according to the code.

"They used to have a fair number of what could be described as
junkets, so what they're saying is knock it off," Caplan said.

The new document doesn't regulate direct-to-consumer advertising or
drug trials, unless a violation of other principles is involved, Bale
said.

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