Pharma Disclosure of Payments to Doctors

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Newspapers across the U.S. have written stories and editorials on

disclosure of pharmaceutical payments and gifts to doctors.

See here: http://www.psychsearch.net/disclosure.html (webpage under

construction)

Legislation was proposed last year in 11 states and a federal bill was

filed by Senator Grassley to require reporting of these payments.

Stay tuned for more news on: Disclosure

http://www.sptimes.com/2007/12/27/Business/Doctor_combats_pull_oshtml#ra

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Doctor combats pull of drug reps

He's in the lead of a drive to curtail effects of industry freebies.

St. sburg Times

By KRIS HUNDLEY, Times Staff Writer

December 27, 2007

P. Orlowski may not be the only doctor in the Tampa Bay area who

has given pharmaceutical sales reps the boot.

But he's the only one listed in the online directory of No Free Lunch

(www.nofreelunch.org), an organization opposed to accepting freebies

from the pharmaceutical industry.

That means Orlowski, chief of pediatrics at Tampa's University Community

Hospital, rejects all drug company goodies, from free pens to expensive

dinners. By doing so, he's rebuffing a well-oiled marketing machine that

spends about $7.2-billion a year wooing doctors and another $18-billion

on sample drugs.

Pharmaceutical salespeople, known as drug detailers, generally

soft-pedal their spiel, casting themselves as trusted resources for both

research and free medicines. But when they talk to doctors, well-trained

reps know exactly how much of their product the doctors have prescribed

in the past. The reps' goal is simple: increase it.

Orlowski said that when he was a struggling medical student at Case

Western Reserve 33 years ago, no one discussed the ethics of accepting

drug company gifts, and freebies like medical instruments and textbooks

were hard to resist.

" Then I saw research that showed these gifts have tremendous influence

on prescribing practices, though physicians always deny it, " Orlowski

said. " There's no way I was going to let a drug company gift influence

my decisionmaking. "

Orlowski refuses to see drug reps and has refused to let the American

Medical Association sell personal information that makes it possible for

pharmaceutical companies to track his prescribing habits.

What's more, Orlowski, 60, has used his position to influence University

Community Hospital's policy regarding pharmaceutical reps. Where they

once wandered freely through its halls, dispensing doughnuts and free

lunches, drug reps are now restricted to certain areas of the hospital

and are not allowed to approach students, doctors or nurses or host

lunches.

Orlowski also tries to instill a wariness of pharmaceutical reps in the

medical students who rotate through his department. A recent survey of

all U.S. medical schools by the American Medical Student Association

found that only five institutions completely restrict drug reps' access

to their campuses and hospitals.

The University of South Florida's College of Medicine, which reportedly

is in the process of drafting a policy regarding student interaction

with drug reps, received a " C " from the group.

Orlowski, who mentors students from USF as well as Nova Southeastern

College of Medicine in Fort Lauderdale, said he often finds

pharmaceutical companies' pens in students' pockets.

" I ask them if their interactions with drug reps are in the best

interests of patients or if they help them in the practice of medicine, "

he said. " I believe the answer is no. "

Though Orlowski was an early opponent of pharmaceutical marketing, there

is a growing sensitivity to the issue among doctors in private practice,

hospitals and medical schools.

Research has repeatedly shown that even inexpensive giveaways like

coffee mugs create a sense of obligation and influence prescribing

habits. According to a study that appeared earlier this year in the

journal of the American College of Obstetrics and Gynecology, " Even

small gifts produce in their recipients a disproportionately powerful

willingness to reciprocate in some manner. "

While free samples might seem to help patients initially, they also

result in doctors prescribing expensive brands over generics which may

be just as effective. And " research " on new products provided by drug

reps is often biased and incomplete. " Free information is worth about

that, " said Orlowski, who relies on the independent publication Medical

Letter for drug research.

Rob Restuccia, executive director of the Prescription Project in Boston,

said the billions spent on drug marketing to doctors undermine

professionalism, increase cost and undermine care.

" From all angles, it's an important issue that is symptomatic of a lot

of problems in the health care system overall, " he said. " And it's

essentially gone unregulated. "

The intensity of the industry's marketing blitz was tracked recently by

a member of the National Physicians Alliance, a 10,000-member group that

supports a ban on all gifts.

Over a six-week period, the doctor, an internist in Minnesota, turned

down 12 free breakfasts, 18 lunches, 16 branded pens, a branded

eyeglasses cleaner, two branded pen lanyards, branded pill holders,

Post-it Notes, notepads, a pocket Physicians Desk Reference, correction

paper strips, a coffee mug, a poster, a highlighter, a diagnostic

manual, a giant clip-refrigerator magnet, a ruler, a water-oil globe, a

History of Viagra book and a Viagra soap dispenser.

About a dozen states, including Minnesota and Vermont, require drug

companies to disclose gifts to doctors. Earlier this year, Sens. Chuck

Grassley, R-Iowa, and Herb Kohl, D-Wis., introduced a bill that would

make such reporting mandatory nationwide. Florida has no law or pending

legislation to require drug companies to report physician gifts.

" Normally I don't like seeing the government get involved, " Orlowski

said. " But this type of public exposure is likely to influence doctors. "

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