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AIS's Health Business Daily
Featured Story August 11, 2008 New PhRMA Code Bans Meals, Pens, Mugs and Other Common Gifts to Physicians Reprinted from REPORT ON MEDICARE COMPLIANCE, the nation's leading source of news and strategic information on false claims, overpayments, compliance programs, billing errors and other Medicare compliance issues. By Nina Youngstrom, Managing Editor, (nyoungstrom@aispub.com) Brand-name drug makers that follow their trade group's updated voluntary code for interacting with providers will no longer distribute freebies such as pens and coffee mugs. Companies also should not be buying meals for providers without offering product education at the same time, the Pharmaceutical Research and Manufacturers of America (PhRMA) says in its "PhRMA Code on Interactions with Healthcare Professionals," released July 10. While the changes should have been expected by health care entities and physicians, older doctors may have more trouble adjusting, two experts say. "Appropriate marketing of medicines ensures that patients have access to the products they need and that the products are used correctly for maximum patient benefit," the code says. "Our relationships with health care professionals are critical to achieving these goals." This version of the code is updated from one released in 2002 and takes effect in January 2009. PhRMA says this is an ongoing process. Companies that publicly say they will follow the code will be listed on PhRMA's Web site and will have to certify annually that they have policies and procedures in place to foster compliance with the code, the organization says. The most visible change may be that pens with company or drug logos, seen carried by countless doctors and nurses, could disappear altogether if all companies adhere to the PhRMA code. "Providing items for healthcare professionals' use that do not advance disease or treatment education - even if they are practice-related items of minimal value (such as pens, note pads, mugs and similar 'reminder' items with company or product logos) - may foster misperceptions that company interactions with health care professionals are not based on informing them about medical and scientific issues," the organization says. But educational items, such as anatomical models for exam rooms, are still OK a long as they cost less than $100, according to the code. PhRMA says companies can still buy meals for providers, but they must be "modest," "occasional" and must take place in the office or hospital setting and should accompany an informational presentation. Entertainment tickets are out now too. PhRMA also says arrangements under which health care professionals work as consultants should be handled with care. "It is appropriate for consultants who provide advisory services to be offered reasonable compensation for those services and reimbursement for reasonable travel, lodging, and meal expenses incurred as part of providing those services. Any compensation or reimbursement made in conjunction with a consulting arrangement should be reasonable and based on fair-market value," the code says. "With some exceptions, revisions to the PhRMA Code reflect many of the policy changes already implemented by health care providers in response to OIG focus on industry relations," says Nickie Braxton, corporate compliance officer at Hartford Hospital/Hartford Health Care Corporation in Connecticut. The prohibition of pens, pads, etc. "will have little impact on providers who have increasingly prohibited acceptance of these marketing materials already," along with free meals inside or outside the workplace. "Many health care providers, including Hartford Hospital, prohibit these meals altogether. Industry representatives must make appointments to meet with our hospital representatives and may not bring snacks or meals with them," she says. Can Bagels and Danishes Influence Docs? "Physicians accustomed to bagels and Danishes, meals, golf resorts,…entertainment at industry-sponsored events, etc., will probably be less than enthusiastic about these changes, although most have surely been hearing about these compliance concerns for some time," Braxton continues. Many physicians "are offended by the notion that they may be influenced by these minor offerings, and they're indignant at the notion that they would prescribe a drug simply because someone brought them a bagel. But these [drug] companies are made [up] of very bright, creative, industrious individuals. Why would they spend millions of dollars on bagels and Danishes each year if this strategy had no impact?" she asks. Braxton says that physicians are being pursued by pharmaceutical and durable medical equipment manufacturers for many different business relationships, including consulting and investments. They should enter these arrangements with eyes wide open, she says, because even deals that seem "reasonable and transparent" may "raise questions of conflicts of interest and kickback activity to the federal government," Braxton says. Lee Tumminello, an attorney with Baker & Daniels LLP, agrees that the updated code may be a bigger change for the older generation of physicians, but that young doctors have been urged by groups such as No Free Lunch to refuse gifts and meals from companies. Pharmaceutical manufacturers also have been instituting many of the policies on their own over the years because of government enforcement actions based on the anti-kickback statute and other laws, Tumminello says. "For the goals of the code to be achieved, everyone in this industry has to participate in this and should educate themselves on what these guidelines are. This is what the government has been looking to when it enforces the anti-kickback statute," she says. Read the code at
www.phrma.org/files/PhRMA%20Marketing |
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