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PhRMA's revised marketing code, which goes into effect January 2009, tightens the restrictions on gifts, meals, and honoraria given to healthcare providers.
Some health-system pharmacists believe that the marketing code that was recently revised by the Pharmaceutical Researchers and Manufacturers of America (PhRMA) will have an impact on healthcare provider behavior, although they would like to see the code go even further to help ensure proper disclosure.
PhRMA's Code on Interactions with Healthcare Professionals places more restrictions on what drug companies can do when it comes to distributing gifts to physicians, compared with the last amendment to the code in 2002. The new code goes into effect in January.
The revised code prohibits the distribution of noneducational materials, even those perceived to have minimal value, such as pens and mugs that include a pharmaceutical company's logo. In addition, company sales representatives are prohibited from providing restaurant meals to healthcare professionals, although they may provide occasional meals in conjunction with informational/educational presentations.
In the section of the revised code that addresses speaking and consulting fees, some pharmacists believe that the guidelines are too vague. "There should be a set fee for what the honorarium is. That tends to vary," Russ Lazzaro, RPh, director of pharmacy at Holy Name Hospital in Teaneck, N.J., said. Lazzaro said the honorarium should be a set rate or at least a variable rate based on a speaker's credentials. On the topic of whether providing food influences behavior, Lazzaro said food gives drug reps access to the doctors office. "The office manager controls who sees the doctor."
Stevenson said that the section in the code regarding meals provided at educational sessions needs clarification because it seems to conflict itself in a few places. While institutions don't want pharmaceutical reps providing any direct meals, the code seems to indicate that if a company makes an educational grant to an institution, that institution may choose to provide food at the program. But at other points in the code it seems as if the pharmaceutical company would be allowed to provide food for a small education session provided in a healthcare setting, such as in a clinic.
Among PhRMA members, some large, innovator drug companies publicly endorse the revised marketing code. "We believe that the meaningful Code revisions that have been adopted will address the concerns of our various stakeholders and strengthen the public trust in our industry and help to ensure that the information exchange with healthcare providers continues to be appropriate and ethical," Robert Brown, chief marketing and operations officer for Lilly's U.S. operations, said.
Johnson and Johnson in a press release stated: "Acceptance of the revised PhRMA code is consistent with Johnson and Johnson's ongoing commitment to ensure the integrity of our relationships between representatives and doctors, as well as to protect medical judgment and treatment choices from inappropriate influence."
ANTHONY VECCHIONE is a freelance health and medical writer based in New Jersey.