Group Urges Ban on Medical Giveaways: should be banned - in all 129 of the nation’s medical colleges - conflict-of-interest policies ... NY Times April 28, 2008

[Guest guest]

NY Times April 28, 2008 Group Urges Ban on Medical

Giveaways By GARDINER HARRIS Drug

and medical device companies should be banned from offering free food, gifts,

travel and ghost-writing services to doctors, staff members and students in all

129 of the nation’s medical colleges, an influential college association

has concluded. The proposed ban is

the result of a two-year effort by the group, the Association of American

Medical Colleges, to create a model policy governing interactions between the

schools and industry. While schools can ignore the association’s advice,

most follow its recommendations. Rob Restuccia,

executive director of the Prescription Project, a nonprofit group dedicated to

eliminating conflicts of interest in medicine, said the report would transform

medical education. “Most medical schools

do not have strong conflict-of-interest policies, and this report will change

that,†Mr. Restuccia said. The rules would apply

only to medical schools, but they could have enormous influence across

medicine, said Dr. Rothman, president of the Institute on Medicine as a

Profession at Columbia University. “We’re

hoping the example set by academic medical colleges will be contagious,â€

Dr. Rothman said. Drug companies spend

billions wooing doctors — more than they spend on research or consumer

advertising. Medical schools, packed with prominent professors and

impressionable trainees, are particularly attractive marketing targets. So companies have for

decades provided faculty and students free food and gifts, offered lucrative

consulting arrangements to top-notch teachers and even ghost-wrote research

papers for busy professors. “Such forms of

industry involvement tend to establish reciprocal relationships that can inject

bias, distort decision-making and create the perception among colleagues,

students, trainees and the public that practitioners are being

‘bought’ or ‘bribed’ by industry,†the report

said. A group of influential

doctors decried these practices in a 2006 article in The Journal of the American Medical

Association, and said that medical schools should ban them. In the

article’s wake, the medical college association created a task force. With Dr. Roy Vagelos,

a former Merck chief executive, serving as the task force’s chairman and

the chief executives of Pfizer, Eli Lilly, Amgen and Medtronic on the roster,

some who advocate for greater restrictions on industry influence in medicine

predicted that the report would be weak. They were wrong. In addition to the

gift, food and travel bans, the report recommended that medical schools should

“strongly discourage participation by their faculty in industry-sponsored

speakers’ bureaus,†in which doctors are paid to promote drug and

device benefits. It recommended that

schools set up centralized systems for accepting free drug samples or

“alternative ways to manage pharmaceutical sample distribution that do

not carry the risks to professionalism with which current practices are

associated.†It suggested that schools audit independently accredited

medical education seminars given by faculty “for the presence of

inappropriate influence.†And it said the rules should apply to faculty

even when off-duty or away from school. Speakers’

bureaus and drug samples are pillars of the industry’s marketing

operations, and many medical school professors have resisted efforts to

restrict them. Only a handful of medical schools presently bar faculty members

from serving on speakers’ bureaus, so if this recommendation is widely

adopted, it could transform the relationship between medical school faculty and

industry, and it could change substantially the way medical education is

routinely delivered. Indeed, the chief

executives of Pfizer and Eli Lilly dissented from the report’s

recommendation regarding speakers’ bureaus. “We continue to

believe that these types of programs, which are subject to clear regulations

regarding their content, can be worthwhile educational activities,†wrote

B. Kindler of

Pfizer and Sidney Taurel of Lilly. Beier, an Amgen

senior vice president, wrote a letter that endorsed the report’s

recommendations but disagreed with some of its text “because we have a different

view about the accuracy concerning representations about the motives of the

participants in industry-academic interactions.†Ken of the

Pharmaceutical Research and Manufacturers of America, said his group would

review the report. “Providing

physicians — and medical students — with timely, accurate

information about the medicines they prescribe clearly benefits patients and

advances healthcare throughout the

United States ,†Mr.

said. Dr. J. Alpern,

dean of the Yale School of Medicine, said that the university presently had no limits on participation

in company speakers’ bureaus, but that because of the medical college

association’s report he was thinking of taking them on. “I don’t

have a problem with doctors making $3,000 or $5,000 a year on the side,â€

he said, “but it’s a totally different thing when it’s $80,000.â€

Even more distasteful, Dr. Alpern said, is that the slides used in many of

these presentations are created by drug makers, not the speakers. “That’s

like ghost-talking,†Dr. Alpern said. Dr. Arthur S. Levine,

dean of the University of Pittsburgh

School of

Medicine , said that when he graduated

from medical school in 1964, Eli Lilly gave him his first doctor’s bag,

and Roche gave him an Omega watch for being valedictorian. He still has the

watch. But this year’s

graduating class of doctors at Pittsburgh will not be allowed to accept any of these gifts, and the daily pizza lunches

brought by drug companies are gone, he said. Gottlieb,

assistant dean of policy coordination for s Hopkins University

School of Medicine, said

Hopkins had adopted some

of the association’s recommendations and was considering others. “This report is

bound to influence our deliberations,†she said. Dr. Vagelos, formerly

of Merck, said that the report’s recommendations were certain to face

resistance among faculty who liked the present system. “The outcome of

this for the industry is that those companies that are strong in science will

always be welcome at medical colleges and others won’t,†Dr.

Vagelos said.

No virus found in this outgoing message.

Checked by AVG.

Version: 7.5.524 / Virus Database: 269.23.5/1400 - Release Date: 4/27/2008 9:39 AM